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Differences between Generations on Views Towards Vaccination

Collin Doster, Megan Urban, Noor Alnemer, Sebastian Krajewski

WRTG 3030-001, University of Colorado, Boulder, Colorado 80309, United States

ABSTRACT:

Vaccination is a topic of utmost importance, not only for its medical utility, but also for the societal implications of its widespread adoption. In recent years, there has been much publicity surrounding alleged links between vaccines and serious diseases, and a resultant rise in so-called “anti-vaxxer” sentiment. Here, the team reports the collection and analysis of 166 survey responses concerning attitudes towards vaccination distributed amongst different age groups. Overall, the large majority of the surveyed population held a definite pro-vaccination attitude, with the most vocal respondents being pro-vaccination, regardless of age. Those more skeptical of vaccination and less likely to vaccinate their children were most commonly found amongst persons of ages 26-45. However, the statistical correlation between age group and attitudes towards vaccination remains somewhat uncertain, given the relatively low number of respondents in this age group.

Introduction:

According to the Colorado Department of Public Health and Environment, eleven vaccines are mandatory to enter child care, and an additional three vaccinations in order to attend kindergarten through 12th grade (School-Required). Although most parents commit to the first of a set of shots, many do not return to complete the process. In a 2013 study by the BlueCross BlueShield, only 77% of children born in the US completed all necessary steps of vaccinations (Early Childhood). In recent years, an anti-vaccine movement has lead some parents to question whether they should vaccinate their children. During the 2015 ad campaign for awareness by the National Vaccine Information Center, a movement for

“No Forced Vaccinations” reached audiences stretching from New York to Washington, advocating

against vaccine injuries and deaths (Vaccinations?). HPV and influenza vaccinations were the two most

neglected vaccinations in 2014 with completion rates of just 60-70% among US citizens, while most

other vaccinations prevailed at 90% in 2014. Since these vaccinations are required by law to enter

schools, jobs, etc., only three exceptions are allowed: medical, religious, or philosophical beliefs. The

National Vaccine Information Centers explains that although all 50 states accept medical excuses, only 47

now accept religious reasons and only 18 states accept philosophical reasons (Vaccinations?). Some

parents are seeing this as a violation of their constitutional rights to exercise agency to protect their

children and/or practice their religious beliefs.

Due to the invention of these vaccinations, nine major diseases on the vaccination list (including

measles, smallpox, and mumps) have all decreased in appearance by 92 - 100% (Ventola). Notably,

smallpox was the first infectious disease to be eradicated, with the last instance of natural infection in

October 1977. However, the fight against other ailments is far from over, as some of these diseases still

lurk in other countries and leave those unvaccinated vulnerable to catching a traveling disease and passing

it on to others. The Center for Disease Control and Prevention alarms that in 2000, measles were declared

eliminated after attacking three to four million people each year, but is now in fact re-emerging, such as in

the recent outbreaks at Disneyland and Amish communities in Ohio (National Vaccine). The measles was

assumed to have originated from an overseas traveler who attended the densely populated Disney theme

park, resulting in a total of 147 cases of measles across multiple states (National Vaccine).

As beneficial vaccinations are, some are worried that they contain harmful ingredients that can

cause a variety of diseases and ailments, such as autism and diabetes, or dangerous allergic reactions.

Most famously, the mercury-containing chemical thiomersal has been blamed for a supposed link

between vaccines and autism. However, the medical community has found no correlation between

vaccines and autism (Immunizations and Autism). This seems to just be something that is said to

introduce controversy and fear into the discussion of vaccinations. Despite this, the number of Americans

receiving vaccinations remains inconsistent. Statistics regarding the participation of childhood vaccination

fluctuates year to year due to these inventions, outbreaks, new findings, and religious protests that leads to

trends per generation. This study aims to uncover a trend between age and opinions surrounding

vaccination.

Methodology

For this analysis, a survey was created using Qualtrics that consisted of 9 multiple-choice questions that are supposed to be able to provide answers to each aspect of the research question.

