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Sunday, September 23, 2018

Antivax Impact in Italy

In The Politics of Autism, I look at the discredited notion that vaccines cause autism..

Jason Horowitz at NYT writes about Italy's Five Star Movement.
Its co-founder raised links between vaccines and autism. Its political leader campaigned against a law making vaccines obligatory. Its myriad websites drew traffic with posts by vaccine skeptics, and its party representatives blamed vaccines for tumors and allergies. For one senator, vaccine scars were “branding for beasts.”
On Thursday, as school began this week around Italy, the Five Star Movement and its coalition partner, the League, passed a measure that allows children to stay in school as long as their parents attest that they have been vaccinated, or will be by March. No doctor’s note is required.
[Former health minister Beatrice Lorenzin] attributed the surge of distrust in vaccines to the fact that the diseases had become so rare as to seem unreal, to the debacle of a since-rejected and retracted report in the scientific journal The Lancet linking vaccines to autism, and to what she called “Doctor Google.”

By 2015, coverage had declined to about 85 percent. Cases of measles, which can cause blindness, brain inflammation, pneumonia and in some cases death, have been rising.
Italy’s “No-Vax” movement has risen, too. In Rimini, a hotbed of No-Vax activity and the site of a 2012 ruling by a local judge, later overturned, that linked autism to vaccines, anti-vaccination advocates attached streamers to planes that read, “Everyone to School. Freedom of Choice.”
Mattia Marchi, a spokesman for the Veneto chapter of Corveleva, a No-Vax umbrella group, said parents skeptical of vaccines still had little choice but to vaccinate.

“No one ever said that a vaccine causes autism,” Mr. Marchi said. “But if a thousand people see a U.F.O., do we want to tell these people that they are crazy or do we want to find a solution?”
Beppe Grillo, the co-founder of the Five Star Movement, has raised a link between vaccines and autism, suggested that vaccines weaken the immune systems of healthy children, and claimed that the pharmaceutical industry has pushed them for profit. Members of the party in the European Parliament have proposed eliminating some obligatory vaccinations for some public employees and professed a link between leukemia, tumors, allergies and autism to vaccinations.
At Vox, Julia Belluz cautions that measles outbreaks are not just attributable to the antivax movement alone. 
When describing why measles is spreading, the researchers and public health officials working on the ground in these countries talk about austerity, the economy, and failing public health systems.
  • A new paper in the European Journal of Public Health found that the parts of Italy that cut their public health budgets the most had lower rates of vaccine coverage. “Our analysis suggests that austerity measures adopted in Italy contributed significantly to the resurgence of measles,” the authors wrote. “We estimated that each 1% reduction in real public health expenditure per-capita corresponded to a 0.5 percentage points reduction in MMR coverage.”
In other words, an underfunded public health infrastructure may be more to blame for the uptick in measles than anti-vaxxers. “The [public health spending] cuts were mainly on prevention — like preventive clinics and also staff,” the study’s lead author, Veronica Toffolutti, a health economist at Bocconi University in Milan, told me. “Many people were not hired anymore as staff.” And without staff and services in place to vaccinate people, more people aren’t getting vaccinated, and measles is spreading.