Imagine being in the hospital with your newborn baby lying in your arms and a nurse asking you to make one of the most important decisions to be made in his or her lifetime.  The question of vaccination. Having not researched the pros and cons of vaccination to be able to weigh options thoroughly, you recall one piece of terrifying news published by reliable scientific sources which haunts you in making this decision: that vaccines cause autism. Autism is the "most severe developmental disability appearing within the first three years of life. It causes impairments in social interaction such as being aware of other people's feelings as well as debilitating verbal and nonverbal communication" (Autism, 1). Autism is a condition that any parent would protect their child from if possible. Knowing only the facts published in the media and basic information provided by search engines, the safe decision seems ideal; the choice shielding the child from developing a life altering condition which will cause them to struggle to make friends, be accepted by peers, prosper educationally and have the opportunity to successfully provide for a family one day. The decision to relieve a child of temporary needle sticks and possible side effects so he or she can live a "normal" life can seem like the most promising decision. Any reasonable and protective parent would make this decision if this was the extent of their education on the subject.

The action of vaccinating a child, injecting them with a "weakened or killed microbe in order to stimulate the immune system against the microbe thereby preventing the disease" (Def. of Vaccination, 1), has been in controversial question since inception and is not a decision to be made lightly. Vaccines provide immunity against different communicable diseases which if developed could cause the body to become very ill and possibly lead to death in some circumstances. Since the first vaccine was invented in 1796, illnesses including smallpox, whooping cough, diphtheria, and rubella are now preventable. Most childhood vaccines are 90%-99% effective in preventing disease and, according to Shot@Life, "vaccines save 2.5 million children from preventable diseases every year" (ProCon, 1). Disease prevention organizations which are reliable scientific sources have been researching and testing vaccines since invention and are aware of both the intended preventative effects as well as the low rates of adverse reactions. In fact, the most common side effect of vaccination is anaphylaxis, a severe allergic reaction, and occurring in one per million vaccinations (ProCon, 1).  The true facts of disease prevention by vaccination are discredited and concealed by the media and other means of communication which seem credible to people who are not well educated on the subject. Individuals who accept fear based propaganda as truth rather than educating themselves with scientific research and evidence often fall victim to erroneous beliefs. Due to a plethora of reasons concerning new and improperly educated parents, vaccination rates are declining which is soon to have detrimental effects on the population.

As time passes and the vaccination rate decreases, there has been an urgent push to find the cause. According to an experiment in 2009, approximately 39.8% of parents "delayed or refused to vaccinate their children" (Smith et al., 135). There are several societal reasons which avert parents from choosing to vaccinate their children. Many struggle with the idea that vaccines are not "natural" and therefore subject the body to an unpredictable foreign substance. While it is true that most medications are synthetic products manufactured in laboratories, history reveals that the benefits of vaccination are much greater than the potential risk of adverse side effects. Vaccination can offer a lifetime of immunity against a deadly illness versus a short term discomfort such as a fever or headache. As mentioned in the previous scenario, scandals falsely reporting that vaccines cause autism have been exceedingly successful in provoking parents to choose against vaccination. In today's society there is also an immense distrust of pharmaceutical companies. Parents who feel the medical industry is primarily focused on making a profit or that certain information is intentionally withheld from consumers are too skeptical to pursue their products. Herd immunity is yet another factor in the reduced rates of those being vaccinated. Often, those reluctant to vaccinate rely on "high rates of protection among everyone else" (Brody, 1). The logic being that vaccinated individuals will minimize risk enough for the non-vaccinated to remain unaffected. All of these stated reasons which encourage parents to refuse vaccination for their children could be refuted with proper education and truthful information.

The question of naturality is immensely impactful in today's society. The current public, being more health conscious, is more interested in how synthetic products impact health, the environment, animals, and the earth as a whole. The word "natural" means a substance occurs in nature and is not made, caused, or enhanced by humankind (Bradford, 1). The thought of injecting an unnatural substance into a child can be unnerving for parents who are undecided or completely against vaccination. The quandary becomes the reality of introducing the unnatural and its consequences into a child's body. While sufficient information exists to support the benefits of natural products and substances such as foods, beauty products, and household cleaners, scientific evidence supports the opposite regarding vaccination. Thorough scientific research proves that vaccines substantially prevent life threatening illnesses while both increasing the quality and duration of life. UNICEF reports that the primary killer of children in developing countries is the inaccessibility of routine immunization and health services due to poverty. The measles death toll in Africa is so high that every minute one child dies from this preventable disease (UNICEF, 1).  As much as a parent may attempt to keep unnatural substances away from their child, the likelihood of this is so minimal that a new question evolves; is it worth letting a child become diseased because avoiding anything considered "unnatural" eases one's mind? In essence, not vaccinating a child can be easily argued as knowingly putting them at risk for deadly diseases. Out of all of the unnatural things that will go into the human body over the span of a lifetime, a life saving intervention would be more beneficial than most.

