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The news that a 43-year-old air hostess is in a coma after being infected with measles either in New York Israel or on board a flight between the two, should to concern us all.
An illness that we thought was gradually moving towards eradication has come back to life. Isolated epidemics have frustrated public health officials, pediatricians and traditional nurses who have already seen the effectiveness of immunization programs as self-evident. Up to 2019, more than 110,000 cases have been reported worldwide, nearly three times more than at the same time last year.
The World Health Organization noted that "the disease quickly spread among unvaccinated groups of people". He ranked "vaccine reluctance" among the top 10 health threats in the world, raising the danger of misinformation at the same level as the Ebola virus, hospital "superbugs" and air pollution.
Mistrust of vaccination goes against reliable data that shows that it is one of the most cost effective ways of controlling childhood diseases, preventing from 2 to 3 million deaths a year worldwide. Most parents have no experience of the disabling effects that these diseases can cause. Instead, a deluge of misinformation undermines their confidence in the proven benefits of vaccines. Thousands of people now refuse to vaccinate their children for religious, personal or medical reasons, thus dangerously reducing the level of protection of the community.
Anti-vaccination groups have developed effective social media campaigns to spread fear and mistrust of a vaccine within a transnational network. These groups often recruit younger, well-intentioned parents who are not necessarily opposed to vaccines, but who are looking for answers to reasonable questions about immunization schedules, safety and benefits.
Vaccination of children has not yet become a problem in cultural war in the same way as abortion. This must be avoided at all costs before losing any hope of rational discussion. For this to not happen, public health organizations must respond quickly to a well-designed and vaccine-friendly campaign supported by governments.
Until now, the answer was to state goals for disease prevention using phrases such as "herd immunity," a term coined in 1923 to define the percentage of vaccinated individuals required to protect the disease. Whole community (or flock) of an illness.
In the case of highly transmissible diseases such as measles, collective immunity requires a 95% vaccination rate to protect the group. Even in this case, immunity is never complete. Exposure to the virus from outside the flock exposes every non-immune person to a risk, not only of measles itself, but also of complications such as encephalitis – swelling of the brain – and even death.
The flight attendant who is now comatose with encephalitis was under-immunized and had only one dose of MMR vaccine in the child, which, according to US Centers for Disease Control and Prevention, is effective that 93% against measles is 97% effective). Infants too young to have been vaccinated or any child whose immune system is suppressed as a result of cancer treatment or hereditary disease are at greatest risk.
In our efforts to restore broad societal trust in immunization, a good starting point would be to completely remove the term "collective immunity" and promote the idea of community protection. We need to equate immunization with other public services such as police, firefighters and sanitation. Personifying the problem, as the US Forest Service did with the Smokey Bear character, could remind people of their role in protecting their families and their communities.
Rebuilding confidence in vaccines should also include addressing the concerns of vaccine refusers – not alienating or rejecting them. Technology platforms should develop and adhere to guiding principles to eliminate misinformation, as well as badually explicit or violent messages. The medical, scientific and public health communities should engage with one voice in ending vaccine hesitancy if we are to counter the threat of outbreaks of childhood illnesses that are unhelpful. exist more.
The writer is a senior member of the Harvard Kennedy School.
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