A Shot of Truth

The Global Burden of Measles and the Influence of the Anti-Vaccine Movement

Author: Katherine Lesser

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Photo: U.S. Air Force photo/Airman 1st Class Matthew Lotz

Measles, a highly contagious vaccine-preventable disease that was once on a clear path toward global eradication, has made a startling resurgence thanks to growing vaccine hesitancy and the spread of misinformation. In 1998, a now-retracted study published in the English medical journal The Lancet claimed the measles-mumps-rubella (MMR) vaccine was linked to children developing autism spectrum disorder. The study was later withdrawn, and the author has since lost his medical license. The study may have been retracted but the damage was already done, provoking the modern anti-vaccine movement.

Measles had been declared no longer endemic in several countries over the past 20 years, like the U.S. in 2000, and much of the European Region just last year. However, many countries worldwide have seen a decline in vaccine rates, often falling below the 95% “gold-standard” threshold needed to achieve what is referred to as herd immunity. Measles outbreaks are increasingly making headlines: one of the most unsettling in recent memory began in California’s Disneyland in 2014, resulting in 147 cases across multiple U.S. states, with a majority of the documented cases occurring among unvaccinated individuals. Meanwhile, in 2018, Europe has seen a “record high” of measles cases, with more than 41,000 new cases within the first six months of the year alone, mostly in unvaccinated individuals. The emotionally driven and scientifically inaccurate rhetoric surrounding vaccines could result in the continued global burden of a dangerous disease.

The “anti-vaxx” community often has a strong voice in  popular culture, and can also influence public policy, as exhibited by the Italian government’s rollback of mandatory vaccinations in children. This unprecedented turnaround on vaccine policy is fueled by the ongoing mistrust surrounding vaccines that followed the 1998 retracted MMR-autism study. For years, this study was used as the base argument for vaccine deniers, and the study is still cited among the anti-vaccine community as factual despite being debunked. Recently, a 2002 study that heavily cited the aforementioned Lancet article was retracted by the journal Lab Medicine. Both of these articles took over a decade to be disproven and retracted by the respective journals.

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Photo: CDC Global Health

The anti-vaccine movement is harmful because it puts unvaccinated individuals at risk for contracting serious and life-threatening diseases that can be easily prevented. This poses a problem especially for people who are medically unable to receive immunizations, such as those who are immunosuppressed or allergic to vaccine ingredients. The anti-vaccine discourse is also extremely harmful and stigmatising towards people with autism. Sarah Kurchack explains how it perpetuates a narrative that having autism is worse than any other consequence, including death. She argues that every time the scientific community must exert energy to continuously prove that vaccines are safe, it detracts from time and research that should be directed at improving the quality of life of people with autism.

The spread of misinformation is one of the major contributing factors to the increase in the prevalence of vaccine-preventable disease. Heidi J. Larson writes in Nature that the biggest pandemic risk of the future is viral misinformation. She explains that this stream of bad information damages the trust in vaccines and can strain the relationship between families and pediatricians. She proposes that targeted social media, engagement, and creating dialogue is crucial to reducing the spread of misinformation; and increasing immunization rates.

Good and credible vaccine literature is available online but the problem lies with accessibility of information. Peer-reviewed literature is often filled with scientific jargon and may take a lot of time and energy to interpret.  The other problem is that this literature is often locked on journal websites behind an institutional paywall. Meanwhile, many mainstream and non-reputable sites are databases of bad information that are readily accessible. Good scientific literature, in general, should be available and accessible to the public, and shouldn’t require institutional access or a Ph.D. to understand.

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Photo: Centers for Disease Control and Prevention

As public health professionals, we need to be able to use platforms such as social media to properly and accurately distribute information to the general public. The U.S. Centers for Disease Control and Prevention and the World Health Organization’s social media accounts do an excellent job of posting clear and concise infographics and information regarding public health concerns, and it is our duty to share that information and debunk whatever bad information we find with the truth. Furthermore, participating in advocacy or donating to reputable organizations allows for continued vaccination coverage worldwide, thus reducing the burden of vaccine-preventable diseases everywhere. We must do our part to help facilitate the spread of evidence-based information, advocate for causes that help to reduce the global burden of diseases such as measles and combat the stigma and damaging stereotypes propagated by the anti-vaccine community.

 

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