不接種疫苗已成美國社會主流

Kathleen Wiederman is not staunchly against vaccines. She simply believes it is better for her child to naturally battle an illness than to be vaccinated against it.

"Doctors don't know everything," said the 42-year-old recruiter, who prefers alternative medicine and gave birth at her home in the well-heeled Virginia suburbs without the aid of a pain-killing epidural.

At first, she and her husband agreed on the matter, but when their marriage ended, he pushed for their daughter to get some of her recommended vaccines and Wiederman relented.

Now her daughter is five and has had a handful of shots, including against chicken pox and measles, but not polio.

And if her child gets sick?

"Then we treat it however you need to treat it and work through it," she told AFP.

Wiederman, who has a law degree, is among a growing number of Americans who oppose vaccines, raising concerns about a resurgence in contagious diseases like measles and whooping cough.

Vaccine hesitancy is increasingly common, and not only when it comes to infant and childhood immunizations, experts say.

Two in three working age adults refuse to get the annual flu vaccine and the same proportion of parents decline the human papillomavirus (HPV) vaccine for young adolescents, according to the US Centers for Disease Control and Prevention.

"The people we are concerned about are the people who are hesitant. The general demographic is well-educated and upper middle class," said Barry Bloom, a professor of medicine at Harvard University.

"I think they are on the rise everywhere."

In recent years, reports linking vaccines to autism have been debunked, but fears of adverse events -- which experts say are rare -- have proven difficult to erase.

Some parents are troubled by the increasing number of vaccines children are given, which have risen from seven in 1985 to 14 today, a result of medical advances, according to the Centers for Disease Control and Prevention.

"I was stunned by the number of vaccines," said Alina Scott, a 37-year-old project manager and mother of a two-year-old son.

Scott said she began reading everything she could find on the topic, even before her child was born, and decided that vaccines were not for them.

"This lasted until about a year ago, when I just felt like I wasn't finding any new information. It's like I hit the end of Internet," she said. "I don't think we will be vaccinating any time soon."

- Religious exemptions -

Nearly all US states require a standard list of immunizations before children can enter school, but they allow religious exemptions for vaccines. Some allow parents to opt out for personal reasons.

Some measles outbreaks in recent years, including in the Orthodox Jewish community in New York City, have been linked to parents refusing vaccines.

"Today you are allowed to have philosophical reasons not to vaccinate and I think that is crazy," said Anne Gershon, director of the Division of Pediatric Infectious Disease at Columbia University Medical Center.

"The reason is that it hurts many people. It is not just your child."

Some young people cannot get vaccines, including those with cancer or immune diseases, and very young infants are vulnerable to pertussis, or whooping cough, until the age of two months when they can get begin to get doses of the vaccine.

Particularly with measles, one of the most contagious diseases, outbreaks will occur unless 94 percent or more of the population is vaccinated, according to Bloom.

Nationwide, vaccination rates among US kindergarteners have stayed high -- near 95 percent.

But a 2011 poll in the journal Pediatrics found that one in 10 parents did not stick to the recommended schedule of vaccines for their child, and a quarter of parents had doubts about vaccine safety.

The United States typically sees about 60 cases of measles per year.

"We don't have a crisis, but nonetheless the trend is going up and the number of immunizations is going down," said Bloom.

- Flu shots, cancer vaccines -

Another trend is resistance to vaccines like the annual flu shot, experts say.

The CDC said in February that two-thirds of adults aged 18 to 65 had not had their seasonal shot, and that hospitalizations in this age group had doubled over last year. Deaths from flu complications were also far higher than usual.

Doctors are also surprised at how many decline the three-dose shot to prevent HPV, a sexually transmitted infection which can lead to cervical cancer in women and cancers of the head, neck, penis and anus in men.

The vaccine is recommended for school age boys and girls before they become sexually active, and can be given as early as age nine.

Just one in three women aged 19 to 26 had been vaccinated in 2012, and just 2.3 percent of men, the CDC has reported.

"I think for physicians, the idea that vaccines could prevent cancers seems phenomenal," said Anne Schuchat, Assistant Surgeon General and director of the National Center for Immunization and Respiratory Diseases.

"It has been a surprise it has not been going like hotcakes."

When it comes to how to communicate the benefits of vaccines to a skeptical public, experts are stumped.

In Bloom's view, vaccines have fallen victim to their own success.

