05.09.2018 | Brussels Background The comeback of preventable diseases – measles and co on the rise

The latest measles outbreaks as well as alarmingly high numbers of infections with other communicable diseases – all this could have long been a thing of the past. But hesitancy towards vaccination is growing, vaccination rates are dropping significantly across Europe and the anti-vaccination lobby is stronger than ever. Governments across Europe need to reinforce the confidence in long established medical treatments – but how?

The development of modern vaccination is probably one of the biggest benefits for society as it is today. Whereas in the late 17th century, people suffered from smallpox and almost 15 percent of the infected died of it, this illness has almost completely vanished thanks to vaccination. This was also mostly true for other “childhood diseases” such as measles, rubella and mumps. Although a few cases appeared here and there, the number of infections in Europe was very low. Unfortunately, this fact has changed. In 2017, over 14000 people contracted measles, which is three times the infection rate of 2016. Although being one of the regions with a high public health status, Europe is failing to eliminate measles in line with agreed WHO targets. And it’s not only measles. The number of infections with other communicable diseases are on the rise as well.

But what caused this trend? Certainly, one reason is the growing hesitancy in the population to vaccinate their children. This hesitancy is even emphasised by a very aggressive and vocal anti-vaccination lobby. One popular claim is that measles vaccination can cause autism in children – a very old claim without any scientific basis. Another reason for them to condemn vaccination is a strong suspicion against the pharmaceutical industry and politicians. A fact that has worsened in recent years due to social media. Admittedly, another factor that causes existing vaccination schemes to become more fragile are the increasing costs and shortages in vaccine production in Europe. Moreover, the fact that due to vaccination schemes in all European countries, some diseases like polio simply do not exist anymore, which leads to the fact that there is no awareness for the threats of these diseases anymore. However, if the trend continues the European Union polio-free status is at risk according to a recommendation of the Council. 

Most of the Member States of the European Union do have existing strategies and vaccination promoting programmes. And in some Member States, having your children vaccinated is mandatory and to refrain from that can even lead to fines. In Germany, there is no obligation to vaccinate your child but all players involved in the health care system heavily recommend to have your child vaccinated. Every year, the Standing Committee on Vaccination publishes their recommendations which vaccinations infants and adults should have. Moreover, most paediatrics try hard to convince parents of having their children vaccinated. However, parents are free to not vaccinate their child without stating any reasons. In other Member States, like Belgium and France, vaccinations are mandatory. Yet the problem is, that the vaccinations included in the obligations differ broadly in the two neighbouring countries. Whereas in Belgium only the vaccination against polio is mandatory since 1966, France upped its legislation in 2017. As of this year, parents have to vaccinate their children against eleven communicable diseases. 
The thing about communicable diseases is: they don’t stop at borders. The fragmented approach as shown in the example above might have also been a reason for the European Union to take a stand and work on a strategy which aims to harmonise vaccination strategies throughout the European Union. In a Proposal for a Council Recommendation that was published in April 2018 and a Communication that was published the same day, the Commission stresses the need for a more coordinated approach. Furthermore, the Commission believes that the differences in strategies are also contributing to the growing level of vaccine hesitancy. The Recommendation calls on all Member States to work on their existing vaccination schemes, aim for the 95% percentage coverage rate of measles vaccinations and raise awareness and establish trust in the population. Moreover, the Commission together with the Member States plans several Joint Actions. Further to this, a European Vaccination Information System, an information portal as well as the constant monitoring of the vaccination status with the support of the EMA are some of the goals the Commission wants to see realised by 2020. 

The pharmaceutical industry has to contribute as well. Due to a deep-rooted distrust that lead to the current status of vaccine hesitancy, it is also the industry’s turn to work on this misconception. Clear and transparent communication as well as supporting the European Union and its Member States in their awareness campaigns could be the way forward. If we don’t act now, Antimicrobial Resistances won’t be the only threat catapulting us back to the medical middle ages.