Immunization against disease is among the most successful global health efforts of the modern era, and substantial gains in vaccination coverage rates have been achieved worldwide. However, that progress has stagnated in recent years, leaving an estimated 20 million children worldwide either undervaccinated or completely unvaccinated. The determinants of vaccination uptake are complex, mutable, and context specific. A primary driver is vaccine hesitancy - defined as a "delay in acceptance or refusal of vaccines despite availability of vaccination services". The majority of vaccine-hesitant people fall somewhere on a spectrum from vaccine acceptance to vaccine denial. Vaccine uptake is also hampered by socioeconomic or structural barriers to access. On August 17-20, 2020, the Forum on Microbial Threats at the National Academies of Sciences, Engineering, and Medicine held a 4-day virtual workshop titled The Critical Public Health Value of Vaccines: Tackling Issues of Access and Hesitancy. The workshop focused on two main areas (vaccine access and vaccine confidence) and gave particular consideration to health systems, research opportunities, communication strategies, and policies that could be considered to address access, perception, attitudes, and behaviors toward vaccination. This publication summarizes the presentations and discussion of the workshop.

The Immunization Safety Review Committee was established by the Institute of Medicine (IOM) to evaluate the evidence on possible causal associations between immunizations and certain adverse outcomes, and to then present conclusions and recommendations. The committee's mandate also includes assessing the broader societal significance of these immunization safety issues. While all the committee members share the view that immunization is generally beneficial, none of them has a vested interest in the specific immunization safety issues that come before the group. The committee reviews three immunization safety review topics each year, addressing each one at a time. In this fifth report in a series, the committee examines the hypothesis that exposure to polio vaccine contaminated with simian virus 40 (SV40), a virus that causes inapparent infection in some monkeys, can cause certain types of cancer.

Abstract:

This book focuses on how to formulate a mental health response with respect to the unique elements of pandemic outbreaks. Unlike other disaster psychiatry books that isolate aspects of an emergency, this book unifies the clinical aspects of disaster and psychosomatic psychiatry with infectious disease responses at the various levels, making it an excellent resource for tackling each stage of a crisis quickly and thoroughly. The book begins by contextualizing the issues with a historical and infectious disease overview of pandemics ranging from the Spanish flu of 1918, the HIV epidemic, Ebola, Zika, and many other outbreaks. The text acknowledges the new infectious disease challenges presented by climate changes and considers how to implement systems to prepare for these issues from an infection and social psyche perspective. The text then delves into the mental health aspects of these crises, including community and cultural responses, emotional epidemiology, and mental health concerns in the aftermath of a disaster. Finally, the text considers medical responses to situation-specific trauma, including quarantine and isolation-associated trauma, the mental health aspects of immunization and vaccination, survivor mental health, and support for healthcare personnel, thereby providing guidance for some of the most alarming trends facing the medical community. Written by experts in the field, Psychiatry of Pandemics is an excellent resource for infectious disease specialists, psychiatrists, psychologists, immunologists, hospitalists, public health officials, nurses, and medical professionals who may work patients in an infectious disease outbreak.

A “clear and insightful” takedown of the anti-vaccination movement, from its 19th-century antecedents to modern-day Facebook activists—with strategies for refuting false claims of friends and family (Financial Times) Vaccines are a documented success story, one of the most successful public health interventions in history. Yet there is a vocal anti-vaccination movement, featuring celebrity activists (including Kennedy scion Robert F. Kennedy Jr. and actress Jenny McCarthy) and the propagation of anti-vax claims through books, documentaries, and social media. In Anti-Vaxxers, Jonathan Berman explores the phenomenon of the anti-vaccination movement, recounting its history from its nineteenth-century antecedents to today’s activism, examining its claims, and suggesting a strategy for countering them. After providing background information on vaccines and how they work, Berman describes resistance to Britain’s Vaccination Act of 1853, showing that the arguments anticipate those made by today’s anti-vaxxers. He discusses the development of new vaccines in the twentieth century, including those protecting against polio and MMR (measles, mumps, rubella), and the debunked paper that linked the MMR vaccine to autism; the CDC conspiracy theory promoted in the documentary Vaxxed; recommendations for an alternative vaccination schedule; Kennedy’s misinformed campaign against thimerosal; and the much-abused religious exemption to vaccination. Anti-vaxxers have changed their minds, but rarely because someone has given them a list of facts. Berman argues that anti-vaccination activism is tied closely to how people see themselves as parents and community members. Effective pro-vaccination efforts should emphasize these cultural aspects rather than battling social media posts.