The autism scandal, which horrified society, has been most prevalent in the decision to refuse vaccination for the last 18 years. In 1998, Dr. Andrew Wakefield published a paper describing a new autism phenotype which was triggered by environmental factors such as the MMR (measles, mumps, and rubella) vaccination (Flaherty, 1302). The phenotype was called the regressive autism-enterocolitis syndrome, and this correlation decreased the confidence which parents had in public health vaccination programs while creating a global public health crisis (Flaherty, 1302). The press boomed as this new break through went viral. Just about every media outlet displayed this newly found gut-wrenching news. New parents became fearful and therefore skeptical of these lifesaving immunizations. Parents of children who had been vaccinated and were subsequently diagnosed with autism became utterly heartbroken at the thought that they could have prevented the disorder. After ten years of controversy and thorough investigation, new data and knowledge emerged. Studies show the data presented by Dr. Andrew Wakefield was fraudulent resulting in no correlation at all between the MMR vaccine and autism. It was confirmed that Wakefield had no scientific reason to make such claims, leading to the idea that his only aim was to write something interesting that would consequently be published. After confirmation of the fraudulent work, Dr. Wakefield was found guilty of ethical, medical, and scientific misconduct in the publication of the autism report (Flaherty, 1302). This highly incorrect report has had such an enormous impact on the public that parents remain hesitant to vaccinate their children. The media was so prominent in the process of broadcasting false information but made no efforts to explain the circumstances or ease the minds of the people affected with updated accurate reporting. To this day, the impact of this false report continues to affect vaccination choice, leaving some parents to believe that vaccines substantially put children's health at risk. 

Misinformation is one of the main causes for the refusal of vaccination. The media is very quick to publish scandalous and misrepresented information but they fail to correct themselves leaving the public confused and misinformed. If the media would have published a follow up denouncing the correlation between autism and the MMR vaccine, the reaction of society toward vaccinations would have evolved differently. The Wakefield scandal was not the only time the media published incorrect information causing failure to properly educate the public with truth. A few years ago, the media published videos and photos of scientists putting shrimp on treadmills for research. While some people found this humorous, "a video clip of a shrimp running on a treadmill has somehow become the nation's poster child for wasteful spending" (Scholnick, 1). Based on media coverage, the public assumed that the science industry was wasting millions of our hard earned taxpayer dollars to exercise shrimp. In an article written by the marine biologist who conducted the experiment, he explains that he and his colleagues were studying how "recent changes in the ocean could potentially affect the ability of marine organisms to fight infections" (Scholnick, 1). This study actually tested an important question which could change our view of the environment and the entire experiment cost less than fifty dollars in total. The public was never informed that the treadmill was made from spare parts in the laboratory, the experiment was paid for out of the scientist's pocket, and the data helped make discoveries which would benefit the science world in its entirety. 

Pharmaceutical mistrust in today's society is astonishing; fear that the medical industry's best interest is not the safety of their consumers. Reports show the number of adverse reactions to vaccines are so low that an individual is "100 times more likely to be struck by lightening than to have a serious reaction to a vaccine" (ProCon, 1). Even though side effects are extremely rare, uplifting stories of how vaccines save lives do not make media headlines nor capture public attention through shock and awe. Instead, it's the one in a million case where a person gets sick or dies following vaccination that becomes newsworthy. October of 2006 in Israel, three adults died after receiving the influenza vaccine and a fourth was reported dead shortly after (Anis, E. et al., 318). The media published articles saying that vaccines cause death and once again the nation panicked. After further investigation, it was found that the three men were all in the age range of 70-75 and all had previously suffered from serious heart conditions. It was confirmed a mere coincidence that the men died shortly after getting vaccinated but the media made little to no effort in sharing this revelation. The pharmaceutical industry continues to be negatively impacted by media misinformation causing distrust in medical science. Failure to educate the public combined with the publishing of misleading information continues to damage the industry causing mistrust and skepticism to increase. 

