ONLINE POST, commissioned | AMP Student 2016;2
Opposed to what is currently believed, anti-vaccination movements began long ago in the 19th Century, being their foundation strongly related to the first vaccination policies.
Vaccination began in 1796 with Edward Jenner’s experiments. Although Jenner did not discover vaccination, he was the first person to confer scientific status on the procedure. However, vaccination was not accessible to all people by this time. Only in 1840, when the first Vaccination Act was published, were set up the first public vaccination services. In 1853, a new Vaccination Act was released making vaccination compulsory for all infants and settling some punishments for defaulting parents. For some, these commitments meant a threat to personal liberty and choice and so anti-vaccination movements contesting the sanctions predicted for conscientious objectors began. These movements continued to grow around Europe and in 1885 a royal commission was convened to inquire and report the consistency of anti-vaccinationists’ objections and the usefulness and safety of vaccination. In its final report in 1896, the commission demonstrated the efficacy of vaccination but recommended the abolition of cumulative penalties due to non-compliance with these laws[2,3].
More recently in 1998, Andrew Wakefield and 12 of his colleagues published a case series in The Lancet suggesting a connection between the administration of MMR vaccine and the occurrence of autism and some forms of colitis. However, immediately afterwards, epidemiological studies were conducted refuting the proposed link and 10 of the 12 co-authors of the paper retracted their interpretation of the original data. Moreover, it was also soon unveiled that Wakefield had failed to disclose a major conflict of interest – he was receiving a remuneration of 81 800 euros by lawyers who had been engaged in lawsuits against vaccine-producing companies. The Lancet completely retracted Wakefield’s paper in February 2010, and he was guilty of serious ethical violations, scientific misrepresentation and deliberate fraud, being restricted from practising medicine in the UK[3,4].
As seen, anti-vaccination has been a highly discussed topic throughout times. However, its impact on society has exponentially grown due to current improvements on information sharing, particularly on social media, that allows the dissemination of anti-vaccine ideals, most of them being parents’ reports of what they believed to be a vaccine reaction[3,5]. Nonetheless, through a brief review of published medical literature on the subject, not even a single reference is seen arguing in favour of anti-vaccination, proving how these arguments lack scientific support.
Despite major improvements on information sharing, the arguing basis of these groups has remained nearly unchanged. Some of the most common objections that anti-vaccine advocates express and their counterarguments may be seen below.
Regardless of being discredited in medical literature, anti-vaccination movements have been showing a significant impact on vaccination intentions, as seen in one study where beliefs in anti-vaccine conspiracy theories were demonstrated to be associated with reduced vaccination intentions. Other study also provided strong evidence of a causal relationship between movements against whole-cell pertussis vaccine and pertussis epidemics by comparing two groups of countries with different attitudes towards pertussis-vaccination.
In Portugal, as far as I am aware, no data regarding the impact of anti-vaccination movements on vaccine preventable diseases in Portuguese population has been published.
Thus, vaccination conspirancy theories have led to the introduction of a new concept of “vaccine hesitancy” defined by WHO as a “delay in acceptance or refusal of vaccines despite availability of vaccination services, including factors such as complacency, convenience and confidence”. This reluctance to vaccinate is mining the proven benefits of vaccination on society’s health, being health care workers and medical students’ responsability to spread scientific based information, in order to facilitate decision-making experience in the context of overwhelming and contradictory vaccine information.
More useful information: http://www.cdc.gov/vaccines/hcp/vis/current-vis.html
1. Riedel S. Edward Jenner and the history of smallpox and vaccination. Proc (Bayl Univ Med Cent). 2005;18:21-25.
2. Wolf RM, Sharp LK. Anti-Vaccinationists past and present. BMJ. 2002;325:430-432.
3. Tafuri S, Gallone MS, Cappelli MG, Martinelli D, Prato R, Germinario C. Addressing the anti-vaccination movement and the role of HCWs. Vaccine. 2014; 32:4860–4865.
4. Rao TSS, Andrade C. The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Indian J Psychiatry. 2011; 53:95–96.
5. Shelby A, Ernst K. How providers and parents can utilize storytelling to combat anti-vaccine misinformation. Hum Vaccin Immunother. 2013. 9:1795-1801.
6. Bedford H, Elliman D. Concerns about immunization. BMJ. 2000;320:240–243.
7. Jolley D, Douglas KM. The Effects of Anti-Vaccine Conspiracy Theories on Vaccination Intentions. PLoS One. 2014; 9.
8. Gangarosa EJ, Galazka AM, Wolfe CR, Phillips LM, Gangarosa RE, Miller E, et al. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet. 1998; 351:356-361.
9. Who.int. Immunization, Vaccines and Biologicals: Addressing Vaccine Hesitancy; 2015. http://www.who.int/immunization/programmes_systems/vaccine_hesitancy/en/ [accessed 11/02/2016].