The latest publication from our Australian Father’s Study addressed the subject of infant vaccination (1). Our aim was to explore father’s attitudes. We surveyed 407 Australian men whose partners were in the final trimester of pregnancy, and asked them about their attitude towards infant vaccination.

Overall, 89% had a positive attitude.

However, 9% reported being neutral and 2% expressed a negative attitude towards infant vaccination.

Vaccinations have saved millions of lives

In this modern era we forget about the importance of vaccinations. Many diseases have been eradicated through vaccination. Smallpox is a classic example of a disease now only found in high security laboratories. Yet, Smallpox used to devastate communities causing death and disfigurement.

Ridding the world of Polio

Diseases such as Polio are now also rare. I was in East Timor a decade ago and was privileged to watch a mass vaccination scheme in operation. International funding had been allocated to vaccinate the country against Poliomyelitis.

At the time I was in Aileu, which is one of the 13 administrative districts in East Timor. It was a small district with a population of only  44,325 (Census 2010) and an area of 737 km² (2). The main hospital was located in the district capital, which was also called Aileu (2).

In the week before the vaccination team visited, the local nuns (who ran the public health service at that time), and local hospital staff, had energetically spread the message far and wide for the local populace to attend for vaccination.

On vaccination day, Aileu was a bustling hive of activity. Many families walked or rode on mopeds into the district capital  for vaccination. Entire families lined up to prevent the scourge of Polio.

Polio was a real and present danger in East Timor at that time. I had visited the main hospital in the capital Dili only a few days earlier and had seen two children hospitalised with Poliomyelitis. One was expected to die. Even as an experienced clinician, there is always something soul breaking about seeing a beautiful, cherished young child dying of a disease that could have been prevented by vaccination.

Fortunately, in the case of Polio at least, the private sector (primarily the Bill and Melinda Gates Foundation) and governments have joined forces to promote vaccination and help eradicate this disease.

In 1988, when the Global Polio Eradication Initiative was launched, Polio was present in more than 125 countries and paralyzed about 1,000 children per day (3). Thanks to immunisation efforts, nearly  3 billion children have been immunised against Polio (3).

The impact of the immunisation campaign has been to reduce the number of new cases of Polio by more than 99%. This translates into saving more than 13 million children from paralysis or death.  Today, Polio is found only in Pakistan and Afghanistan, and fewer than 100 cases were reported in 2015. (3)

The need for herd immunity

One critical factor for the success of mass vaccination programs is ‘herd immunity’. Many children still contract vaccine preventable diseases because they were too young to be vaccinated or were unable to receive vaccinations for medical reasons. Unless a sufficient number (critical mass) of people are vaccinated, the disease can still reach our most vulnerable children.

Despite this, some parents choose not to vaccinate their children, citing political, personal or philosophical motives for declining (4-7).

Some parents question the safety, efficacy and necessity of recommended vaccines (4-7).

Australian Father’s opinions on vaccination

So what did our Australian fathers think about vaccination. As stated above, most had a positive attitude and supported vaccination. However, a minority did not.

One key finding in our study was that fathers with neutral or negative attitudes towards infant vaccination considered themselves as having ” significantly higher levels of knowledge of vaccination issues” compared to fathers with positive attitudes to vaccination.  Interestingly, those fathers with neutral or negative attitudes towards vaccination were more likely to have gained their knowledge from the Internet, as opposed to fathers with a positive attitude to vaccinations who gained their knowledge from direct contact with  a healthcare professional.

The comments from some fathers were interesting.

Vaccinations are a medical advance.

Most fathers who had a positive attitude believed vaccinations were a demonstration of the progress of medicine and a sign of an advanced society. One of our fathers said:

“I’m going to make sure my child is vaccinated. When you think back how entire families were wiped out, in the old cemeteries and such, I mean why wouldn’t you vaccinate your child. They are progress.”

Vaccines result in health benefits

Many expectant fathers with a positive attitude felt that vaccinations were essential and saved lives and unvaccinated children were at risk.

“Everyone knows vaccines save lives. Those parents who don’t vaccinate their children put all other children at risk.”

