Vaccine Hesitancy

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong.

Heidi J. Larson, Emmanuela Gakidou, and Christopher J.L. Murray have an article in The New England Journal of Medicine titled "The Vaccine-Hesitant Moment."

Although many observers point to the 1998 Lancet article by Wakefield et al. (retracted in 2010) as the source of parental fears that MMR vaccination might cause autism, the search for what could be causing the seeming increase in autism was already brewing. In the United States, however, anxieties were more focused on thimerosal in vaccines as a possible cause of autism.45 The attention to thimerosal emerged in the context of a larger global movement that highlighted concern about mercury in food and drugs and in the environment. In 1999, as part of a review of mercury-related ingredients in all food and drugs, the Food and Drug Administration called for an assessment of thimerosal in childhood vaccines, although the small amount of thimerosal used in vaccines contains only a minute amount of ethylmercury and does not contain any methylmercury (the more dangerous type of mercury), which was the prime focus of the larger review.46 The U.S. Public Health Service and the American Academy of Pediatrics followed with a recommendation to remove thimerosal from childhood vaccines as a precautionary measure.47 Even though the recommendation was precautionary, with no evidence of harm, it reinforced public concern and prompted an initial 38% decrease in the hospitals that offered hepatitis B vaccination with thimerosal-containing vaccines for infants.48

To address the growing concerns, the Institute of Medicine conducted a major review of studies investigating links between vaccines and autism and concluded that neither MMR vaccines (which do not contain thimerosal) nor thimerosal-containing vaccines could cause autism.49 Meanwhile, some attention was shifted to the possibility that the increased number of vaccines given to children could be a cause of autism, a concern that is also not supported by any evidence. Nonetheless, the parental concerns have persisted. One study showed 70 additional MMR vaccine–related injury claims per month in the United States after publication of the report by Wakefield et al.50 Other research pointed to the effect of concern about a link between the MMR vaccine and autism on vaccine hesitancy in Somali immigrant communities in Norway and the United States.51 In 2012, a court ruling in Italy granted compensation for vaccine-related injury on the basis of the report by Wakefield and colleagues, which further amplified public anxiety. Having lost his credentials as a general practitioner in the United Kingdom, Wakefield became an activist, appealing to concerned parents and reinforcing their vaccine anxieties, alongside environmental lawyer turned vaccine critic Robert F. Kennedy, Jr., whose previous work on the toxic effects of mercury in the environment provided fertile ground for his campaign against thimerosal and vaccine safety risks more broadly. The launch of Google in 1998, followed by a cascade of new Internet-based and social media technologies, allowed widespread access to information, as well as misinformation, and fueled the viral spread of questioning about vaccines (Figure 1).52

A study in Italy investigated YouTube video content between 2007 and 2017 that focused on the suspected link between the MMR vaccine and autism.53,54 In addition to an escalation in the amount of negative content over the 10-year study period, partly reflecting the growth of YouTube after its 2005 launch, the study showed that negative videos about the MMR vaccine outnumbered positive ones by a factor of 3, with the negative videos more widely viewed. Another Italian study of vaccine-related content on YouTube had similar findings. A number of studies investigating HPV vaccine content on YouTube also showed that negative videos attracted a larger following than positive ones.55-57

Concern about one vaccine can also prompt questioning and hesitancy regarding other vaccines, such as the reported risks associated with a dengue vaccine (Dengvaxia) in the Philippines that contributed to a drop in measles vaccination58 and an HPV vaccine scare in Denmark that triggered a decline in MMR vaccine uptake. After HPV vaccine uptake declined (from 95% to just over 30%) after negative media reports, two-dose MMR vaccine coverage also dropped, from 86% to 80% among girls and from 85% to 79% among boys.59

Autism, Vaccines, and the Pope

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.  

Antivax sentiment is strong in Italy -- but not the Vatican.

Nicole Winfield reports at AP:

The Vatican is taking Pope Francis’ pro-vaccine stance very seriously: Any Vatican employee who refuses to get a coronavirus shot without a valid medical reason risks being fired.

