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COLUMNS
The long-suffering challenge of vaccination
Most individuals of education and science know how important vaccination is to public health, yet it has seen, and still sees, many challenges. Pearly Neo takes a closer look.

In the 2016 to 2017 period, healthcare-covering media all around the world would have noticed periodical spikes in vaccination-related news, a large amount of which was either negative or tragic. From a presidential candidate openly exhibiting full support for the anti-vaccination movement1 to healthcare professionals going against their own medical code of conduct to promote2 or even assist3 patients in not being vaccinated, despite concrete evidence,4 countless anecdotes5 and news results showing that this can be potentially fatal.6 There is even a fancy hashtag - #antivaxx – that denotes the modern anti-vaccination movement on social media.

The anti-vaccination message is not new – indeed, it has been ongoing for many years, and though its origin can be traced to several possible sources, one very definite culprit is currently-discredited researcher Andrew Wakefield, who published a controversial (now debunked) paper in The Lancet back in 1998 detailing how the measles, mumps and rubella (MMR) vaccine showed a conclusive link to autism in children, igniting both horror and fury in parents across the globe. Although the paper was later revealed to have only contained 12 test subjects, and Wakefield was found to have paid many of the test subjects to donate blood for experimentation, as well as subsequently stripped of his medical license, the damage he caused became deeply-rooted and lingers on till this day. Even though many studies since then have repeatedly found no link between vaccines and autism, and a 2011 in-depth study reinforced these findings, the anti-vaccination movement is still going strong, and only science and education will be able to overthrow this in time.

Vaccination and herd immunity

Despite this challenge, healthcare professionals everywhere continue to tirelessly fight for vaccination for one simple reason – no better alternative currently exists to protect us against infectious diseases. Vaccination is essentially the introduction of immunity to the human body via an artificial process, by prepping the immune system for an infectious disease attack long before the actual infection arrives, thus ensuring that the body is equipped with the required antibodies and factors required to fight off the infection if ever the time comes. Typically administered via hypodermic injection, vaccination has worked wonders in controlling infectious diseases like polio, cholera and typhoid, and the World Health Organisation announced that it even successfully eradicated smallpox back in 1980.7

Even more important than this, is vaccination’s crucial role in providing herd immunity. Herd immunity is defined as a form of immunity that occurs when a significant proportion of a population (herd) is vaccinated, which then protects those who have yet to be vaccinated or are unable to be vaccinated, e.g. very young children, elderly individuals, patients with compromised immune systems or those who are simply too sick or too weak to accept vaccination. In short, once enough people are vaccinated, the disease will no longer spread, and vulnerable members of the population will be protected.8 The proportion of a population that needs to be vaccinated in order to achieve herd immunity varies according to the type of disease. Herd immunity is not permanent, given that new-borns are constantly entering the equation, and international travel is more common, enabling the possible transport of pathogens at different rates, hence if immunisation rates fall, the risk a community faces of an infectious disease outbreak will increase accordingly. This is why the anti-vaccination movement is so damaging to public health.

The consequences can be devastating, because the diseases concerned can have severe outcomes. Measles can cause swelling of the brain, leading to brain damage. Meningitis could cause deafness. Polio could lead to paralysis. Worse yet, children are amongst the groups most vulnerable to these diseases, and there are no treatments or cures for the diseases mentioned above.9 Vaccination and prevention is the only way to stop these, and knowingly choosing not to vaccinate a child against these pathogens increases their chances of contracting these diseases by many times-fold.

Vaccination and its many challenges

As mentioned earlier, one of the main challenges that vaccination faces is its reputation of being associated with autism. This is one of the most long-standing issues public health faces, and sadly, the anti-vaccination movement is strongest in developed countries that choose to believe it despite having access to life-saving knowledge. Other countries are not so lucky, for example many developing countries in Southeast Asia. Here, many infectious diseases are widespread due to a lack of access to vaccination and health services, as well as poor hygiene and other practices. Although similarly due to a lack of education, limited medical services means that this could be fatal.