Social Ecology of Infectious Diseases explores how human activities enable microbes to disseminate and evolve, thereby creating favorable conditions for the diverse manifestations of communicable diseases. Today, infectious and parasitic diseases cause about one-third of deaths and are the second leading cause of morbidity and mortality. The speed that changes in human behavior can produce epidemics is well illustrated by AIDS, but this is only one of numerous microbial threats whose severity and spread are determined by human behaviors. In this book, forty experts in the fields of infectious diseases, the life sciences and public health explore how demography, geography, migration, travel, environmental change, natural disaster, sexual behavior, drug use, food production and distribution, medical technology, training and preparedness, as well as governance, human conflict and social dislocation influence current and likely future epidemics. - Provides essential understanding of current and future epidemics - Presents a crossover perspective for disciplines in the medical and social sciences and public policy, including public health, infectious diseases, population science, epidemiology, microbiology, food safety, defense preparedness and humanitarian relief - Creates a new perspective on ecology based on the interaction of microbes and human activities

The public has voiced concern over the adverse effects of vaccines from the moment Dr. Edward Jenner introduced the first smallpox vaccine in 1796. The controversy over childhood immunization intensified in 1998, when Dr. Andrew Wakefield linked the MMR vaccine to autism. Although Wakefield’s findings were later discredited and retracted, and medical and scientific evidence suggests routine immunizations have significantly reduced life-threatening conditions like measles, whooping cough, and polio, vaccine refusal and vaccine-preventable outbreaks are on the rise. This book explores vaccine hesitancy and refusal among parents in the industrialized North. Although biomedical, public health, and popular science literature has focused on a scientifically ignorant public, the real problem, Maya J. Goldenberg argues, lies not in misunderstanding, but in mistrust. Public confidence in scientific institutions and government bodies has been shaken by fraud, research scandals, and misconduct. Her book reveals how vaccine studies sponsored by the pharmaceutical industry, compelling rhetorics from the anti-vaccine movement, and the spread of populist knowledge on social media have all contributed to a public mistrust of the scientific consensus. Importantly, it also emphasizes how historical and current discrimination in health care against marginalized communities continues to shape public perception of institutional trustworthiness. Goldenberg ultimately reframes vaccine hesitancy as a crisis of public trust rather than a war on science, arguing that having good scientific support of vaccine efficacy and safety is not enough. In a fraught communications landscape, Vaccine Hesitancy advocates for trust-building measures that focus on relationships, transparency, and justice.

Vaccine reluctance and refusal are no longer limited to the margins of society. Debates around vaccines' necessity -- along with quesitons around their side effects -- have gone mainstream, blending with geopolitical conflicts, political campaigns, celebrity causes, and "natural" lifestyles to win a growing number of hearts and minds. Today's anti-vaccine positions find audiences where they've never existed previously. Stuck examines how the issues surrounding vaccine hesitancy are, more than anything, about people feeling left out of the conversation. A new dialogue is long overdue, one that addresses the many types of vaccine hesitancy and the social factors that perpetuate them. To do this, Stuck provides a clear-eyed examination of the social vectors that transmit vaccine rumors, their manifestations around the globe, and how these individual threads are all connected.

"—from the foreword by Arthur L. Caplan, NYU School of Medicine