The development of vaccines to combat disabling, deadly diseases have been one the most remarkable achievements of modern medicine and science. Thanks to the advances and the continuous research into preventive immunization, diseases like poliomyelitis, measles, pneumonia, smallpox, rubella, hepatitis and several others have lost, for some, the frightening sound they had in the past. Smallpox has been eradicated thanks to the mass vaccination of the population and the disease, with nowhere to survive, disappeared. With time and worldwide vaccination campaigns, many other will follow suit.
It sounds madness not wanting to protect ourselves and our children against potentially deadly diseases, but even where vaccines are widely available and free , here and there we see a periodical drop in the number of immunisations and a consequential increase in the cases of the relative infections.
In the UK the most recent case was a massive drop in the number of children receiving the MMR jab after 1998, tendency that has since then reverted and it is advancing towards 90% coverage. France, in the same year, saw the Hepatitis B vaccine withdrawn by the government. In 2003 the immunizations against poliomyelitis was boycotted by the Nigerian authorities.
Although seemingly unrelated, these three events share a cause: fear of adverse effects of the vaccine.
The UK case sprung up after a medical researcher, Andrew Wakefield, published a piece of research that connected the MMR vaccine with the insurgence of autism in children. The claims were proven false shortly afterwards and the scientific paper was retracted, but the news had been around for long enough to cause extensive damage to the reputation of the vaccine and to make Wakefield a martyr of the anti MMR campaigners.
In France, the Hepatitis B vaccine had been linked to cases of Multiple Sclerosis, but even in this case the link was coincidental and not causal. The Government suspended the administration of the vaccine temporarily. Even after 10 years, and with the vaccine back on the shelves, the percentage of full immunization (3 doses) was still around 30% only.
In Nigeria, claims that the vaccine was infected with the HIV virus caused public distrust, a drop in vaccinations and a surge in the cases of poliomyelitis, outbreak that affected the surrounding countries as well.
For as harsh as it may seem, deciding not to receive the vaccination can put other people`s life at danger too.
That vaccines are not always 100% safe it is a fact, especially for patients with compromised immune systems, where they can cause complications and in some isolate cases, the disease they are supposed to protect from. But is also true that vaccines are possibly the best regulated and monitored area of public health. Research to check and improve their safety and efficacy is constantly undergoing, and the side effects or adverse reactions closely looked at, ready to take the most opportune action. The oral poliomyelitis vaccine that caused the disease in a few infants has been substituted by a different formulation using the inactivated virus for increased safety. And when these ameliorations happen, often they are not communicated to the public but just a few health professionals.
But it is the health of children we are talking about, and the publication and display of hard scientific data will not be enough to rebuild their parents` confidence.
The key to win the public trust and to reinstate confidence are transparency, honesty and openness about the research, the production, the risks and benefits of vaccines.
The first point of contact of parents with the immunization process are nurses and GPs, and it is in these categories that is ever more important to make sure the risks and benefits of vaccines are clear, of what is scientifically proven and what is just unfounded rumors. Let`s not forget they are likely to be parents themselves.
Other useful actions are information campaigns and encounters with opposing groups to hear their concerns and to reply with facts. Limiting the action to ignore or criticise their views will just strengthen the doubt that something is being hidden to the public. Useful would be to reach out for parents and be the first to ask what is scaring them and reply to their questions, honestly, and presenting the facts as they are.
Defeating some of the most fearful diseases is possible and we do have the weapons to fight them.
A few references
The Lancet, Early Online Publication, 9 June 2011
doi:10.1016/S0140-6736(11)60678-8Cite or Link Using DOI
Addressing the vaccine confidence gap
Dr Heidi J Larson PhD a Corresponding AuthorEmail Address, Prof Louis Z Cooper MD b, Juhani Eskola MD c, Prof Samuel L Katz MD d, Scott Ratzan MD e f
Nature 473, 436-438 (2011) | doi:10.1038/473436a
Vaccines: The real issues in vaccine safety