For example, pandemic influenza (H1N1) was reported by Thailand to have caused the most number of deaths in the country, and India reported the most multidrug-resistant tuberculosis in the region.10 Worse yet, more new diseases are predicted as current microorganisms evolve – and without herd immunity to stop infection, the more hosts are infected, the faster this rate of evolution is likely to occur. Recent research on the commonality of drug resistance by organisms, but the rarity of vaccine resistance11 has shown that due to vaccines’ preventative nature (vs the therapeutic nature of drugs), as well as their tendency to effectively attack multiple targets on a pathogen by inducing the body’s immune system, this basically stops pathogens short before they are able to replicate or evolve, and exhibit just how important it is for biomedical science to explore the limitations and potential of vaccination technology.

Apart from these, religion has also been a major obstacle to vaccination at various points in time, because vaccines tend to contain immunogens from animals, which some consider ‘offensive’. The same has occurred with human rights groups, claiming that government-enforced immunisation is a violation of human rights. Notably, some of vaccination’s greatest enemies have been celebrities with a great deal of influence, for example, actress Jenny McCarthy back in the day, and more recently, make-up mogul and celebrity tattooist Kat Von D.12 All too commonly, the response from ‘anti-vaxxers’ is that this is a ‘personal choice’ – but they are wrong. These decisions affect entire communities and entire nations, especially due to herd immunity, and given that each complication mentioned above has the power to influence many people, especially youths and parents, the risk of immunisation rates dropping is very real, and as aforementioned, once this occurs, herd immunity will follow, and infectious diseases could well re-emerge in societies that were once disease-free. This has already seen some precedence – polio, which was well on its way to eradication in 2012, made a dramatic reappearance in 2013 in war-torn countries like Syria, which had no resources to vaccinate their children,13 and also made a recent reappearance in Papua New Guinea in June 2018 - a chilling occurrence, as polio was declared to be eradicated in the country 18 years ago.14

As such, it is of utmost importance that science and education are properly and thoroughly spread throughout communities, ensuring that the message is spread, that vaccination is key to a healthy society, and that its benefits far outweigh its risks.

References

  1. https://www.washingtonpost.com/national/health-science/trump-energizes-the-anti-vaccine-movement-in-texas/2017/02/20/795bd3ae-ef08-11e6-b4ffac2cf509efe5_story.html?noredirect=on&utm_term=.00b83a0a63c4
  2. https://www.statnews.com/2017/01/07/anti-vaccine-claims-cleveland-clinic/
  3. http://www.abc.net.au/news/2017-08-24/melbourne-doctors-investigated-over-anti-vaccination-allegations/8837554
  4. https://www.medscape.com/viewarticle/878093
  5. https://thescientificparent.org/learning-the-hard-way-my-journey-from-antivaxx-to-science/
  6. https://news.vice.com/article/these-anti-vaccine-parents-found-guilty-in-the-death-of-their-toddler
  7. http://www.who.int/csr/disease/smallpox/en/
  8. https://www.vaccinestoday.eu/stories/what-is-herd-immunity/
  9. https://www.caringforkids.cps.ca/handouts/when-parents-choose-not-to-vaccinate-risks-and-responsibilities
  10. http://www.who.int/bulletin/volumes/88/3/09-065540/en/
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378080/
  12. https://www.bbc.com/news/world-us-canada-44483000
  13. https://www.popsci.com/article/science/reemergence-polio-global-health-risk
  14. https://www.channelnewsasia.com/news/health/polio-returns-to-papua-new-guinea-after-18-years--who-10470802#cxrecs_s

 

 Pearly is an experienced writer and editor with particular interests in the food, travel and biomedical science fields.

 

 

 

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NEWS CRUNCH  
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EDITORS' CHOICE  
COLUMNS  

APBN Editorial Calendar 2018
January:
Obesity / Outlook for 2018
February:
Searching for the fountain of youth
March:
Women in Science - Making a difference
April:
Digestive health in the 21st century - Trust your guts
May:
Dental health - The root to good health
June:
Cancer - Therapies and strategies for better patient outcomes
July:
Water management - Technologies for biotech and pharmaceutical industries
August:
Regenerative technology - Meat of the future
September:
Doctor Robot - The digital healthcare revolution
October:
Bones / Breast cancer
November:
Liver health / Top science research nations & institutions
December:
AIDS / Breakthrough of the year/Emerging trends
Editorial calendar is subjected to changes.
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