Many parents refusing immunizations expect their families to be protected by the health and immunity of other children. This reliance upon herd immunity is incredibly threatening to our population's health. It seems to be commonly inferred by improperly educated parents that if every other child is vaccinated and therefore healthy then no other children will be able to get sick because the disease is not present. This misconception focuses on the reliance of others to be healthy rather than the benefits of protecting oneself through vaccination. The premise of vaccination is self protection against deadly illnesses, which when practiced by all benefits the entire population. The harsh reality of this mindset is that if we all were to rely on other parents to take the "risk" and vaccinate their children then no one in the world would be safe from disease. Herd immunity is ineffective unless 95%-99% of people are vaccinated (Brody, 1). This is a percentage that is not even remotely achieved in today's society. Schools and public play areas seem to be the biggest germ incubators in which children inhabit. The Center for Disease Control and Prevention, also known as the CDC, recommends vaccines for all children whether they will attend public schooling or not. While many vaccine opponents argue the government should not have any interference with medical choices, it's important to remember that not just one child's health is in jeopardy but the whole community can be affected by a single unvaccinated child. The government has an obligation to intervene and protect its citizens which is why all 50 states currently require vaccinations for children entering public schools (ProCon, 1). One commonly utilized loophole for this law is an exemption for religious purposes. California recently joined West Virginia and Mississippi in passing a law that eliminates exemptions from vaccinations for personal or religious reasons (Brody, 1). Only children with medical conditions causing vaccinations to hinder their health are exempt (Brody, 1). This law in California was passed with urgency after an outbreak of measles that started in Disneyland in January of 2015. There were 125 cases reported, most of which occurred among unvaccinated people who relied upon herd immunity for health (Brody, 1). 

Disastrous effects stem from the increasing rate of parents refusing vaccines for their children. As vaccination rates lower, the immunity of the population as a whole decreases; the amount of disease increases causing more frequent doctor visits and higher death rates. Lower societal immunity leads to the re-introduction of rare and closely eradicated diseases. The measles are extremely rare in today's world, but the outbreak in California re-introduced the disease to 125 individuals who then consequently had the ability to pass it on with whom they interacted. If most of the people who interacted with and followed in the diseased pathways of those 125 compromised individuals had not been vaccinated, the disease would have continued to circulate and affect even more citizens. Economic downfall is derived from the number of diseased individuals increasing due to lessened immunity. Very often, medical expenses are incurred by the tax payer for sick children due to diseases that could have easily been prevented. It is less expensive to vaccinate a child than to pay for treatment after they have already become sick. This issue creates substantial societal unrest in many ways. Tax payers who have made the decision to vaccinate their children feel penalized for other parent's decisions. Increasing costs of medical care and health insurance cause the paying citizen to become intolerant of what is viewed as a senseless and unintelligent choice. It is often felt that the increased disease, resulting from the non-vaccinated, requires heightened medical attention interfering with necessary care for those who followed immunization advisements. The public views caring for people dying of cancer and other life-altering illnesses as put "on hold" to help the others who have diseases that simply following vaccination recommendation and traditional custom would have prevented. As the harmful effects of the refusal of vaccination mounts, disastrous effects unfold which hurt not only the diseased individuals but society as a whole.

The most obvious and logical primary prevention strategy for this issue is education. Parental fears and misconceptions regarding vaccination could be eradicated with scientific knowledge. It is imperative to properly educate the public on vaccines by providing the necessary resources to become fully knowledgeable prior to making the decision of whether or not to vaccinate. In the U.S., parents should be thoroughly informed about vaccines, how they prevent deadly diseases, and individual and societal benefits. They should be exposed to statistics and information which documents proven success of immunization combined with information concerning harmful effects of communicable diseases if vaccination is refused. If a parent refuses vaccination they should be aware that they are knowingly putting their child at risk as well as the general public. Documentation of vaccination decision should be required to acknowledge liability and to provide traceability for repercussions occurring as a result of non-vaccination. Guidelines and boundaries should be required for media publication as well. Media outlets should be held accountable when unnecessarily causing societal unrest or panic for providing misinformation or inaccurate information regarding public health. While being aware of medical news is important, the general well-being of the population should not be overlooked. Previously published media scandals should be exposed and correct and truthful information made known to society. It is vital for the public to become properly educated regarding vaccinations in order for trust to be re-established in the medical industry. While nothing in life can be 100% guaranteed, it each citizen's responsibility to acquire education resulting in the best possible decisions for self and community in all circumstances.

