Vaccines: trends, mistrust and consequences

Vaccines have saved tens of millions of lives, but vaccination rates have stagnated in recent years, in part because of misinformation that vaccinations could cause measles, autism, or infertility.

Here are some key facts about vaccinations:

– Tendencies –

Vaccination prevents two to three million deaths each year and could prevent another 1.5 million more if immunization programs are fully implemented.

But vaccination rates have stagnated "dangerously," according to a July report from the World Health Organization (WHO) and UNICEF.

In recent years, 19.8 million children under one year of age have not received the triple core DTP vaccine against tetanus, diphtheria and whooping cough, or have not been protected against measles.

"This means that more than one in ten is not getting all the vaccines it needs," said Kate O. Brien, head of the WHO vaccines department.

Two-thirds of these unvaccinated children live in 10 countries: Angola, Brazil, Ethiopia, India, Indonesia, Nigeria, Pakistan, Philippines, Democratic Republic of Congo (DRC) and Vietnam.

Around the world, vaccination rates with DPT and measles have stagnated since 2010 at around 86%.

For measles, this figure has fallen to 69%, taking into account the booster, which is necessary for a high level of immunity.

Although these figures may seem high, they remain "insufficient" and must reach 95%, warned WHO.

– Consequences –

Measles outbreaks occur around the world in rich and poor countries. More than 360,000 cases have been reported since January, the highest numbers since 2006, the WHO said.

In the first six months of 2019, 90,000 cases were reported in Europe, more than double those of the same period last year.

Based on data from 2018, four European countries have recently lost their "measles-free" status: Albania, Great Britain, the Czech Republic and Greece.

Measles is more contagious than tuberculosis or Ebola, but it is perfectly preventable thanks to a vaccine that costs a penny.

Often benign, it can still cause severe symptoms – fever, rash, cough – as well as blindness and, for pregnant women, miscarriages.

The disease can also be fatal. In 2000, it is estimated that measles killed more than half a million people. In 2016, this figure had fallen to 90,000 but climbed the following year to 110,000.

– Backsliding –

Immunization rates have stagnated for two distinct reasons.

One of them is increasing mistrust – mainly in rich countries – fueled by fear of causing diseases or diseases such as autism. The second is limited access in countries with fragile health systems.

Ironically, France – the home country of Louis Pasteur, the inventor of the vaccine – hosts one of the highest suspicion rates: one in three is not sure whether vaccines work, according to a survey conducted for the Wellcome Trust UK Health Foundation.

Gabon, Togo, Russia and Switzerland are also among the countries with the most doubts about vaccines.

In contrast, almost the entire population of Bangladesh and Rwanda says they trust the effectiveness and safety of vaccines.

"These are areas in which you have more infectious diseases," said Imran Khan, public engagement officer of the Wellcome Trust and lead investigator for the survey.

"Maybe what you see is that people in these countries can see what happens if you do not vaccinate."

– Skepticism –

A large number of "anti-vaxers" cite a 1998 study published by The Lancet, a reputable medical journal, which revealed a causal link between vaccines and autism in children.

When it was revealed that the evidence underlying this claim had been falsified, the study was withdrawn and its author, Andrew Wakefield, excluded from the profession. But the damage was done.

Hostility with regard to vaccination may also have religious roots.

New York State, for example, has recently revoked a school-based exemption of schoolchildren from religious beliefs following measles outbreaks in districts with large Jewish Orthodox communities.

In Afghanistan and Pakistan, some religious leaders said the polio vaccine was part of a plot to sterilize Muslim children. And in the DRC, an audio recording circulated on social networks earlier this year, calling on people to physically attack health workers inoculating against the Ebola virus.

Vaccines are also, to some extent, victims of their own success.

"We no longer see the diseases, we report only possible side effects," said Cornelia Betsch, a researcher at the University of Erfurt in Germany, who has written extensively on vaccine policy.

"This leads us to overestimate the risks of vaccination and to underestimate the risk of disease."