A new threat to the health and safety of children has recently begun to take center stage: diseases that were once thought eradicated have reemerged into public consciousness. These diseases have been aided and abetted by the irresponsible and dangerous behavior of people opposed to vaccines, otherwise known as anti-vaxxers.
The WHO lists "vaccine hesitance" as among the top 10 health threats facing the world in 2019. The other top global health threats include: air pollution and climate change; non-communicable diseases such as cancer, heart disease and diabetes; global flu pandemic; antimicrobial resistance; Ebola; weak primary health care; dengue; HIV; and lack of access to basic health care.
The movement against vaccinations has taken hold in a number of countries, including the United States. The percentage of American children aged 19 to 35 months who have not been vaccinated has quadrupled since 2001, according to U.S. Centers for Disease Control and Prevention data. Surprisingly, even the rise in diseases thought eradicated such as measles has not stemmed the anti-vaccination tide. A growing number of people in many U.S. states are anti-vaccination, according to a recent study in the journal PLoS One.
"Since 2009, the number of 'philosophical-belief' vaccine non-medical exemptions has risen in 12 of the 18 states that currently allow this policy: Arkansas, Arizona, Idaho, Maine, Minnesota, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas and Utah," the study authors reported.
Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2 to 3 years and measles caused an estimated 2.6 million deaths each year, according to the WHO. For those who survived measles, serious complications such as brain damage, deafness and pneumonia were a possibility.
Dozens of infants and children in Romania died recently in a major measles outbreak, as celebrities campaigning vocally and publicly against vaccination. Europe as a whole, experienced a 400 percent increase in measles cases from 2016 to 2017.
The picture in the United States is no better. Kansas just experienced its worst outbreak in decades, precipitated by a few unvaccinated families. Just as in Romania, parents in the U.S. are fooled by the false claim that vaccines cause autism. This belief has spread widely across the U.S. and leads to a host of problems.
As recently as two decades ago, measles was considered eliminated in the United States. So why has a disease that was effectively erased from our collective consciousness had a recorded 1,000 cases in the first few months of 2019? This is more than occurred in the ten year period from 2000 to 2010, according to the Centers for Disease Control and Prevention.
An obvious answer is that fewer Americans are receiving vaccines. The number of American children under the age of two who are unvaccinated has quadrupled. Parents are choosing not to vaccinate their children, placing their own children at risk and weakening the overall immunity within the community.
A recent article in The Atlantic suggests a multifaceted problem rooted in social constructs and attitudes: with the foundation of a lack of concern for the overall public good. Coupled with a mistrust of institutions and a short memory for history, the return of diseases such as measles highlights not only a health problem, but a social and civic problem as well.
As writer and philosopher George Santayana has said, "Those who cannot remember the past are condemned to repeat it." This seems to be the case with deadly diseases and vaccines: technology may improve and science may advance, but lessons fade and people have short memories. Declining vaccination rates reflect a lack of historical perspective and reveal an overconfident population inundated with false expertise. When every parent can access a wealth of information through the Internet, every parent can become an expert, even if the information they are accessing is wrong. For a particularly compelling example of this, take the "connection" between autism and vaccines. Although the original report has been proven false many times over, the myth that vaccines cause autism is a persistent presence on the Internet, and the basis of many conspiracy theories involving vaccines.
In addition, distrust of governmental agencies has grown, a trend that has enveloped scientists and researchers under the umbrella of suspicion. A 2014 study found that distrust of government was correlated with distrust of vaccines. The best predictor of someone’s view of vaccines is their trust in government and their openness to conspiracy theories.
Add to this list the growing trend of individualistic parenting, with an emphasis on autonomy and self direction. Autonomy and individualism are not inherently bad, but they do contribute to a social climate that sometimes lacks connection and responsibility. Remember when the entire neighborhood kept an eye on children, and you were just as likely to be yelled at by the neighbor as your own parents if you rode your bike recklessly down the street?
The emphasis on individuality at the expense of the greater good can pose a threat to public health. Considering the risk versus benefit for any one child means the case for vaccinating against measles may not be obvious. Although the vaccine is relatively safe for healthy children, measles isn’t necessarily that dangerous. That is all well and good when your child is healthy. The problem is that for others in society—those with a compromised immune system—measles may be deadly. Protecting this group is neither easy nor straightforward, since they often cannot receive vaccinations at all.
Protection of the most vulnerable in society is obtained through the development of herd immunity--parents vaccinate their own children, thus ensuring that they do not spread the disease, and help develop a collective immunity that protects all. This requires thinking more about the collective and less about the individual, a mentality that is growing rarer.
The implications of this attitude and social paradigm shift are far greater than any one disease. Measles will not be the last challenge of this type we face, and indeed the next one could be far worse. If we are to protect ourselves and our families, we also have to realize we belong to a larger community and invest our efforts in protecting others as well.