Immunological Insurgency: Assessing Vaccine Hesitancy in the Relationship Between Pertussis Outbreak, Non-Medical Vaccination Exemptions, and Minority Communities in Texas

Abstract

Vaccine hesitancy has often been oversimplified into a binary phenomenon that consists of individuals either fully accepting all vaccines or completely rejecting them. Vaccine hesitancy is actually a spectrum in which different degrees of and reasons for hesitancy towards vaccines exist between the two extremes of total rejection and total acceptance. Since eradication is the most cost-effective method for addressing vaccine- preventable diseases, vaccine hesitancy must be effectively investigated and mitigated. The purpose of this study is to investigate the relationship between the proportion of racioethnic and religious minorities in county populations, disease outbreak, and vaccination exemption rates in the state of Texas during 2011. This year was chosen to represent a midway point within a larger ten-year timeline, starting with the release of Dr. Saad Omer’s study in 2008 and ending in the present day, to see if epidemiological trends during 2011 can be considered predictors vaccine hesitancy-related disease outbreaks of subsequent years. This study is a recreation of Omer’s 2008 study on Michigan. Contrasting the differences in outcome between the two states allows for analysis of how geographic and demographic differences can shape epidemiological conditions. This study was initially conducted using a series of logistic regression models, and further investigated using a count data regression with Poisson Distribution. No significant positive correlation was found between pertussis outbreaks and non-medical vaccination exemptions, and no significant positive correlation was found between these two factors and the proportion of racioethnic minorities in the population. This directly contradicts the results from Dr. Saad Omer’s Michigan study. Only the proportion of religious minorities in the population, specifically Muslims, showed a significant and positive correlation with non-medical vaccination exemption and pertussis outbreak rates. These results support the argument that heterogeneity not only exists between countries, but within them as well. With respect to Texas, Muslim communities should be prioritized with respect to the allocation of educational resources used to mitigate vaccine hesitancy. Studying Texas revealed that more regions, in the U.S. or out, should be examined in this way.