The benefit of expanding the use of vaccines worldwide seems like a no-brainer: A cheap and easy way to stop disease dead in its tracks.
Yet polio persists despite a massive global campaign. The crippling disease is back in the Horn of Africa and new violence against vaccinators in Pakistan prompted the World Health Organization to again suspend its polio immunization work there.
The ups and downs of the polio campaign is a cause for concern to those seeking to eradicate this disease. But it isn’t just polio vaccines, or vaccinators, in poor countries that are targeted. There’s a disturbing synchronicity among vaccine opponents – whether it’s the Pakistani Taliban, Nigerian Islamists or Seattle granola heads. Seattle, in addition to being an epicenter for global health, is also known for having the lowest rate of child vaccination for any US city.
Part of the problem may be that a vaccine’s benefit is invisible on the individual level – lack of death and disease. Perhaps another reason vaccines are so frequently targeted for boycotts is the contagion of scientific illiteracy.
For further proof of the damage caused by a decline in vaccine rates, look no further than Great Britain. A fraudulent study published by Dr Andrew Wakefield in 1998 claimed that the measles, mumps and rubella (MMR) vaccine caused autism. It took 12 years for the medical journal The Lancet to retract the paper. Researchers could not replicate the paper’s results and some of the information was faked. Of the 9 children supposedly with autism, it was determined that only one clearly had it and three had no form of autism.
The Lancet distanced itself from the paper as early as 2004, but did not issue the retraction because of the conversation it sparked. Lancet Editor Dr Richard Horton later told NPR in 2010 that he did not consider the wide reach the paper could have due to media reports.
MMR vaccine rates in the UK dropped, reaching lows in 2003-4. A resurgence of vaccines followed to now record levels. However the damage was done.
Measles made a comeback in England and Wales last year. 2,000 cases were recorded in the two countries, the highest number in two decades. As a comparison the United States sees about 60 cases of measles each year. The parts of Wales where vaccine rates dipped below 60% of children under two years old now shoulder the burden of the measles outbreak. Health officials estimate roughly 38,000 children are unvaccinated in Wales, putting them at risk of measles and now the greater population at risk of rubella.
“This is the legacy of the Wakefield scare,” Dr. David Elliman, spokesman for the Royal College of Pediatrics and Child Health, to the AP.
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Pakistan faces similar challenges due to disruptions in vaccine delivery. Rather than feat of autism, it is fear of death by bullet that yet again forced a campaign to stop. A pair of young vaccine workers were shot while distributing polio vaccines in Peshawar. At least one died and the UN again stopped the campaign, having taken similar steps in December following a rise in attacks on polio vaccine workers by the Taliban.
“Operations will remain suspended in Peshawar until the security situation returns to normal,” said WHO spokesperson Maryam Younas.
Meanwhile, Kenya and Somalia are dealing with two cases of polio that caused paralysis. It is concerning because both countries are considered to be polio-free and the cases of paralysis indicate that there may be more infected children in the region. The Kenyan Ministry of Health indicated that it is going to conduct a new round of vaccines that will reach over 500,000 children in the region bordering Somalia. Ensuing rounds will provide coverage to the arid northern half of the country.
Vaccine advocates say that people should stick to the science that shows how vaccines work.
“Where a vaccine already has an established and strong safety record and is saving lives, the onus should be on producing evidence of a genuine risk before there is any change in policy related to its availability,” wrote GAVI alliance CEO Dr Seth Berkley in the New York Times.