The World Health Organization (WHO) released the list of its top ten priorities for 2019. Listed among those priorities is combating what it terms vaccine hesitancy. This is what WHO states:
“Vaccine hesitancy – the reluctance or refusal to vaccinate despite the availability of vaccines – threatens to reverse progress made in tackling vaccine-preventable diseases. Vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved. Measles, for example, has seen a 30% increase in cases globally. The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy. However, some countries that were close to eliminating the disease have seen a resurgence. The reasons why people choose not to vaccinate are complex; a vaccines advisory group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy. Health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions, and they must be supported to provide trusted, credible information on vaccines. In 2019, WHO will ramp up work to eliminate cervical cancer worldwide by increasing coverage of the HPV vaccine, among other interventions. 2019 may also be the year when transmission of wild poliovirus is stopped in Afghanistan and Pakistan. Last year, less than 30 cases were reported in both countries. WHO and partners are committed to supporting these countries to vaccinate every last child to eradicate this crippling disease for good.”
As WHO states, the issue of why people do not vaccinate is complex. In the United States, vaccine-preventable diseases have been greatly reduced in the last few generations through the use of antibiotics, improved medical technology, a better availability of healthcare and, of course, vaccination. This has led to many people not seeing vaccine-preventable diseases as a problem.
Combine this lack of awareness of what vaccine-preventable diseases can do with a barrage of misinformation on vaccines, and you get many parents who are at best “skeptical” of vaccines and at worst outright hostile to anything to do with vaccination. Or you can combine that lack of awareness with a politically-inclined movement that doubts science facts like global climate change, or evolution. Or combine it with social strife, government instability or war.
Again, it’s complex.
Because it is a complex problem, the solutions need might have to be just as complex. The solutions might need to include strong incentives to get parents to choose vaccination, and these incentives could be punitive or rewarding. On the one hand, unvaccinated children (without a reasonable and legitimate exemption) may be ineligible for public education, like California has recently done. On the other hand, parents of vaccinated children might get better health insurance rates or a discount on daycare.
Then there is just simple education and re-education of parents on vaccines. There used to be a time when people did not like to use seat belts in their cars. Children rode in the back, unsecured. Yes, most children survived, but there were still plenty of preventable injuries. After some time, because of education on the benefits of securing children to their seats combined with fines and penalties for not doing so, placing children in car seats is now a common practice in the United States.
Maybe this can be done with vaccines?
So what about the other nine priorities? Well, that’s for another blog post at a later time…