"If they have never seen a kid blinded from measles, or mentally retarded from pertussis, it is very hard in this wonderful, happy, affluent world of kindergartens and first and second grades to see that there is a problem that vaccines are preventing."凱思琳·維德曼並非是疫苗的堅定反對者，她只是相信，她的孩子通過自身免疫對抗疾病，比接種疫苗要好得多。

“醫生並不瞭解所有的事，”42歲的招聘人員維德曼表示。她喜歡替代療法，並在位於富饒的弗吉尼亞郊區的家中生孩子，全程不使用硬脊膜外注射麻醉來避免疼痛。

起初，她和丈夫同意這樣的做法，但當他們離婚後，她丈夫讓女兒接種了一些她所推薦的疫苗，這時，維德曼的態度有所軟化。

現在，她的女兒5歲了，已經注射了幾種疫苗，包括水痘和麻疹疫苗，但沒有接種小兒麻痹症的疫苗。

那麼，如果她的孩子病了，該怎麼辦呢？

“無論需要怎樣的治療，我們都會提供，來治好孩子的病，”她告訴法新社。

反對疫苗接種的美國人數量不斷增加，擁有法律學位的維德曼是其中一員，而她卻擔心像麻疹和百日咳這樣的傳染性疾病會再次出現。

專家表示，對疫苗持觀望態度的現象日益普遍，並不只侷限於嬰兒和兒童的免疫。

美國疾病控制和預防中心表示，在處於工作年齡的成年人當中，每三個人中就有兩人拒絕接受每年的流感疫苗注射，同樣比例的父母拒絕讓年齡還小的青少年注射人類乳頭狀瘤病毒(HPV)疫苗。

“我們所擔心的是那些持觀望態度的人們，他們一般接受過良好教育，屬於中上層階級，”哈佛大學醫學教授巴里·布魯姆說。

“我認爲，他們的人數在每個地方都有增加。”

近年來，一些將疫苗同自閉症相聯繫的報告已被證明是錯誤的，專家也表示注射疫苗後很少出現不良事件，但是，人們對此所產生的恐懼卻很難消除。

疾病控制和預防中心表示，由於醫學的進步，一些父母正受困於孩子可接種疫苗數量的不斷增長，疫苗數量從1985年的7種增加到現在的14種。

“我對疫苗的數量感到吃驚，”37歲的項目經理艾莉娜·斯科特說，她有一個2歲的兒子。

斯科特表示，她開始閱讀她能找到的關於這一主題的所有材料，甚至在她的孩子出生之前就開始了，並且她認爲疫苗不適合他們。

“這一行爲持續到了一年前，那時，我覺得我無法找到任何新的信息，就像是我已經到達了互聯網的盡頭，”她說，“我想，我們不會很快就接種疫苗。”

宗教豁免

幾乎美國所有的州都要求，孩子進入學校前，要進行一系列規定的免疫接種，但是，他們允許對於疫苗的宗教豁免，一些州允許父母可以因個人原因，不讓孩子接種疫苗。

近些年，一些水痘病例爆發，包括在紐約市傳統猶太社區的出現，與父母拒絕爲孩子接疫種苗密切相關。

“今天，你可以有合理的原因不接種疫苗，但我認爲這是瘋狂的舉動，”哥倫比亞大學醫學中心兒童傳染性疾病部門的負責人安妮·格申說。

“原因在於，這會傷及很多人，不僅僅是你的孩子。”

一些年輕人不能接種疫苗，包括那些身患癌症或免疫疾病的人。很小的嬰兒容易患百日咳，他們在兩個月大的時候才能開始接種一些劑量的疫苗。

布魯姆表示，特別需要注意的是水痘，它是最具傳染性的疾病之一，除非94%或更多的人接種了疫苗才能避免大規模的爆發。

就全國而言，在美國的幼兒園兒童當中，疫苗接種率很高，接近95%。

然而，2011年兒科雜誌的民意調查發現，1/10的父母沒有堅持讓孩子接種疫苗推薦計劃表上的疫苗，而1/4的父母懷疑疫苗的安全性。

美國每年通常有60例水痘病例。

“我們沒有這樣的危機，但是即便如此，這一趨勢正在上漲，而接受免疫的數量正在下降，”布魯姆說。

專家說，另一個趨勢是對類似每年流感疫苗的抗拒。

疾病控制中心（CDC）在二月曾表示，18到65歲的成年人當中，有2/3的人沒有接受季節性疫苗注射，這個年齡羣體的住院人數在去年增加了一倍，流感併發症引發的死亡人數也遠高於平常。

注射預防HPV的三劑預防針數量大量減少，醫生也對此感到驚訝。HPV通過性接觸感染，會導致女性的宮頸癌，以及男性頭部、頸部、生殖器和肛門的癌症。

這一疫苗建議在學齡兒童性徵活躍前注射，也可以早在9歲時就接種。

CDC報告稱，2012年，19到26歲的女性中，1/3接種了疫苗，而只有2.3%的男性接受了疫苗注射。

“我認爲對內科醫生而言，疫苗能夠預防癌症似乎很驚人，”外科總醫師助理及國家免疫和呼吸疾病中心負責人安妮·舒查特說。

“令人吃驚的是，它卻沒有那樣暢銷。”

面對挑剔的公衆，如何與他們交流疫苗的好處，這難倒了專家。

在布魯姆看來，疫苗已經成爲了他們自身成功的受害者。 “如果他們從未見過一個孩子因水痘而致盲，或因百日咳而智力發展受阻，就很難在美好、快樂和豐富的幼兒時期和一二年級時發現這個問題，即疫苗正受到人們的抗拒。”