A vaccine in time saves lives

The Minister for Health is correct to fight for childhood immunisation

As a new dad, it’s understandable that vaccines are on Minister for Health Simon Harris’s mind. In recent weeks, he has sought the advice of the Attorney General on the constitutionality of preventing children attending school unless they have completed a course of vaccination, as laid out in the national immunisation programme. And he has labelled hesitancy around vaccinations as “one of the greatest threats to public health”.

The Minister has sought support from opposition parties for a cross-party motion on vaccination which calls on the Oireachtas to reduce vaccine hesitancy, strengthen dialogue with people who have concerns about vaccinations, and establish a vaccine alliance.

“I believe this is an opportune time for the Oireachtas to send out a very clear message about its position on the issue of vaccinations. The motion challenges policy-makers to combat vaccine hesitancy and tackle the myths and misinformation around vaccination and to work with those who have genuine concerns.

“There are parents who have concerns and we want to work with them. However, there are also others who deliberately spread lies and nonsense about vaccinations and we need to call them out too,” the Minister said.

His view is shared by the World Health Organisation (WHO), which has listed “vaccine hesitancy” among 10 global health threats in 2019. The WHO said that vaccination currently prevents up to three million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved.

Outbreaks of vaccine-preventable diseases, such as the ongoing pan-European measles outbreak, indicate failures in healthcare and public health systems. One type of failure occurs when a vaccine offers insufficient protection, for example during the flu season, when the predominant circulating strain hasn’t been matched in the annual vaccine. Another type of failure occurs when a safe and effective vaccine is available in wealthier nations, but is not accessible to eligible patients in less-wealthy nations because it is prohibitively expensive. A third type of failure occurs when parents choose not to immunise their eligible children with recommended vaccines. This particular form of system failure puts each unvaccinated child at risk for vaccine-preventable illness, and also undermines herd immunity.

Vaccine hesitancy is a growing trend whereby parents and guardians either delay or decline to have their children vaccinated according to recommended schedules. It is principally based on parents’ beliefs rather than medical contraindications. But their decisions are amplified because parents who share belief systems about childhood vaccinations tend to congregate socially and residentially, thereby forming clusters of unvaccinated children who are at elevated health risks when exposed to vaccine-preventable diseases.

Vaccine hesitancy flourishes even though it is a proven scientific fact that vaccines are one of the greatest medical innovations, given their ability to save lives. They are responsible for the near eradication of smallpox and polio and a significant reduction in harm caused by many other infectious diseases.

But hesitancy is alive and well in Ireland. A recent global survey revealed Irish people have a lower-than-average belief that vaccines are safe; some 74 per cent of people here express trust in vaccines — less than the global average of 79 per cent.

There are many reasons for vaccine hesitancy. They include religious beliefs, philosophical viewpoints and poor education. Both rural ethnic minorities and wealthy urban residents express concerns regarding vaccine safety. But the phenomenon of false news plays an increasingly important role. Alt-right movements have perfected false news campaigns on social media, and their methods have been taken up by anti-vaccine campaigners worldwide. Vaccines are presently one of the key targets of false news.

One of the key issues for the Attorney General is whether childhood vaccination is a matter of social justice, rather than parental choice. In Australia, some states have mandated vaccination as essential for entry to childcare or kindergarten and the federal government offers financial incentives and withholds certain entitlements from parents who do not vaccinate their children.

Even though vaccination policy is based on sound science, expertise is no longer valued. Acknowledging that the evidence is sometimes conflicting, and openly accepting that absolute certainty is elusive, doesn’t seem to work with many vaccine sceptics. And while most people still support immunisation, a vocal and disruptive group of vaccine sceptics have adopted uncivil tactics, including the use of false news.  At the very least, their actions disrupt healthy, transparent debate.

So the Minister is right to actively fight for childhood immunisation. Let’s hope all TDs and Senators get behind him.