A Feb. 8 decree signed by the governor of the Vatican city-state says that employees who opt out of vaccination without a proven medical reason could be subject to a sanction up to and including “the interruption of the relationship of employment.”

The directive cited the need to protect Vatican employees in the workplace, as well as guidelines issued by Francis’ advisory COVID-19 commission, which said individuals have a moral responsibility to get vaccinated “given that refusing a vaccine can constitute a risk for others.”

In September, AP reported:

 Pope Francis told a group of children with autism and spectrum disorders Monday that they are beautiful, unique flowers in the eyes of God.

Francis met with members of an Austrian center for autism, Sonnenschein (“Sunshine”), in an audience at the Vatican. He told them that the center’s name evoked a flower-filled lawn in the sun “and the flowers of this house are you!”

Speaking to the children, their parents and caregivers from the center, Francis said: “God created the world with a great variety of flowers of all different colors. Each flower has its unique beauty. And each one of us is beautiful in the eyes of God, who loves us.”

Pope Francis is unusual among pontiffs in having a scientific background. He studied chemistry and worked as a chemist before entering the seminary.

Five Star Fiasco: Italy and Vaccines

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Jason Horowitz at NYT:

Over a decade ago, an activist in Italy’s Five Star Movement wrote to the nascent party’s leaders to tell them that his law firm, after years of seeking “damages from vaccination,” had convinced a judge that a vaccine was a potential source of autism.

“We’re dealing with a historic legal precedent,” he wrote emphatically.

Today that lawyer, Alfonso Bonafede, is the Italian justice minister, and his populist Five Star Movement leads the government.

The Five Star’s long history of sowing doubt about vaccines may have made its job that much harder as it seeks to convince Italians that a mass inoculation program is necessary to beat back a pandemic that has killed nearly two million people worldwide and shuttered entire economies.

Conspiracy Theory Goes International

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.

Stephen Buranyi at The Guardian:

The seemingly disparate groups that attend these protests are part of a shifting coalition of conspiracist and far-right groups. One of the primary organisers of Saturday’s protest is a UK-based anti-5G movement known as Stand Up X (or by the unbeatable acronym “SUX”). According to Hope Not Hate, the group has previously backed smaller protests by a US-linked, QAnon-friendly outfit in Manchester and other UK cities. They say the groups are part of a growing number of conspiracy outfits “willing to sideline differences in belief” in order to collaborate. And previous investigations by journalists in the US have found far-right organisations behind Facebook groups arranging lockdown protests.

All of this is part of a recent blending of multiple strands of conspiratorial thinking and far-right politics. Conspiracies have always had points of overlap, but over the past few years the anti-vax movement has become more pointedly right wing, while mainstream far-right and right-populist parties have become more conspiratorial.

The Italian Five Star Movement and Northern League have recently questioned vaccine effectiveness, as has France’s Front National. In Hungary, Viktor Orbán regularly suggests the Jewish financier George Soros is about to swamp the country with migrants. And Trump this week claimed his opponent Joe Biden was “controlled” by “people that you’ve never heard of. People that are in the dark shadows.”

Italian Official Quits, Cites Government's Anti-Science Stance

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

In 2017 Italy required vaccinations for pre-schoolers. The Five Star Movement, opposed the move, appealing to the belief that vaccines cause autism. The movement is now part of a coalition government.

From AFP:

The president of Italy's national health research organisation on Wednesday January 2nd said he had been driven to resign due the "anti-scientific" policies of the country's populist government including efforts to undermine confidence in vital vaccinations.

Professor Walter Ricciardi of the National Health Institute (ISS) said an aversion to evidence-based policy among the coalition of Italy's far-right League and anti-establishment Five Star Movement (M5S) put public health at risk.

"Representatives of the government have endorsed unscientific or frankly anti-scientific positions on many issues," he said in an interview with the Corriere della Sera daily.

