Last week we saw how the global drive to eradicate polio has suffered a serious setback due to the politicisation of vaccination efforts and prolonged violence in certain areas of the planet. However, it would be a mistake to assume that this kind of problem only affects poorer societies like Nigeria, Somalia or Syria. In fact, vaccination efforts in the first world have also come under fire.
Until recently, immunisation was not a controversial topic in the West. Vaccination campaigns had led to the eradication of smallpox, a dreadful incurable disease that killed hundreds of thousands every year until the 1970s; why would similar tactics not be employed to fight other afflictions? And yet it now seems that we are fighting our very own vaccination war here in the wealthy West.
The source of the problem
It all began with a charlatan spouting unscientific drivel, and a respected academic journal foolishly believing and publishing it. In 1998, British doctor Andrew Wakefield together with a dozen others authored an article that was published in The Lancet. In it, they linked the widely-used measles, mumps and rubella vaccine (commonly known as ‘MMR’) to autism in small children. Let’s be very clear: Wakefield’s work is utter rubbish and has been discredited time and again, even leading to his barring from practising medicine in the UK. However, once the article was published and its main author got considerable air time, the damage was already done.
Soon enough a handful of B-list celebrities jumped on the Wakefield bandwagon, providing the movement with a real media presence. Wakefield, who was suitably punished for his fraudulent research, became a martyr in the eyes of those who believe that big pharma is out to get us rather than to cure us. In a feature that is very characteristic of modern media, spectacular lies spread fast, but the refutations that discredited such lies did not reach similar audiences. Quite simply, a grandiose conspiracy theory involving pharmaceutical companies will get more likes and retweets than the boring scientific truth.
Measles basically a non-issue since the introduction of a vaccine (Wikimedia Commons)
How do we respond to the thread?
The effects of this new anti-vaccination movement are hard to measure. Most children in the West are still protected against MMR, and this means that those who are not vaccinated can benefit from herd immunity. However, the hard facts show that immunisation rates have reached dangerously low levels, and measles has once again become an endemic disease in the UK. It is easy to say that Andrew Wakefield and his acolytes should be made responsible for this relapse, but it is much more difficult to come up with a solution to it.
Part of the problem has to do with the nature of the diseases involved. Measles, mumps and rubella are generally not as lethal as smallpox or as potentially crippling as polio. Autism, on the other hand, remains a misunderstood disorder that has boomed in recent years. For parents who believe Wakefield’s theories, MMR may not be a big enough concern to make up for the perceived risk of making their children autistic. This particular issue has no simple solution. MMR are not about to become more deadly, and it is unlikely that we will find a single, clear cause for autism in the next two decades.
However, there are strategies that governments may follow to alter the cost-benefit analyses that parents make when considering vaccinations for their children. A simple option that has already been implemented in many societies is to use coercive measures to encourage immunisation. For example, some states in the USA require children in public schools or child care centres to have been vaccinated against certain diseases. However, the problem here is that parents can often be exempt from such requirements for religious or philosophical reasons, which can make such a measure rather pointless.
Another much-debated option is to simply sue parents who refuse to have their children immunised. If an unvaccinated child is found to harbour a vaccine-preventable disease that then spreads to others in his/her environment, the parents could be expected to face the legal and economic consequences. Although this option would provide parents with a good reason to accept vaccinations, it can also be criticised for being much too harsh and contrary to individual liberty.
Sticks and carrots can change the cost-benefit calculation made by the parent of unvaccinated children, but they will not be enough. In the long term, the only strategy that will stop anti-vaccination groups is education. People must be told about the many checks that are in place to ensure that vaccinations are safe and effective. The modern idolisation of everything natural, from food to medicine, must be fought with facts. Only when everyone understands that far-reaching vaccination programmes are necessary in order to keep society healthy will we be able to eradicate today’s diseases. So the next time a parent tells you that their kid is not vaccinated, be sure to tell them that they are not only endangering their child, but also society as a whole.
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