Parents were questioning the effectiveness of vaccines long before a now debunked 1998 report linked the MMR vaccine to autism, according to a new article from researchers at the University of Waterloo and Univeristé​ de Montré​al.

A lack of public education, access to vaccines, training and "perhaps most importantly, lack of political will for a national immunization schedule," are largely to blame, history professor and the study's co-author Heather MacDougall said.

MacDougall and co-author Laurence Monnais of Univeristé​ de Montré​al analyzed data on the measles vaccine from the mid-1960s to 1998. 1998 was the year the Lancet published the debunked report from Andrew Wakefield that linked the mumps, measles and rubella (MMR) vaccine to autism.

Their article, published in the Canadian Medical Association Journal, found "vaccine hesitancy" started before the 1990s.

"Vaccination hesitancy has always been an issue, actually, since the beginning of vaccination," Monnais said in a CMAJ podcast about their report.

Advice to be 'perfect' parents

The researchers noted in 1962, the thalidomide disaster, combined with new styles of parenting led to the popularization of alternative medicine.

There were measles outbreaks in the 1970s and 1980s, which happened at the same time there was a shift in how people thought about their health.

In the CMAJ podcast, MacDougall said the MMR vaccine was introduced in 1972, but people began questioning its effectiveness almost immediately.

Also in the 1970s and 1980s, researchers said, people stopped thinking about their health in terms of how it impacted society as a whole and saw it more as an individual issue.

As women entered the workforce, they turned less to their parents and doctors for advice and became more dependent on parenting guides, MacDougall said.

"There's a huge upsurge in parenting guides during the 1970s and 1980s. There was so much advice and there was so much pressure on them to be good or perfect mothers," MacDougall said.

That has only intensified over the years, she said.

"The internet today is a huge source of excessive pressure on young mothers, particularly, although young men are equally pressured in a way that parents in the past weren't," MacDougall said.

By the 1990s, young parents became more willing to question whether they should vaccinate their child.

Lack of 'sustained training'

The researchers said the division of healthcare between the federal and provincial and territorial governments has meant there's no consensus on a national immunization program.

It took many years for federal government to create a national immunization strategy in 2003, MacDougall said.

"Unfortunately, [the government] hasn't subsequently provided consistent funding or leadership" for that strategy in the years since, she said.

As well, there has been a lack of "sustained training" in immunology, and healthcare practitioners have limited knowledge to provide guidance to parents and patients.

"The real problem, I think, is that current healthcare professionals have probably never seen an actual case of measles unless they trained overseas and are very much products of current society," MacDougall said.

She said they hope their article "will create questions in people's minds about the history of vaccine policy in Canada and that it will lead to some understanding that it's more complex than simply manufacturing and administering vaccines."