In US states that strongly embrace myriad anti-science beliefs, like California, Washington and New York, dangerous preventable diseases like Whooping Cough have come roaring back after a long hiatus, due to a belief by cultural elites that as long as uneducated poor people get vaccines, things will be fine.

It is going to take a lot to combat the entrenched mentality that causes some to distrust science and medicine, because groups have spent a lot of money promoting conspiracy stories about pharmaceutical companies and doctors and selling their 'alternative' medicine. It will take education, awareness and nurses can help, write Emily Peake, APRN, MSN, FNP-C, CLC, and Lisa K. McGuire, MSN, MBA-HCM, RN.

Why? The anti-vaccination campaigns have focused on doctors and drug companies, just like anti-GMO efforts have vilified farmers and seed companies. Nurses are not part of the smear campaign.

Caused by infection with Bordetella pertussis  bacteria, pertussis has been increasing in recent years. In the United States, average annual pertussis cases increased from less than 3,000 cases per year during the 1980s to 48,000 in 2012, including 20 deaths. Pertussis is a major cause of death in infants worldwide.

Why is pertussis on the rise? Anti-vaccine beliefs in red states are the chief reason, that is why those states have the most outbreaks, and to a smaller extent the arrival of illegal non-vaccinated immigrants adds to it. The authors also make a note of religious objections but that is a tiny minority. Comparing super-religious Alabama and it's 99%+ vaccination rate to more atheist Washington state shows religion and vaccines are a non-issue today, compared to decades ago when religious fringes were the only anti-vaccine groups.

Nurses should reassure parents that that recommended vaccines are safe, they write. Current diphtheria-tetanus-pertussis vaccines do not contain the mercury-containing preservative thimerosal, which was a hysteria promoted by discredited research Andrew Wakefield in England (where the anti-GMO movement also started). Adverse events occur in only a small fraction of vaccinated children, and most of these are mild local reactions.

Education Is Key to Increasing Pertussis Vaccination

"Practitioners must build a trusting relationship with patients and reinforce the need for vaccinations through face-to-face contact, engaging parents to discuss concerns, and provide evidence-based research to guide recommendations and reassure patients of the safety of vaccines," Peake and McGuire write. Waiting rooms provide a good opportunity to present videos and other educational materials.

The World Health Organization is working to increase the percentage of infants who receive at least three doses of pertussis vaccine to 90 percent or higher, especially in developing countries. The authors discuss some international efforts to fight pertussis and other vaccine-preventable diseases, such as the United Nations Foundation's

Shot@Life campaign.

Closer to home, partnerships should be formed with service organizations, food banks, churches, hospitals and schools. "These groups can help identify those most likely not to be vaccinated and help them find free or low cost immunizations," the authors write. "Faith community nurses are in an ideal role to create and lead these partnerships."

Nurses can also advocate for policies aimed at making universal vaccinations available for adolescents and adults. Peake and McGuire conclude, "By using our resources and uniting, a global battle will be waged and won against pertussis and the children of tomorrow can breathe easier for a lifetime."