Vaccines: Education and access aren’t enough in a skeptical Europe, survey finds

Ukrainian pediatrician Fyodor Lapiy examines a child before administering him a combined vaccine against diphtheria, whopping cough and tetanus in a Children's Hospital. AP 2013

Despite their wealth and superior access to health care, Europeans are the most skeptical about vaccine safety, according to the largest-ever global survey of vaccine confidence, published last week, and overconfidence in their health could be to blame.

Researchers from the London School of Hygiene and Tropical Medicine, Imperial College London and the Saw Swee Hock School of Public Health in Singapore questioned nearly 66,000 people across 67 countries about their attitudes on immunization. The goal was to take the global temperature on vaccine sentiment and identify countries where confidence is low – and vulnerability to outbreaks is high.

Overall, they found that attitudes are positive across the world. But while some of the poorest countries in the world had the most trust in vaccine safety, Europe, which has excellent access to immunizations, was the least confident. France was the world’s most skeptical country, with anti-vaccine sentiment around 41 percent – more than 300 percent higher than the global average (12 percent).

The study did not delve into the reasons for the discrepancies. But the lead author, Heidi Larson, surmised that it could be that the challenges to vaccinating populations in the past have changed.

“What we’ve seen in Europe says loud and clear that this is not about lack of education. This is not about lack of access,” said Larson in an interview with Humanosphere. “I think some of it is a bit of overconfidence. Overconfidence that we’re doing well.”

When people feel that they, their family or their society are doing well, she said, they are more likely to feel that any potential risks associated with vaccines may not be worth taking. There is also a new and sweeping wave of overconfidence in homeopathy and ideas about natural immune function, which are not harmful in themselves but can be devastating if it prevents a parent from immunizing their child from measles or whooping cough.

“There is something there, about human nature, in all of this,” Larson said. “It’s a bit of hubris, to be honest, that we can do OK and not take those little risks any more, not even the smallest risk of a vaccine.”

These risks associated with vaccines are sometimes real – such as the risk of a headache and diarrhea from the flu vaccine – and are sometimes completely false, like the link between childhood vaccines and autism. But presenting health-care workers and patients with accurate information does not seem to be enough.

When weighing the risk between any vaccine-associated risk and the disease itself, like measles, many people turn to outside sources of information to confirm their doubts about the vaccine. The most common outside source has, arguably, been the internet. Humanosphere spoke to Larson in May about the dangers of misinformation on social media networks, which have allowed “anti-vaxxer” groups to organize and spread misconceptions wide and fast.

One step policymakers and health-care workers could take, according to Larson, is to keep track of these misconceptions and provide vaccine-specific information to those who hear them.

Vaccine refusal has been linked to outbreaks of measles, whooping cough and other infectious diseases in the U.S., Europe, Asia, the Pacific and Africa in recent years, and it has also caused serious setbacks to global ambitions to eradicate polio. The researchers behind the study said its insights could help policymakers learn how to tackle such problems.

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com