Qualtrics is an online system that can be used to create and distribute professional surveys, students of the University of Colorado have free access to this system. The questions were designed so that a trend between age group and attitude towards vaccination could be seen. Additionally, five questions consist of free-response, open ended answers so a true understanding through quantitative as well as qualitative data. The qualitative data is meant to provide further insight on people’s opinions surrounding vaccines.

The questions given on the survey are as follows:

1. How old are you?

2. What is your gender?

3. Were you vaccinated as a child?

4. Will you vaccinate your children?

5. How effective do you believe vaccinations are at preventing disease?

6. How do you perceive the overall safety of vaccinations?

7. Do you believe all 29 required vaccinations for school are necessary?

8. Do you believe it is unsafe for unvaccinated children to be around vaccinated?

9. List any diseases or complications that can arise from vaccines.

10. List any hazardous chemicals in vaccines.

11. Are you aware of reemerging diseases that are were once eliminated by them?

12. Do you believe that vaccines lead to autism?

13. What negative side effects have you seen/experienced?

14. Any additional comments welcome.

The survey was passed out via email to friends and family who were asked to share to their friends as well. This resulted in a “snowball” effect. Posts on social media were made to allow us to reach out to people in different cities and within all different age groups. This method allowed for a large number of surveys to be distributed in a time efficient manner, all of the data was collected over a seven day period. By gathering data on the age of each surveyed responder, the team was able to divide the responses into distinct age groups. These groups were somewhat arbitrary, but are broken out into ten year sections. Once all off the information was gathered the data spreadsheet was gone through by hand and incomplete responses were discarded. Incomplete surveys not only provide inconsistent data but also make data analysis hard as it causes problems when read into Matlab. The data was then loaded into Matlab and was plotted and analyzed. The data shown in this report was what was considered to be the most interesting and relevant. Data for questions that had overwhelming results in the pro-vaccine direction were not included because they are trivial.

Results and Discussion

Results and Discussion Figure 1: The overall age distribution of survey respondents In total, 173 survey

Figure 1: The overall age distribution of survey respondents

In total, 173 survey responses were collected, and of those 166 were fully completed. The data

analyzed includes only those 166 responses. The age of the respondents ranged from 16 to 77 years old. The mean age was 33 years, and the most common age 21 years. As seen in figure 1, there were two clear clusters of age groups into which most respondents fell. Specifically, there were many responses from college aged (~18-24 years) persons, and a number of responses from older persons whose ages are roughly thirty years greater than the previous group. In total, multiple responses from all generations with birth dates following World War Two were obtained, with a large bias towards those in their early-mid twenties, and those in their 50s and 60s. This is because the team was most easily able to distribute the survey to other college students and their parents. Unfortunately, reaching the middle age groups proved

difficult. Additionally, the majority of responses were from female respondents, with 75% of all survey responses indicating a female gender.

with 75% of all survey responses indicating a female gender. Figure 2: Percentages of participants who

Figure 2: Percentages of participants who were vaccinated when they were children

Out of 166 respondents, only five indicated that they had not been vaccinated as children. Interestingly, all who were unvaccinated as a child were in the youngest age bracket of 16-35 years, as seen in figure 2. One hundred sixty-five persons answered positively to “Were you vaccinated as a child?”, and the remaining two respondents answered “Maybe”. Thus, the vast majority (95+%) of the data collected comes from those who were subject to vaccination at one time or another.

Respondents were asked to provide reasoning behind their answer to the question, “Do you believe all 29 vaccinations required for kids to attend school are necessary?”. The given responses covered a wide variety of reasonings behind both positive and negative answers to the previous question. Many cited personal experience with vaccines as justification, almost always in favor of vaccination, although at least one subject cited their having not been vaccinated (and lack of disease thereafter) as reasoning for a negative response.Many respondents also referenced medical/scientific literature as

having influenced their decision, in both direct (e.g. reading scientific literature) and indirect (e.g. talking to friend/family with medical experience) manners. Finally, those who answered “Maybe” to the previous question often cited lack of knowledge surrounding vaccines as their reasoning.

Figure 3: Responses to the question “How do you perceive the overall safety of vaccines/vaccination?”

Figure 3: Responses to the question “How do you perceive the overall safety of vaccines/vaccination?”

