In August it was reported that the UK, along with four other EU nations, had lost its 'measles-free' status. (1) The government response included calls for social media campaigns to counter the misinformation of so-called 'anti-vaxxers', greater public awareness and vaccine reminder campaigns. At one point, Health Secretary Matt Hancock even suggested mandatory vaccinations. (2)
The US faces a similar challenge to its measles-free status, (3) despite measures such as school registration being dependent on vaccination. In New York, an exemption from compulsory vaccination for religious groups (particularly the Orthodox Jewish community) was withdrawn in June as the state has seen significant decreases in MMR vaccinations and a corresponding upswing in measles cases. The result has been an ongoing confrontation between religious groups and the state government. (4)
Overall confidence in vaccinations in the UK is high and above regional and global averages. (5) A report from the National Audit Office instead places the blame squarely on poor and inconsistent administration of vaccine reminders for pre-school children. It also notes that there are problems with getting reminders to marginalised groups such as travellers. In London, with a large, transient population, uptake is particularly low. (6) Some blame NHS funding cuts for this, and it seems clear that this area of public health needs attention and resourcing. (7)
Vaccines do save lives globally. It is also clear that public trust in vaccinations is diminishing around the world. Some of this is due to misinformation from anti-vaccine campaigners, but the general decline of trust in institutions and science as well as failures of health infrastructure are equally at fault.
Rebuilding trust and truth-telling are going to be vital in reversing these trends, as is investment in health infrastructure. Furthermore, globalisation and the movement of people means that it is in all our interests to invest in good vaccine education worldwide.
This will take time - instant answers, like compulsory vaccinations are a distraction that could backfire badly.
Review by Steve Fouch, CMF Head of Communications