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SAN ANTONIO
MEDICINE

setts (1905), which upheld the authority of tually combat the etiology of information that References
states to enforce compulsory vaccination laws, yields hesitance to vaccines. To do this, we de- 1. Littman RJ. The Plague of Athens: Epi-
and in Zucht v. King (1922), which upheld signed a study for the purposes of establishing demiology and Paleopathology. Mount
school districts’ ability to exclude unvacci- correlation with the suspected etiology of vac- Sinai Journal of Medicine: A Journal of
nated students from matriculation. By the cine hesitance and its prevalence is a case-con- Translational and Personalized Medicine.
1980s, all states had compulsory vaccine laws trol, retrospective study. 2009;76(5):456-467. doi:10.1002/msj.
regarding schooling. However, during this The groups involved fall under one of two 20137
time, antivaccination movements widened categories: 1. those parents/guardians who 2. Thucydides. Book II, Chapter VII, The
their scope to include not only an objection choose to vaccinate their children indicating Plague of Athens. In: History of the Pelo-
to government overreach, but also the govern- no hesitation and 2. those parents/guardians ponnesian War. 2nd ed. London: J.M.
ment’s proclivity to knowingly administer in- who choose not to vaccinate their children in- Dent; 1914:132-132.
8
sidious vaccines. dicating hesitation. The survey we developed 3. Silverstein AM. Chapter 1, Theories of ac-
And while the antivaccination movement then explores the patients’ history for expo- quired immunity. In: A History of Im-
increased momentum in recent years, we also sure to the risk factors (anti-vaccination in- munology. 2nd ed. New York, New York:
witnessed outbreaks of vaccine-preventable formation). This provides four distinct Academic Press; 2009:5-11.
diseases among unvaccinated populations. The numbers labeled A, B, C and D. A indicates 4. Plotkin SA, Plotkin SL. The development
pivotal example of adverse effects of decreased the total sample with vaccine hesitation who of vaccines: how the past led to the future.
vaccination has been several outbreaks of have also been exposed to the risk factor. B in- Nature Reviews Microbiology.
measles in populations with low immuniza- dicates the total sample without vaccine hes- 2011;9(12):889-893. doi:10.1038/nrmi-
tion rates. In 2008, an intentionally unvacci- itation who were exposed to the risk factor. C cro2668
nated child knowingly infected with measles indicates the total sample with vaccine hesi- 5. Stern AM, Markel H. The History Of Vac-
returned to San Diego from a trip to Europe. tation who were not exposed to the risk fac- cines And Immunization: Familiar Pat-
Subsequently, 850 cases of measles were re- tor. D indicates the total sample without terns, New Challenges. Health Affairs.
ported that traced back to exposure to the in- vaccine hesitation who were not exposed to 2005;24(3):611-621.
dividual. Of the 850 cases, 75% (637) were the risk factor. The odds ration formula is doi:10.1377/hlthaff.24.3.611
intentionally unvaccinated as well, with an ad- then applied to determine correlation of risk 6. Plotkin SA. Vaccines: past, present and fu-
ditional 48 children who were too young to be exposure to prevalence. At this point in time, ture. Nature Medicine. 2005;11(S4):S5-
9
vaccinated becoming hospitalized. our research findings are still in their infancy, S11. doi:10.1038/nm1209
And so, while the scientific field of vaccinol- but our research team hopes to yield its find- 7. Hilleman MR. Vaccines in historic evolution
ogy is one that is still fairly new, the funda- ings within the near future. and perspective: a narrative of vaccine discov-
mental experience of human immunity to eries. Vaccine. 2000;18(15):1436-1447.
disease has been expressed in simple terms doi:10.1016/s0264-410x(99)00434-x
throughout recorded history. Over the past 8. Toward a Twenty-First-Century Jacobson
two centuries since its inception, our under- v. Massachusetts. Harvard Law Review.
standing of vaccines has widened such that the Rebecca L Sanchez, PhD is an Assistant Pro- 2008;121(7):1820-1841. www.jstor.org/
mechanisms by which they work are better fessor of Microbiology at the UIWSOM. Omar stable/40042718. Accessed November 9,
understood, ultimately improving their effi- A. Caballero, MS, OMS-II and Travis B. Fen- 2020.
cacy and safety. But despite the remarkable in- lon, OMS-II are second year Osteopathic Med- 9. Sugerman DE, Barskey AE, Delea
roads that have been made in the field of ical Students at the UIWSOM. MG, et al. Measles Outbreak in a Highly
vaccinology, there is a growing degree of hesi- Vaccinated Population, San Diego, 2008:
tance to their administration, resulting in a Role of the Intentionally Undervaccinated.
growing number of new outbreaks to many PEDIATRICS. 2010;125(4):747-755.
vaccine-preventable diseases. Therefore, as doi:10.1542/peds.2009-1653
part of a growing public health initiative, our
research team sought out to identify and even-

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