By Alison Campbell 17/01/2019


You read that right. Vaccine hesitancy – “the reluctance or refusal to vaccinate despite the availability of vaccines” – is viewed by the World Health Organisation as one of the top 10 health threats we face in 2019.

And worse, that hesitancy will have an effect on other threats in that top 10 list. Ebola and the potential for an influenza pandemic are also on that list; vaccination is a tool available to address those threats; and yet reluctance or refusal to vaccinate can (and sadly, probably will) reduce the effectiveness of that tool. The WHO has already described the value of vaccination in the fight against Ebola in countries such as the Democratic Republic of Congo. Unfortunately, it’s difficult for health workers to control its spread in this war-torn region – a difficulty made worse by fears about vaccination. As Laurie Garrett reports:

On Jan. 11, for example, villagers in Marabo rose up in protest against the construction of an Ebola treatment center in their community after three high school students were diagnosed and placed in quarantine to stop a local chain of transmission. When international disease fighters tried to vaccinate all of the high school students, rumors spread that the vaccine was dangerous, students fled, and their three infected colleagues were helped to escape quarantine. Such events have been repeated throughout the area since the outbreak began.

The WHO also identified weak primary health care as a threat:

many countries to not have adequate primary health care facilities

And in the event of an outbreak of a vaccine-preventable disease (VPD), there’s the potential for those facilities to be overwhelmed. Since 2017 many countries in Europe have been experiencing a measles outbreak, including countries that had previously either eliminated or at least interrupted such epidemic spread. (Those affected are mainly unvaccinated, both adults and children.) In the first six months of 2018 more than 41,000 measles cases had been reported in EU countries, with 37 deaths and significant numbers of hospitalisations – France reported a hospitalisation rate of 22%.  That’s a big impost on public health services, and we’re talking well-off countries here. The impact on public health systems in poorer countries will be much higher.

As the WHO says, the underlying reasons for vaccine hesitancy are complex: they include complacency, difficulty/inconvenience associated with access, and lack of confidence in the efficacy of vaccines. A lack of confidence that’s been at least partly driven by the activities of anti-vaccine individuals and organisations.

Andrew Wakefield and his ilk have a lot to answer for.

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