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Fewer than 60% of Americans believe vaccines are safe, effective, study finds

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Sept. 10 (UPI) — Less than 60% of Americans believe vaccines are safe and effective, according to an analysis published Thursday by the Lancet.

Although that figure is on par with much of Western Europe — and is far higher than those in many eastern European and Asian nations — it may be “masking pockets of dissent,” study co-author Heidi Larson told UPI.

The findings are significant, given the global quest for a vaccine against COVID-19, which as of Thursday afternoon has infected nearly 28 million people globally, including 6.4 million in the United States, based on figures from Johns Hopkins University.

The pandemic won’t end until there is a viable vaccine and large numbers of people take it, experts have said.

“Our U.S. data is from a nationally representative sample,” said Larson, a professor of anthropology and director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine.

“Based on our social media analysis and other locally specific data collection, those who are overtly against vaccines are more highly organized, and louder, and their messages are having repercussions in different parts of the world,” she said.

The Vaccine Confidence Project was founded a decade ago to help monitor public attitudes to vaccines and to inform policymakers of the changing trends and determinants of vaccine confidence around the world.

Public confidence in vaccines varies widely from country to country, according to Larson and her colleagues.

Although signs exist that public trust in preventive vaccines for diseases ranging from the flu to measles may be improving in parts of Europe, several countries — particularly those experiencing political instability and religious extremism — are seeing growing skepticism.

In addition, the spread of misinformation online is threatening vaccination programs worldwide, the researchers said.

In 2019, the World Health Organization declared vaccine hesitancy as one of the top 10 threats to global health. Declining public confidence can result in vaccine delays or refusals, which is contributing to outbreaks of vaccine-preventable disease like measles, polio and meningitis, according to Larson and her colleagues.

For their analysis, the researchers mapped global trends in vaccine confidence across 149 countries between 2015 and 2019, using data from more than 284,000 adults worldwide who who responded to 290 national surveys about their views on whether vaccines are important, safe and effective.

The team then estimated trends in public perceptions about the safety and effectiveness of vaccines, and the importance of vaccinating children. It also considered the relationship between vaccine uptake in each country and demographic — including religious beliefs — and socioeconomic factors.

Confidence in vaccine safety is increasing in several countries, including Britain, Finland, France, Italy and Ireland, the team reported. In France, where confidence in vaccines has been persistently low, 30% of those surveyed in December 2019 said they believe vaccines are safe — up from 22% one year earlier.

In Britain, 52% of those surveyed in November 2019 expressed confidence in vaccine safety, up from 47% 18 months earlier, the researchers said.

In the United States, meanwhile, public confidence in vaccines has remained fairly steady, with 50% to 60% of people surveyed believing they are safe, according to the researchers.

Conversely, in Poland, which has a growing anti-vaccine movement, 53% of respondents reported confidence in vaccine safety in 2019, down from 64% in 2015, the data showed.

In other Eastern European countries, fewer than 20% of the public believes vaccines are safe, while in some countries in the Middle East, where some Muslim religious leaders urge followers to not get vaccinated, that percentage is below 5%, according to the researchers.

“Vaccine confidence is highly volatile — with ups and down, shocks and wobbles — which means it is vulnerable to crashing, and needs constant vigilance and nurturing to be sustained,” Larson said.

Writing in a related commentary, Daniel Salmon and Matthew Dudley, both professors at the Johns Hopkins Bloomberg School of Public Health who were not involved in the study, said that “vaccines have a remarkable safety record, based on rigorous processes of phased randomized controlled trials.”

“Without substantial global investment in active vaccine safety surveillance, continuous monitoring of public perceptions and development of rapid and flexible communication strategies, there is a risk of [COVID-19] vaccines never reaching their potential due to a continued inability to quickly and effectively respond to public vaccine safety concerns, real or otherwise,” the professors wrote.



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Study links epidural in childbirth to slightly higher risk for autism

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Children whose mothers were given an epidural during labor may face a slightly heightened risk of autism, a large, new study suggests.

Researchers found that the rate of autism was a little higher among those kids, versus their peers whose mothers did not get epidural pain relief during childbirth: 1.9% versus 1.3%.

The reasons for the difference are not yet known. And experts stressed that the findings do not prove epidurals directly raise the odds of a future autism spectrum disorder, or ASD, diagnosis.

“I don’t think people should be panicked,” said senior researcher Anny Xiang, of Kaiser Permanente Southern California’s Department of Research and Evaluation.

For one, she said, the rates of ASD were low in both study groups.

Instead, the findings point to a need for more research to better understand what is going on, Xiang said.

Other experts agreed. Autism is a complex brain-based disorder, and it’s thought that many factors — before, during and after birth — may influence the risk, said Dr. Rahul Gupta, chief medical and health officer for the March of Dimes.

“It’s quite unlikely that just the drugs used in epidural would cause ASD,” he said.

Gupta pointed to a bigger-picture question: Women who did or did not have epidurals during delivery may have differed from each other in various ways that the study could not take into account: They may have had different exposures to infections, environmental toxins or medications during pregnancy, for example.

Gupta noted that a large U.S. government study, called SEED, is digging into potential risk factors for autism. It recently found an elevated risk among kids whose mothers were prescribed opioids painkillers shortly before they became pregnant.

When it comes to medications in general, Gupta said, researchers need to learn more about the possible effects during pregnancy.

Autism is a brain disorder that affects social skills, communication and behavior control. It affects about 1 in 54 children in the United States, according to the U.S. Centers for Disease Control and Prevention.

