Anti-vaccination: a private choice leading to collective outcomes

A baby gets polio drops in Uganda (UNICEF, 2019)

This article was exclusively written for the Sting by Ms. Maha Mezouar is a 2nd year medical student in Marrakech, Morocco. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect neither IFMSA’s nor The European Sting’s view on the topic.

The Anti-vaccination movement can be considered as old as vaccinations themselves. A substantial amount of vaccine hesitancy has been remarkably spreading throughout the past centuries among individuals in different communities without a truly based information about vaccination’s none efficiency or danger. This phenomenon is considered as one of the consequences of the emergence of a new paradigm of health care where the power has shifted from doctors to patients, the legitimacy of science is questioned, and where expertise is redefined.

The main theoretical structures of anti-vaccination ideology are: vaccines cause idiopathic illness, vaccine immunity is temporary and an alternative healthy lifestyle, personal hygiene and diet stop diseases. These stereotypes make some parents overemphasize the immediate side effects of a vaccine: rash, swelling, or pain. They then justify these side effects as a valid reason to avoid vaccination. This is a much attenuated level of hesitancy but can be a gateway to under-immunization, delays, and further questioning.

Some other common concerns focus on the number of vaccines currently mandated. In particular, the aspects relating to the short interval between doses, simultaneous administration, immune system intolerance, and the proposed fast approval of newer vaccines.

Thus, two studies conducted in La Sierra University, California, identified four Anti-vaccination attitudes: mistrust of vaccine benefit, worries about unforeseen future effects, concerns about commercial profiteering, and preference for natural immunity. These four factors reflect differences in concerns about vaccination and how one’s body might react to substances recommended by health care providers. They might look logically valid from an intellectual perspective; however, they are not supported by medical research, they are mostly a non-evidence-based opinions obtained from internet and TV rather than from health care professionals.

It has also been reported that the negative behavior toward vaccination are clustered by race, education, and socioeconomic backgrounds. Parents with lowest income and education level express greater concern regarding the need for and the unwanted effects of vaccines.

In 2014, a large measles outbreak swept through the Disneyland theme park in California, resulting in an estimated 125 people contracting the disease. Several of the children who initially spread the disease were intentionally left unvaccinated by their parents.

Multiple breakouts of measles, one of the most notable “eliminated” diseases, have occurred in many countries especially in the western world, infecting dozens of patients and even causing deaths.

Undoubtedly, organized anti-vaccination groups have contributed to the drop in vaccination compliance and anxieties concerning vaccination; and doing so they did not only put them at risk, but also made the individuals around them and their communities more exposed to some diseases that can be prevented by vaccination.  For instance, some British parents refused to vaccinate their children in the 1970s and 1980s against pertussis in response to the publication of a report in 1974 that credited 36 negative neurological reactions to the whole-cell pertussis vaccine. This caused a pertussis outbreak in the UK. A few decades after, a study showed that Pertussis incidence was 10 to 100 times lower in countries where high vaccine coverage was maintained than in countries where immunization programs were compromised by anti-vaccine movements. Given the safety and cost-effectiveness of whole-cell pertussis vaccines, far from being obsolete, these vaccines continue to have an important role in global immunization.  In addition to this, the schedule of pediatric vaccines given to a hypothetical cohort of 4 million children born in 2009 will prevent approximately 20 million illnesses and 42 thousand deaths over that cohort’s lifetime.

“We tend to assume that all people need is more information and the data alone will save the day,” Sara Gorman, a public health and behavioral science expert, said during her presentation at TEDMED 2017. This statement urges public health officials and physicians to providing more evidence-based vaccine information and statistics, and to spend more time familiarizing populations with the benefits and risks of immunization, as well as with potentially devastating consequences of the lack of vaccination consent.

There is also a need for educational campaigns to prevent a decrease in the percentage of vaccination and optimally to make it even higher. Owing crucial role of health care professional in enforcing parental vaccination consent, all medical university students should possess adequate knowledge regarding potential benefits and risks of vaccination, to be able to address all parental concerns. However, the efforts to weaken this movement can only be effective by  firstly recognizing its disingenuous claims, evaluating the information and misinformation encountered and then introducing slowly the fact that vaccines and the realization of their compulsory scheduling are highly studied, safe, and purposeful.

About the author             

Maha Mezouar is a 2 nd year medical student in Marrakech, Morocco. She has been a member of IFMSA Morocco since 2017. She likes writing, and so this year she applied to be a publication assistant in her NMO; she writes articles for the website and the annual magazine “I’m SPIRIT”. Along with being a medical student, she spends most of her time doing sensiblization actions in order to raise awareness about public health, human rights and sexual education.