Restore public confidence in vaccines

Natural-lifestyle parents in California’s anti-vaccine communities seem to believe that it’s better that their children get childhood diseases than to have toxins put into their bodies by being vaccinated. This reasoning is equivalent to brushing teeth with organic, fluoride-free toothpaste and then developing cavity – except that, unlike cavity, measles is contagious and can kill.

Given that the falling rate of immunization has allowed measles to resurge, after it was declared eliminated 15 years ago, an awareness-raising campaign is in order. It’s good that California is trying to make it harder for parents to opt out of vaccinating children, but that doesn’t diminish the need to address the public’s lack of knowledge, misinformation or distrust.

Vaccine is the greatest public health intervention in history. Before the vaccine was available, nearly everyone in the U.S. got measles and hundreds died from it every year. Globally, vaccine is responsible for cutting in half the mortality rates of children under five since 1990. In 2000, the UN adopted routine measles vaccination coverage as an indicator of progress on slashing child mortality. Between 2000 and 2013, measles vaccination prevented nearly 16 million deaths.

Yet vaccine scare is a global phenomenon. While the first world’s concerns and those of the developing world are different, they share one thing in common: mistrust.

In northwestern Pakistan, where the Taliban declared polio vaccine dangerous to health and against Islam ten years ago, immunization workers have been cast as Western spies trying to sterilize Muslims. The CIA’s fake vaccination campaign during the search of Osama bin Laden fueled the suspicions. Last year, during the worst polio outbreak in more than a decade, 40,000 parents in the most affected areas refused to vaccinate their children.

In 2003, Muslim clerics in northern Nigeria boycotted polio vaccination, which resulted in twice as many children becoming disabled the following year. Suspicion of vaccines contributed to 4,000 cases of measles outbreak in just three weeks in early 2013.

The U.K. saw bouts of measles outbreak in affluent areas of London in 2001, after misguided concerns led to a sharp drop in measles, mumps and rubella vaccination coverage. In Ukraine, the death of a boy resulted in the suspension of a measles and rubella vaccination campaign in 2008, even though it had nothing to do with the vaccine.

Bel Air parents who worry about toxins need to realize that we live in a world where sterilized environment doesn’t exist. Even if they never left their gated communities, they aren’t safe from infectious diseases because the world is so interconnected now. With the rise of air travel and international trade, no one is safe from infectious diseases unless they are globally eliminated. If they believe measles – which killed 146,000 people worldwide in 2013 – is a thing of the past, then maybe only a massive, terrifying epidemic at home can shake them from their delusion.

Still, their paranoia is not without reason. It’s understandable that negative aspects of vaccine would draw more attention than the positives. As The New York Times pointed out, scientists and health officials failed to communicate to the public the safety and efficiency of measles vaccination to counter the anti-vaccine argument.

Not everyone who doesn’t vaccinate their children is an anti-vaccine ideologue. Rather they are looking for some clarity. Concerns about vaccines go beyond safety to conflicting policies and new research findings, among others, as London researcher Heidi Larson and her colleagues explained – multiple factors come together to feed public anxiety, including mistrust of the pharmaceutical industry and public institutions, political beliefs and the constant barrage of information on the Internet. Health experts and policymakers need to understand these mechanisms and respond openly to these broader questions, because the overwhelming evidence-based case for vaccination is still no match for the skeptics’ personal narratives.

Any health aid worker in developing country can testify that raising awareness is vital for running a successful immunization campaign. Ideally, they try to understand the local culture, build trust and educate people. It’s what religious leaders did in Pakistan to dispel misinformation about polio vaccine. They teamed up with health workers and went door-to-door, resolving over 8,000 cases of vaccine refusal at one point. Aid agencies, too, continue to pound out communications strategies to inform and gain trust from the public.

This is a good lesson for health officials. They should start reaching out now, before this logic-defying movement turns into another climate change debate.

It behooves us to remember that having the option to get vaccination is a privilege. Measles is one of the leading killers of children around the world for whom safe and effective vaccines are still out of reach.

© Katrin Park and Ex Nemo, 2015. Unauthorized use or duplication of this material without express and written permission from this blog’s author is strictly prohibited.

(Photo credit: Marco Verch via Creative Commons)