What’s the worry?
Specifically, some have claimed that the vaccine is linked to:
- complex regional pain syndrome (CRPS)
- postural orthostatic tachycardia syndrome (POTS)
Why the confusion? CRPS and POTS are real but very rare conditions that can affect teenagers. HPV vaccines are given to teenagers, leading some to wonder whether there is a connection. The concerns are understandable but unfounded. There is no causal link between HPV vaccines and the symptoms of CRPS and POTS. Independent experts at the European Medicines Agency looked at the rates of these conditions in teenagers who had had the vaccine. They compared this to teenagers who had not had the vaccine. The rates of POTS and CRPS were the same in both groups.
ECDC data show that up to 80% of teenagers and young adults who contracted measles in 2017 had not been vaccinated.
ECDC analysis of sub-national data indicates that even countries with high overall levels of vaccine coverage may have groups that are unvaccinated. In recent and ongoing measles outbreaks, ECDC’s recent rapid risk assessment identifies healthcare workers as among those affected.
The rise of alternative health practices and a quest for purity can partly explain the falling confidence in vaccines which is driving outbreaks of preventable diseases such as measles, according to Heidi Larson, professor of anthropology, risk and decision medicine at the UK’s London School of Hygiene & Tropical Medicine. She is working to understand the causes of vaccine hesitancy in order to devise ways of rebuilding trust.
Why would people opt out of recommended vaccines?
‘Most people have their recommended vaccines but many do not. In some cases, people are missing out on immunisation because they cannot access vaccines. But there is a growing and concerning trend that shows people with access and education are saying “no thanks”. This is a real challenge because it’s driven by belief and it’s difficult to change people’s minds when they have decided that they don’t want or need a vaccine.’
What’s driving the hesitancy to accept recommended vaccines?
‘Part of the reason is that preventable diseases are less visible – but it’s more than just that. In Europe, we’ve seen a rise in alternative health practices such as naturopathy and homeopathy. This purity sentiment is also seen in anti-GMO and anti-chemical movements. The human race seems to go through waves of moving forward with scientific advances and then coming back to more primal instincts which can include rejecting science and medicine and preferring nature and religion.’
Immunization rates in the Federation of Bosnia and Herzegovina are as low as 40% in some areas and continuing to decline, increasing the risk of large disease outbreaks. But, no one knows precisely why.
Growing vaccine hesitancy, misinformation in social media, lack of trust in the health system, a shortage of health workers and supply issues are all suspected reasons for low coverage rates. However, these are mostly assumptions with little evidence.
"Right now our immunization programming is based on a lot of assumptions," says Dr Sanjin Musa, epidemiologist at the Institute for Public Health in Bosnia and Herzegovina. "We need better data to understand which population groups have the lowest coverage and why it is so low."
Using WHO’s Tailoring Immunization Programme (TIP) – a structured research approach – the country is working to identify populations susceptible to vaccine-preventable diseases, diagnose barriers and motivators to vaccination, and recommend evidence-informed responses to improve coverage.
Vaccines were one of the great inventions of modern history. They helped stop America’s polio epidemic in the 1950s, when it was paralyzing thousands and killing at least 3,000 a year. They have prevented the deaths of millions worldwide from diseases such as diphtheria, smallpox, measles and tetanus.
And yet many people are reluctant to get their shots or vaccinate their children.
A study published Wednesday concludes that using education campaigns, and simply trying to persuade people to get the shots, is far less effective than using indirect behavioral nudges.
When Roald Dahl’s daughter Olivia was seven, she fell ill. He thought she was on the way to recovery and often read to her. “I was sitting on her bed, showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything,” he said. An hour later, she was unconscious. Twelve hours later, she was dead.
Olivia died of a disease that we can now prevent, but which some choose not to: measles. Measles cases are soaring in Europe again; last year, there were more than 21,000 cases and 35 deaths, up from 5,273 cases the year before, a massive increase. The eminently achievable aim has always been to eradicate measles completely because the vaccine is so effective, but take-up of measles immunisation is dropping in many countries.
The rate of vaccination of schoolchildren against meningitis and whooping cough fell in 2016-17, raising concern about weaker public confidence in vaccines.
Children are offered booster vaccinations against meningococcal group C (Men C) disease and against tetanus, low-dose diphtheria and acellular pertussis (TDAP) in the first year of secondary school. In 2016-17, uptake of TDAP fell 3.4 percentage points to 85.8%, while uptake of Men C fell 2.8 points to 83.9%.
Karina Butler, a consultant paediatrician and infectious disease specialist at Crumlin children’s hospital, Dublin, who chairs the National Immunisation Advisory Committee, said: “There is no doubt but that there has been a shaking of public confidence in vaccines ...
Political views and a person’s trust in the government play a role in whether or not they get vaccinated, a study has found.
A person’s ideology directly impacts who they trust, allowing the person to selectively credit information related to vaccine risks and benefits in ways that reflect their ideology, said researchers at the University of Idaho in the US.
An individual with strong conservative political views is less likely to vaccinate than a person with strong liberal political views, according to the study, as is someone who holds lower levels of trust in government medical experts.
Recent World Health Organization (WHO) estimates indicate that 1.5 million children die every year from vaccine preventable diseases (Sage 2014). As a response to this trend, WHO member states adopted the Global Vaccine Action Plan (GVAP) in 2012 to improve the reach and reliability of vaccine delivery. The main goal of the GVAP initiative was to attain a three-dose diphtheria-tetanus-pertussis (DTP) immunization coverage of 90% in all countries and 80% in all districts by 2020. According to Sage (2014), however, this goal is unlikely to be attained due to a number of obstacles including weak immunization demand related to local social-cultural and religious beliefs (as was the case with my friend’s mum), weak leadership, weak management and coordination, and challenging country contexts such as political conflict and epidemics such as the recent Ebola outbreak in West Africa. Addressing such challenges requires joint efforts from individuals, communities, governments, health professionals and civil society organizations (CSOs) (GVAP 2012). Because CSOs are rooted in the communities they serve, they are in a unique position to understand, articulate, and address the challenges facing local communities. As a result, CSOs are increasingly consulted by international organizations to contribute to health system strengthening in developing countries. The Gavi-funded CSO Constituency Platforms Project implemented by Catholic Relief Services in 24 countries (16 of which are in Africa) provides an instructive example. The project aims to facilitate CSO involvement in strengthening immunization systems. The project seeks to harness CSOs’ capacity to integrate into communities and win their trust, and to expand access to immunization services for those in hard-to-reach areas, including displaced persons and nomadic groups.
When it comes to persuading parents in the United States who are hesitant about vaccinating their children, the public health messages often rely on facts and science to explain how immunization not only protects those children but also shields other vulnerable people from dangerous infectious diseases.
But information campaigns that emphasize fairness or preventing harm sometimes backfire and can worsen vaccine hesitancy, research has shown. A study published Monday in Nature Human Behaviour suggests a more effective way to reach vaccine-hesitant parents may be to focus on two potentially powerful moral values that underlie people’s attitudes and judgments: individual liberty and purity.