Another father discussed the risk versus benefit of vaccinations:

“The side effects listed are pretty mild – sore arm, irritable for a few hours. The benefits are huge. It can save your child’s life or stop them getting deaf or brain damaged. I know the baby’s not here yet but already I feel very strongly protective. I will do anything to reduce the risk of my child being hurt.”

Anger towards parents who do not vaccinate their children

A common theme expressed by some fathers was anger towards people who did not vaccinate their children because it placed their own child at increased risk.

“I read abut (sic) a baby that died cause a mother took her unvaccinated child to day care. That’s crazy. If not vaccinated you (sic) kid can die. If that happened to me I’d want those parents to pay. Maybe they should go to prison or something because really, they’ve killed that child by their actions.”

This theme was also reflected by expectant fathers with a positive attitude towards vaccination whose partners (the baby’s mother) had a negative attitude. Two participants in this situation wrote detailed comments about their frustration that hospital staff ignored them because the mother’s views carried greater weight. In one case where the mother had signed a “Refusal of vaccination” form the father wrote:

“Why should my child be put at risk because we disagree about this? Why does her opinion matter more than my own? I want Hepatitis B and Vitamin K injections at birth. She thinks they are dangerous. Father’s opinions and values don’t count. We are ignored – even when we are the one saying and doing the right thing and agreeing with the doctors. I was so angry that the midwife ignored me I had to leave the room”

Another father who separated from his partner after enrolling in our study, wrote in his questionnaire:

“She’s bitter about me leaving and taking it out on our baby. She knows I want him to have all the needles and tests. I asked the hospital to give them but they said only the mother can say so. Why is that the case? I mean, why is her word worth more than mine? It’s my baby as much as it is hers. I just want what is best for my baby. She just wants to hurt me.”

Fathers with negative attitudes to vaccination

In the sub-group of fathers with a negative attitude towards vaccination, some fathers stated that the risks of vaccination outweighed benefits. One participant wrote:

“The absolute risk of our child contracting a disease is very low. The risks of vaccination disease such as autism and ADD are high.”

Another participant agreed:

“There are 100s of studies that show a link between vaccines and poor outcomes for children. Papers about autism, nerve damage, immune damage, cancer and death (sic). I mean you risk killing your child just to supposedly keep it safe from disease, but you give it a disease instead. Even if you don’t get a bad event, the needles hurt your child and cause them to suffer.”

Some participants felt that people who conscientiously objected to immunization were being unfairly punished for their choices.

“The government overstate this issue and try to make you feel guilty following your own free will.”

Why vaccination is important

At the end of the day the message is simple.

Vaccines still save lives.

We need enough responsible people in the community to vaccinate their children to protect the vulnerable people within our population. We need enough vaccinated people to ensure we have herd immunity.

No parent should have to lose their child because they were not vaccinated or because other parents decided not to vaccinate their children and create herd immunity.

Vaccination is a social obligation to society.

References

1. Prosser N, Petersen R, Quinlivan J (2016) Survey of Australian Father’s Attitudes towards Infant Vaccination: Findings from the Australian Father’s Study. Primary Health Care 6: 228. doi:10.4172/2167-1079.1000228
2. https://en.wikipedia.org/wiki/Aileu_District
3. http://www.gatesfoundation.org/What-We-Do/Global-Development/Polio
4. Brown KF, Kroll JS, Hudson MJ, et al. Factors underlying parental decisions about combination childhood vaccinations including MMR: a systematic review. Vaccine. 2010;28(26):4235-4248.
5. Ramsay ME, Yarwood J, Lewis D, Campbell H, JM. W. Parental confidence in measles, mumps and rubella vaccine: evidence from vaccine coverage and attitudinal surveys. Br J Gen Pract. 2002;52(484):912-916.
6. Dannetun E, Tegnell A, Hermansson G, Giesecke J. Parents’ reported reasons for avoiding MMR vaccination. A telephone survey. Scand J Prim Health Care. 2005;23(3):149-153.
7. Gust D, Brown C, Sheedy K, Hibbs B, Weaver D, Nowak G. Immunization attitudes and beliefs among parents: beyond a dichotomous perspective. Am J Health Behav. 2005;29(1):81-92.