Putting It Together: Health and Medicine

In this module, you examined health, medicine, and the ways that social influences impact health. Perhaps the most important discovery from this module was to better understand how the social institution of medicine is based on the socially constructed understandings of what is (and is not) illness and wellness. Let’s take a closer look at an example of how sociology and medicine are interconnected.

In the United States in 2012, a pertussis (whooping cough) outbreak resulted in over 40,000 cases and twenty pertussis-related deaths, making it the worst outbreak in 65 years[1]. Researchers, suspecting that the primary cause of the outbreak was the waning strength of pertussis vaccines in older children, recommended a booster vaccination for 11–12-year-olds and pregnant women (Zacharyczuk 2011). Pertussis is most serious for babies; one in five must be hospitalized, and since they are too young for the vaccine themselves, it is crucial that people around them be immunized (Centers for Disease Control).

Infant receiving a shot in the thigh from a doctor, while being held by his mother.

Figure 1. Vaccines are not linked to autism, yet the myth persists.

But what of people who do not want their children to have this vaccine, or any other? That question is at the heart of a debate that has been simmering for years. Vaccines are biological preparations that improve immunity against a certain disease. Vaccines have contributed to the eradication and weakening of numerous infectious diseases, including smallpox, polio, mumps, chicken pox, and meningitis.

However, many people express concern about potential negative side effects from vaccines. These concerns range from fears about overloading the child’s immune system to controversial reports about devastating side effects of the vaccines. One misapprehension is that the vaccine itself might cause the disease it is supposed to be immunizing against. Another commonly circulated concern is that vaccinations, specifically the MMR vaccine (MMR stands for measles, mumps, and rubella), are linked to autism. The autism connection has been particularly controversial. In 1998, a British physician named Andrew Wakefield published a study in Great Britain’s Lancet magazine that linked the MMR vaccine to autism. The report received a lot of media attention, resulting in British immunization rates decreasing from 91 percent in 1997 to almost 80 percent by 2003, accompanied by a subsequent rise in measles cases (Devlin 2008). A prolonged investigation by the British Medical Journal proved that not only was the link in the study nonexistent, but that Dr. Wakefield had falsified data in order to support his claims (CNN 2011). Dr. Wakefield was discredited and stripped of his license, but the doubt still lingers in many parents’ minds. The U.S. Center for Disease Control and Prevention has been vocal about the non-existent relationship between vaccinations and autism.[2]

In the United States, many parents still believe in the now-discredited MMR-autism link and refuse to vaccinate their children. Other parents choose not to vaccinate for various reasons like religious or health beliefs. In 2014, a boy whose parents opted not to vaccinate returned home after a trip abroad; no one yet knew he was infected with measles. The boy exposed 839 people to the disease and caused 11 additional cases of measles, all in other unvaccinated children, including one infant who had to be hospitalized. According to a study published in Pediatrics, the outbreak cost the public sector $10,376 per diagnosed case. The study further showed that the intentional non-vaccination of those infected occurred in students from private schools, public charter schools, and public schools in upper-socioeconomic areas (Sugerman et al. 2010), suggesting that differences in preferences regarding vaccination occur across the socioeconomic spectrum.

This heated topic is prevalent in today’s political atmosphere and is the cause of many disagreements—stories about couples calling it quits because of differences in position regarding vaccines are no longer surprising. Should parents be forced to immunize their children? What might sociologists make of the fact that most of the families who chose not to vaccinate were of a higher socioeconomic group, which, as we know, is closely related to educational attainment? How does this story of vaccines in a high-income region compare to that in a low-income region, like sub-Saharan Africa, where populations are often eagerly seeking vaccines rather than refusing them?

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