Figure three shows that the vast majority of respondents think that vaccines are either somewhat safe or completely safe, with only 1 saying that vaccines were completely unsafe. There were also 13 participants that were unsure how to answer. The age group with the largest percentage of respondents that said vaccines were somewhat unsafe was the 26-35 group. For those out of their early twenties, the trend is that as age increases, the percentage falls. This distribution would imply that the age groups most unsure of the safety of vaccines are in their late twenties and early thirties. The free response answers did not provide any reason for why this might be the case.

Perhaps one of the most controversial topics surrounding vaccinations is the idea that they can cause autism, which is scientifically unsubstantiated. The survey asked the participants to answer whether or not they believed vaccines cause autism. The percentage of respondents that either said “Yes” or “Maybe” is broken down by age group in figure 4 below. The results here are similar to those seen in

figure three, there is a trend towards higher percentages in the middle age groups.

a trend towards higher percentages in the middle age groups. Figure 4: Percentage of Respondents That

Figure 4: Percentage of Respondents That Said “Yes” or “Maybe” When Asked if Vaccines Cause Autism.

In two separate questions, the survey asked respondents to list both any hazardous chemicals they believed to be present in vaccines, and to list any diseases/complications caused by vaccines. In both questions, the large majority of answers were “None”, or some variation thereof. The remaining answers seemed to largely derive from popular media reporting on the presence of heavy metals in vaccines, and the notion that vaccines are linked to autism. This idea, as discussed before, has been overwhelmingly proven false by the scientific community. Specifically, seven answers believed that mercury or other heavy metals were present in vaccines, and seven answers believed that vaccines may cause autism. There did appear to be a correlation between the belief that vaccines cause autism and age: Only 2 of 7 who thought so were under the age of forty. Regarding any other diseases or complications arising from diseases, most simply cited allergic reactions to ingredients in the vaccine itself or physical soreness from

the act of injection, although a few answered with serious diseases such as autoimmune disorders or measles.

Interestingly, not a single person surveyed cited religion as having personally affected their decisions regarding vaccines. All but five answered negatively and unambiguously to “Does religion play a role in your decisions regarding vaccines? If so, how?”. A handful explained that religion may affect such decisions, but either rejected this influence personally, or were simply unclear in explaining if it applied to them. Thus, the dataset does not support the claim that religion plays a significant role in views regarding vaccination, and would suggest the opposite, regardless of generation.

The end of the survey provided a space for additional comments, and an overwhelming number of responses expressing strong support for vaccination as a whole were received. However, less than half of respondents wrote anything in the free response section. Notably, persons of all age groups expressed support for vaccines: The youngest subject to leave a comment was 19, the oldest was 71. Only a single comment was received expressing a clear negative attitude towards vaccines. Therefore, it would appear that in the respondents, those with a positive outlook on vaccines were much more confident in their beliefs when compared to those with middling or negative views on vaccines.

Finally the participants were asked if they would vaccinate their own children. The percentage of participants who said that would “Probably not” vaccinate their children is shown broken down by age group below in figure 5. Once again, the trend of higher percentages in the intermediate age groups is seen.

Figure 5: Percentage of respondents that replied “Probably Not” when asked if they would vaccinate

Figure 5: Percentage of respondents that replied “Probably Not” when asked if they would vaccinate their children.

Conclusion

The survey data collected provided both qualitative and quantitative data concerning attitudes on vaccination across a large age distribution. A large number of valid quantitative data was collected, 166 sets in total, a smaller portion of qualitative data was collected in the form of free response answers. As suspected, there did appear to be some sort of correlation between anti-vaccination opinion and age group. The quantitative data analyzed in this study seems to suggest that people ages 26-45 are the most skeptical of vaccination, and the least likely to vaccinate their own children. Unfortunately, this trend may not be strongly supported by the collected data because only 12% of respondents fall within the 26-45 age group, as can be seen in figure 1. This means that while the data seems to show a correlation, it may just be a statistical anomaly. The correlation is however seen over the three questions that are plotted in this report. It is unclear whether or not this trend is an accurate representation of a real-world trend, or just an anomaly in the data. A study with a larger number of people in this age group would need to be conducted in order to help validate these findings.

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