Twenty years after the disgraced British surgeon Andrew Wakefield published his now infamous research paper falsely claiming a link between the measles-mumps-rubella (MMR) vaccine and autism, his deadly legacy continues.
Despite the fact that his findings were found to be fraudulent, that the paper was later retracted and that Wakefield was struck-off the medical register for dishonesty, the damage was done.
Public confidence in MMR and vaccination has never fully recovered, at least not in developed countries. This was made evident by last week’s news that the number of measles cases in Europe increased by 400% in 2017, with more than 20,000 cases and 35 needless deaths.
When the individual stops acting in the best interests of society, the state has to step in
But Wakefield was tapping into fears that have been around since the invention of vaccines. He wasn’t the first and he won’t be the last.
The problem is our readiness to fear vaccines. As medical interventions go, they are somewhat unique.
Apart from the occasional travel jab, the decision to take a vaccine is usually made by parents for their own children.
In addition to this they are also given to healthy individuals. When they are successful, and the disease disappears, these two factors shift the focus of fear away from the disease being prevented and towards the intervention itself.
Then there is herd immunity. In a country where coverage of a vaccine is below the level required to provide herd immunity, the focus is on protecting the individual – your child.
We see this in countries all across the world, where parents are willing to line up patiently for hours to vaccinate their child because they still see the horrific effects of these diseases.
That is why, thankfully, measles cases in developing countries have plummeted. But where coverage is high enough to create herd immunity, the risk of catching that disease falls dramatically.
Only a small number of people, who are too sick or have weakened immune systems preventing them from receiving vaccinations, are left at risk.
Apart from the occasional travel jab, the decision to take a vaccine is usually made by parents for their own children
Suddenly vaccination becomes not about protecting the ones you love, but about protecting others, which parents may be less willing to do, especially if someone in a white coat casts doubt about the safety of that jab. That is how Wakefield’s scare story was able to spread so quickly and retain its power.
The problem is that when enough people feel this way the herd is no longer protected and the disease returns, as we have seen in Italy, Romania, Germany and some parts of the UK.
This may go some way to explain why so many developed countries are now introducing legislation to require parents to vaccinate their children.
When the individual stops acting in the best interests of society, sadly, the state has to step in.
Dr Seth Berkley is chief executive of Gavi, the Vaccine Alliance