About 40 percent of American parents of young children have refused one or more vaccinations for their child, according to Prof. Michael Willrich (HIST). This current refusal rate shows an increase from recent years, perhaps because roughly a quarter of parents believe that vaccines cause autism.This belief stems from a 1998 medical report written by the British medical researcher Andrew Wakefield and colleagues that was published in the medical journal Lancet and has been repeatedly discredited and debunked.

Willrich, a specialist in social and legal history, has taught undergraduate and graduate courses at Brandeis since 2000. His passion for education is clear, and he remarks multiple times on how much he enjoys teaching Brandeis students. But something in addition to his students has occupied his attention lately-the discussion about vaccines.

His determination to help ease the tension and open communications between the two very polarized groups-people who are pro-vaccinations and people who are anti-vaccinations-is evident.

In an op-ed titled, "A Century of Vaccine Scares," which was published in The New York Times on Jan. 20, he argues for candor in a discussion about the risks and benefits of vaccinations.

Willrich also addresses the article by Wakefield in his op-ed. "This is a report that has been repeatedly discredited and debunked, but is still widely cited by anti-vaccinationists today. It helped to heighten parental concerns about vaccines," he said.

These concerns about vaccines are ones that Willrich focuses on.

"I think there is too much of a tendency among supporters of government-mandated childhood vaccinations to simply ridicule people who have concerns about vaccines. I think that one of the things that needs to be done today is to understand better where these fears are coming from-to fight misinformation with good information but also to try to better understand the social and cultural origins of these concerns," he said

Willrich's interest in vaccinations started when he began research for his new book, Pox: An American History, which will be released April 4. While Willrich makes it clear that he has no scientific expertise or medical training, he has been working on his book since 2003. Once he started researching, he said he just "went down the rabbit hole" and started a research process that took 8 years and a writing process that took 3 years.

The book, which is about the smallpox epidemic that started in the 1880s, was going to be about civil liberties during America's progressive era. Yet once he started researching the history of compulsory vaccination in America at the turn of the twentieth century-a period when many were compelled, sometimes by gunpoint, to take the smallpox vaccine-the more he realized that the vaccination question had once been "one of the most important, if not the most important civil liberties issues in America," which compelled him to focus on it in his book, he said.

In this time period, when smallpox epidemics broke out in much of the country, people often refused vaccines because they believed-with good reason-that they or their children might react adversely to the shot. Willrich explained that at the turn of the 20th century, there were virtually no governmental controls of vaccine production in the United States. Many smallpox vaccines on the market were not produced under particularly antiseptic conditions, which allowed for bacteria and other impurities to seep into the vaccination.

Compulsory vaccinations sometimes led to rioting and efforts to change the laws in order to outlaw compulsory vaccination. "I'm a legal historian, and that's really how I got into this topic. I was really interested in all the cases that came up as a result of these compulsory vaccinations," he said.

Willrich became interested in vaccines once he started to wonder "if it's consistent with the Constitution to compel someone to undergo a medical procedure against their will. ... It's a violation of their bodily integrity," he said.

Willrich wrote the op-ed for the New York Times because he "wanted to speak to the broader public about this question," he said. And it seems that he did reach the public-he said that his inbox was filled with e-mails by 9 a.m. on the day that the article was published. "I had a range of responses, and I never have had such an immediate response [to an article]," he said.

In the op-ed, Willrich is "trying to argue that the public health community should use this moment as an opportunity to not just vilify or ridicule the people who are concerned about vaccines, but to have a candid, open discussion about the risks and benefits of vaccinations," he said.

"Vaccines today are far safer than they were a century ago, but there are also many more government-mandated vaccines, which affects how people view them," Willrich notes.

One of the main factors that is shaping how people understand vaccines today is the fact that many of the diseases that vaccines protect us from are not as prevalent today, if at all.

"Some diseases on the [vaccine] schedule are no longer with us visibly. And it's complicated by the fact that there are so many vaccines that are mandated today in order for kids to go to school, or anywhere," Willrich said. The vaccine schedule refers to the list of vaccines that the federal Centers for Disease Control and Prevention recommends that children receive by the time they reach certain ages.

In addition to the decrease in frequency that measles, mumps and rubella are visibly seen today, there is also the fact that polio is extremely rare today but was once a crippling disease that affected many people. Smallpox was eradicated by an international campaign using targeted vaccination coupled with quarantine and surveillance.

"People have forgotten how bad these diseases are. People are able to forget because vaccines have helped to make those diseases so scarce. ... If you think about it that way, public education becomes such an important part of these issues," he said.

Willrich wants to help the pro-vaccine majority grow by educating the public on the dangers of low immunization levels.

"How do we convince people who are on the fence, as many parents are; how do we convince them to fall into full compliance? I think that by taking their concerns seriously and by reminding people of the dangers of low immunization levels and the serious possibility that some of these diseases could come back and start afflicting kids again. ... These are things to talk to the public about," he said.

"I think that one of the ... fears that people bring to the table is the sheer number of vaccination shots that their babies and young children have to have now. The medical community needs to be understanding about that," he said.