The disorder varies widely from one person to the next: Some children have milder problems with socializing and communicating, while others are profoundly affected — speaking little, if at all, and getting wrapped up in repetitive, obsessive behaviors.

Genes are thought to account for much of the risk of autism, but experts have long believed that environmental factors also play a role.

Past studies have looked at mode of delivery: Some have found that children born by cesarean section or labor induction have a higher risk of autism.

This latest study, published Oct. 12 in JAMA Pediatrics, is the first to look at epidural use and autism risk.

Xiang’s team scoured electronic medical records for nearly 148,000 children born at Southern California hospitals between 2008 and 2015. All were delivered vaginally, and about three-quarters were exposed to epidural analgesia.

Children in that exposed group had a somewhat higher rate of ASD diagnosis. The researchers used the medical records to try to account for other factors — including the mother’s age and education level, and health issues such as diabetes, obesity and smoking.

Even then, children exposed to epidural analgesia remained at 37% greater risk of ASD, compared to unexposed kids.

Xiang’s team also looked at one possible explanation: Epidurals can cause a fever and, in theory, that might affect newborns. But there was no clear link between moms’ fevers during labor and the risk of autism.

Several medical groups responded to the study, saying it “does not provide credible scientific evidence that labor epidurals for pain relief cause autism.”

The groups, including the American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists, said women should not be scared away from opting for an epidural.

“Very low levels of these [epidural] drugs are transferred to the infant, and there is no evidence that these very low levels of drug exposure cause any harm to an infant’s brain,” the groups said.

Thomas Frazier, chief science officer for the advocacy group Autism Speaks, called the study “high-quality,” and said it will hopefully spur more research.

Frazier agreed there may be other explanations for the connection between epidural use and higher ASD risk — such as infections or other prenatal factors.

More information

Autism Speaks has more on ASD.

Copyright 2020 HealthDay. All rights reserved.



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Study: Immediate breast reconstruction during cancer treatment doesn’t impact survival, recurrence

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Oct. 14 (UPI) — Women who undergo immediate breast reconstruction with nipple-sparing mastectomy or skin-sparing mastectomy while on chemotherapy for breast cancer have similar rates of survival and disease recurrence as those who have a conventional mastectomy, study published Wednesday by JAMA Surgery reported.

Researchers said data on the safety of performing mastectomy and reconstruction has been “insufficient” compared with conventional mastectomy — performed after cancer treatment — but the new study suggests it is an effective and safe treatment method.

The analysis of breast cancer patients at Asan Medical Center in Seoul found that rates of localized disease recurrence — or the development of tumors in the same area — were 3.7% for women who underwent immediate breast reconstruction and 3.4% for those who had a conventional mastectomy, the data showed.

Meanwhile, just over 17% of the women who had an immediate breast reconstruction suffered a distant metastases — or cancer that spread to other areas of the body — while nearly 19% of those who opted for a conventional mastectomy did so, the researchers said.

In addition, after 10 years, overall survival among women who had immediate breast construction was 92%, compared to 89% for those who had a conventional mastectomy, according to the researchers.

“In this study, there was no significant difference in prognosis between the two groups during the follow-up period,” the researchers wrote.

“Further studies should be conducted in more patients with axillary [lymph node] metastasis” — or cancer that has spread to the lymph nodes, they said.

About one in eight women in the United States will suffer from breast cancer during their lifetime, and about 300,000 are diagnosed with the disease annually, according to BreastCancer.org.

Just over half of women with breast cancer nationally opt for immediate breast reconstruction following mastectomy, research suggests.

For this study, the South Korean researchers compared outcomes in 626 women with breast cancer, half of whom opted for immediate breast reconstruction, while the rest had a conventional mastectomy.

About 7% of the women who had immediate breast reconstruction experienced regional disease recurrence, compared to 5.3% of those who had conventional mastectomy, the data showed.

Five-year, local tumor recurrence-free survival was 96% among women who had immediate breast reconstruction and 97% for those who had conventional mastectomy, according to the researchers.

Disease-free survival was also comparable between the two groups — 77% versus 80% — as was distant metastasis-free survival — both 83% — the researchers said.

“The long-term oncologic outcomes of immediate breast reconstruction with nipple-sparing mastectomy or skin-sparing mastectomy for breast cancer in this study appeared to be comparable to those of conventional mastectomy alone after neoadjuvant chemotherapy,” the researchers wrote.



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Limiting TV ads for foods high in sugar, salt, fat may reduce child obesity

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Limiting TV ads for sugary, salty and high-fat foods and drinks might help reduce childhood obesity, British researchers suggest.

They looked at advertising of these products between 5:30 a.m. and 9 p.m. If all such ads were withdrawn during those hours, the number of obese kids in Britain between the ages of 5 and 17 would drop by 5% and the number of overweight kids would fall 4%, the study found.

That’s equivalent to 40,000 fewer kids in Britain who would be obese and 120,000 fewer who would be overweight, the researchers said.

The findings were published online this week in the journal PLOS Medicine.

Oliver Mytton, an academic clinical lecturer at the Center for Diet and Activity Research at the University of Cambridge, led the study.

“Measures which have the potential to reduce exposure to less-healthy food advertising on television could make a meaningful contribution to reducing childhood obesity,” the authors said in a journal news release.

But they also pointed out that they could not fully account for all factors that would affect the impact of the policy, if implemented.

They added: “Children now consume media from a range of sources, and increasingly from online and on-demand services, so in order to give all children the opportunity to grow up healthy it is important to ensure that this advertising doesn’t just move to the 9-10 pm slot and to online services.”

More information

For more on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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