Abstract
People who do not want immunizations represent a small fraction of the total population. However, they may have significant epidemiologic impact. Reasons for lack of support for immunization include ignorance, fear, contraindication, general opposition based on religion or philosophy, or “informed” opposition. The category of “informed” opposition includes those who have decided, based on reliable information, that the risks of immunization outweigh the benefits in their particular case. It also includes “misinformed” opposition arising from acceptance of unproven allegations about vaccine safety or efficacy. These views may be fostered by media accounts of adverse events alleged to be caused by vaccines. Carefully developed and forthright responses to these issues are needed to assure that people make truly informed immunization decisions.
Résumé
Les personnes qui ne désirent pas être immunisées représentent une petite partie de l’ensemble de la population. Cependant, il est possible qu’elles aient une incidence importante en cas d’épidémie. Les raisons pour lesquelles on refuse de recevoir un vaccin peuvent être l’ignorance, la peur, la contre-indication, l’opposition générale fondée sur une religion ou une philosophie, ou l’opposition „ éclairée ”. La catégorie de l’opposition „ éclairée ” comprend ceux qui ont décidé, à la lumière de renseignements fiables, que les risques posés par l’immunisation dépassent les avantages en ce qui les concerne. Cela comprend également l’opposition mal informée qui découle d’allégations sans fondements au sujet de l’innocuité et de l’efficacité des vaccins. Cette perspective est souvent stimulée par les histoires véhiculées par les médias au sujet d’effets négatifs dont on attribue la cause à des vaccins. Des réponses directes et soigneusement élaborées à ces questions sont nécessaires pour s’assurer que les gens prennent des décisions réellement éclairées en matière d’immunisation.
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