Combating Vaccine Phobia

At a time when a huge campaign is on in India to immunise her population from infectious diseases, anti-vaccine sentiment from the US and Europe is spreading worldwide. The reluctance or refusal to vaccinate, termed ‘vaccine hesitancy’, has been listed by World Health Organisation (WHO) as one of top 10 major threats to global public health in 2019. Considering the success of immunisation drives in eliminating scourges like smallpox and polio, it is surprising that phobia of getting vaccinated has taken strong root in some developed countries. Social media is being blamed for such regressive mentality gaining traction, prompting the likes of Facebook and Google to explore measures to block misinformation about vaccines. ‘Anti-vaxxers’ have been pushing personalised ads and messages on social media platforms, exhorting parents to adopt bizarre ‘natural remedies’ against infectious diseases. They seem to have drawn a sizeable following, judging from recent outbreaks of vaccine-preventable diseases like measles in US and Europe. Some researchers have traced the genesis of this ‘vaccine resistance movement’ to a study published in 1998 in Lancet, the prestigious medical journal, which linked vaccination to increasing numbers of autistic children. Though the study was comprehensively discredited in 2010 and subsequent studies showed no link between ‘Thimerosal’, a vaccine preservative, and autism — the damage was done. Years before Donald Trump was to become US President, he ranted against vaccination as “doctor-inflicted autism” by the Obama administration. Anti-vaccine rhetoric remains popular among Trump supporters, and rising number of parents refusing to vaccinate their children has raised an infection scare in American schools. This in turn has spurred public health experts to call for withholding child-care benefits from such parents (as is done in Australia) or to take legal action against them for putting other schoolchildren at risk.

Elsewhere, the debate has been stoked by the shock action of Italy’s right-wing government last year when it removed compulsory vaccination of schoolchildren, arguing that ‘school inclusion’ is hurt by such mandatory provisions; Interior Minister Matteo Salvini publicly termed vaccinations as “useless, if not harmful”. In contrast, a massive exercise is on in India to immunise all children under age 2 years and pregnant women with all available vaccines. Launched in 2014, Mission Indradhanush targeted diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis B, adding in later phases diseases like Japanese encephalitis, Haemophilus influenza, rubella and pneumonia. This was scaled up to Intensified Mission Indradhanush (IMI) in October 2017, with special focus on cities and districts with low immunisation rates. IMI has been included as one of 12 best global practices in a special issue of British Medical Journal (BMJ) recently; it has also been praised in a report by Johns Hopkins Bloomberg School of Public Health, albeit with a caveat that baby girls are missing out more on vaccinations. There have been occasional scares about the safety of some vaccines, that these could play havoc with the child’s immune system. Delhi High Court last month directed the Delhi government to carry out awareness drive on measles-rubella vaccination by listing out both pros and cons, so that parents can give informed consent to their children being vaccinated at school. A whispering campaign in some other States sought to paint this drive as a conspiracy to make Muslim children infertile! Some years back, a controversy erupted over the safety of HPV (human papillomavirus) immunisation tests in States like Andhra Pradesh and Gujarat, but WHO is planning a full-fledged HPV vaccine drive from this year to battle cervical cancer.

Thanks to the smallpox vaccine, India eliminated this mass killer in 1975. The last polio case in the country was recorded in 2011, even as vaccination drives are being carried out to prevent the emergence of new polio strains. India’s immunisation success story has been accompanied by Indian vaccine manufacturers (public and private) getting a strong foothold in the market with affordable prices; a third of the world’s vaccines are now made in India, 60% of vaccines supplied to UNICEF are from this country. Every year 3 million people around the world die of infections that could be prevented by vaccines, estimates WHO. For a community, vaccine phobia can be dangerous — unless all members are not immunised, the pathogen will always find a host and survive. But fake news and rumours about vaccines through social media platforms can derail immunisation, prompting government agencies and public health experts to issue frequent rebuttals. Observers see two negative trends coming together among a section of the people — suspicion about mandatory programmes as means of government control, and growing distrust of scientists and technologists in an increasingly tech-dependent world. The problem is aggravated when lay people trawl the internet to find their own quick-fix solutions, which suspect operators like anti-vaxxers are exploiting. It boils down to a new challenge in developing scientific temper — restore people’s faith in science and teach them to be patient with its method.