Dr. Jennifer Takagishi, a pediatrician and vice president of the Florida Chapter of the American Academy of Pediatrics, knows what happens when the vaccination rate dips below herd immunity.
“Your child has a personal risk of getting a disease that could potentially not only make them very sick, but could actually kill them,” Takagishi told the News Service of Florida. “A lot of families don’t want to hear that, but I've unfortunately seen a 2-week-old in my practice who died of whooping cough, so I know that it can happen.”
On Monday, President Donald Trump signed an executive order to overhaul the childhood vaccination schedule – including separating the measles, mumps and rubella vaccine into three separate shots – and direct states to expand vaccination exemptions.
Takagishi spoke to the News Service of Florida about what vaccine hesitancy actually looks like for Florida’s pediatricians.
Q: What's been your experience with vaccine hesitancy in Florida?
TAKAGISHI: It's definitely increased over the last several years, our families are asking a lot more questions, which is great. I like that they are looking into the safety and the efficacy, but many are now refusing vaccines that have become standard of care, and that is very concerning to me as we have seen such an increase in measles. We've seen polio in New York, whooping cough in Florida, and that’s a big concern.
Q: What was your reaction to President Trump's executive order about childhood vaccinations?
TAKAGISHI: I don't think that’s the way we want to consider evidence-based medicine to be. It is going to continue to increase the number of families who are hesitant to get the vaccines, who are questioning the medical care that we have proven time and again that it’s appropriate and safe.
I'm not sure what his intent is, is it to benefit families to allow them to make more decisions or to decrease the number of vaccines overall? But the reality is twofold: One of which is, we don't even have a separate measles, mumps or rubella vaccine currently anyway.
So if families are waiting for the industry to catch up on that and refuse the MMR combined in the meantime, we're going to see even more potential measles, plus the return of mumps and rubella.
In addition is the concern that families will think that a lot of these diseases are either so rare or just aren't important enough to protect against, but things like hepatitis B can cause liver cancer, and hepatitis A can also cause shorter term liver damage. Plus there's a whole section in the executive order about wanting to look at states who are not giving the exemptions that he thinks should be allowed, and I think there's enough opportunity already for exemption.
There is already a religious exemption in Florida. I'm not sure why we need to add any more categories.
Q: Have you been able to convince a parent who's been vaccine hesitant to vaccinate their child? How do you get there? How do you talk to a parent to convince them otherwise?
TAKAGISHI: I've had some who, once they understood the rationale, were willing to do it, and a few who have agreed to some of the vaccines, but not all of them. I have had some who are very steadfast and who don’t want them. We have a discussion about what their concerns are.
Where have they learned this information? Are they willing to hear my own experience with some of these diseases? If they have built a relationship of trust with me, then we can move forward from there.
Q: How are pediatricians in Florida feeling about low vaccination rates? The state currently has an average of 88.9 percent vaccination rate, and herd immunity requires 95 percent.
TAKAGISHI: Most of us are scared, to be honest. We're just going to see more and more of these diseases continue to worsen. That 88.9 percent, it's very county dependent. There are some that are significantly lower than that. We just had a huge measles outbreak not too far from where I am in Hillsborough County.
We have such a global economy, people are moving all over that once you have those cases, it’s hard to go back. Even with those cases that have shown up, people are still saying, ‘Well, it's OK to risk it, it won't happen to my child,’ or ‘I can treat it,’ and the treatments are not actual treatments. They're not going to work and some of them can actually cause damage.
Your child has a personal risk of getting a disease that could potentially not only make them very sick, but could actually kill them. A lot of families don’t want to hear that, but I've unfortunately seen a 2-week-old in my practice who died of whooping cough, so I know that it can happen.
But the second part of it is there are people around them, not just the child, but the family, who may not be able to get vaccinated, whether they're too young, they have immune problems, etc. You're not only putting your own family and child at risk, but you're putting all those people around you at risk as well.
Q: What do you think the reason is for parents who decide not to vaccinate their children?
TAKAGISHI: There are so many things that I cannot protect my child against. You want to do everything you can to protect your children, which I think is really the goal that parents have.
I don't think any of the parents that have said no are doing it because they want to put the child at risk, but they have been led to believe that the vaccines that they're giving are posing more of a risk than they are. Are there smaller risks to vaccines? There are, because nothing is risk free. But if you actually become infected with some of these diseases, the risk of becoming ill from them is significantly higher than the risk that you would obtain from getting the vaccine itself.