"It's clear that when the deputy prime minister says that he, as a father, believes there are too many obligatory, useless and dangerous vaccines, that's not just unscientific, it's anti-scientific," he said in reference to League head Matteo Salvini.

...
 "And yet these are issues that are decisive for public health," he said. "All this reminds me of Donald Trump's recommendation to the US National Health Institute to no longer use the term 'evidence-based'. "It's an approach taken by populists, who have great difficulty in interacting with science," Ricciardi added.

Antivax Sentiment Spreads Worldwide. And So Does Measles.

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

Angela Giuffrida reports at The Guardian:

Italy’s health minister has sacked the entire board of the Higher HealthCouncil, the country’s most important committee of technical-scientific experts who advise the government on health policy.

In a move on Monday night that shocked Italian scientists, Giulia Grillo, from the Five Star Movement – a vaccine-sceptic party that has supported unproven cures for cancer – said it was “time to give space to the new”.

“We are the #governmentofchange and, as I have already done with the appointments of the various organs and committees of the ministry, I have chosen to open the door to other deserving personalities,” she wrote on Facebook.

The decision will mean the replacement of 30 board members, including the president, Roberta Siliquini, the head of the school of hygiene and preventive medicine at the University of Turin who was nominated in December 2017 by the former health minister Beatrice Lorenzin.

Zachary Young at Politico Europe reports that social media have helped antivax sentiment spread broadly, affecting France.

And if online activity in the U.S. is any indication, some of the vaccine skepticism in Europe could be driven by Russian bots.

In the online war for public opinion on vaccines, the French government is being overwhelmed. According to an October report from the European Commission, only 69.9 percent of French people agree that “vaccines are safe,” placing the country of Louis Pasteur — the 19th century biologist who discovered the principles of vaccination — 26th in the EU28 totem pole, ahead of only Bulgaria and Latvia. When it comes to the seasonal flu vaccine, France ranks last, with 51.8 percent of respondents feeling secure.

Part of the reason that France has fallen so low in EU rankings has to do with anti-vaccination ideas spreading virally on social media, according to health officials and observers of online activity. According to an April report by Printemps Prevention, a preventative health nonprofit, 18 of the 25 most-viewed YouTube vaccines videos in France take a skeptical position. On search engines, the report shows, anti-vaccine queries have increased by 130 percent over five years.
...


Eleven EU member countries currently fall below the relevant threshold for measles, which requires 93-95 percent vaccination rates, and outbreaks have surged on the Continent since 2017. Whereas the once-rampageous disease was “eliminated” from the Americas in 2016, Europe has this year registered some 41,000 measles cases causing 40 deaths, according to the World Health Organization.

Among 27 European countries measured by the OECD, France has the lowest rate of childhood vaccination for the disease.

Marie Werbregue, from central France, became mobilized in the debate after her daughter became autistic, which she attributes to vaccination. Now, she is president of the association “Info Vaccins France” and co-moderates a 10,319-member Facebook group on the subject.

From the World Health Organization:

Reported measles cases spiked in 2017, as multiple countries experienced severe and protracted outbreaks of the disease. This is according to a new report published today by leading health organizations.

Because of gaps in vaccination coverage, measles outbreaks occurred in all regions, while there were an estimated 110 000 deaths related to the disease.

Using updated disease modelling data, the report provides the most comprehensive estimates of measles trends over the last 17 years. It shows that since 2000, over 21 million lives have been saved through measles immunizations. However, reported cases increased by more than 30 percent worldwide from 2016.

The Americas, the Eastern Mediterranean Region, and Europe experienced the greatest upsurges in cases in 2017, with the Western Pacific the only World Health Organization (WHO) region where measles incidence fell.

“The resurgence of measles is of serious concern, with extended outbreaks occurring across regions, and particularly in countries that had achieved, or were close to achieving measles elimination,” said Dr Soumya Swaminathan, Deputy Director General for Programmes at WHO. “Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-, or unimmunized children, we risk losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease.”