The World Health Organisation (WHO) calls on European policymakers, health care workers and parents to increase vaccination efforts against measles and warns of growing numbers of parents refusing to vaccinate their children. With the now infamous measles outbreak at Disneyland California, it is now clear a growing chorus of parents are questioning the safety and necessity of vaccines.
Recent outbreaks have affected a number of European member states as well, including the Russian Federation, Italy and Germany. From 2013 to 2014 in Europe, outbreaks have accounted for 22 567 cases in 2014, threatening Europe’s goal of eliminating the disease by the end of 2015.
“Speaking as a doctor, I don’t think there’s any question that vaccines have been the most effective of all medical interventions,” says Michael Fitzpatrick, General Practitioner in London and author the book MMR And Autism.
Throughout his career, Fitzpatrick has seen diseases like measles, mumps and rubella—though quite common when he first started—become rare conditions.
“The diseases that vaccines protect against have now become so rare that people under the age of forty have never really seen those conditions. Any sort of memory of how devastating those conditions can be is long gone,” says Fitzpatrick.
And herein lies the problem, as people tend to be more concerned with the possible side effects than they are about the diseases themselves. It comes as no surprise then, that one of the highest selling children’s health books on Amazon is The Vaccine Book, which encourages parents to create alternative vaccine schedules and skip some shots altogether. Are we now seeing the return of the vaccine war?
“Since the invention of the smallpox vaccine by Edward Jenner, there have always been people who are anti-vaccine, and we have to challenge this with public engagement so people are educated about the incredibly rigorous process of vaccine development,” says Professor Helen McShane, a principle investigator at the Jenner Institute, University of Oxford.
Speaking of Research, an advocacy group that provides information on the importance of animal research in science, has previously pointed out the remarkable similarities in the arguments made by animal rights activists and anti-vaccinators. At the heart of it is the premise that animal research produces unsafe medicine. When in reality, animal research is essential for testing the safety and efficacy of vaccines.
“Preclinical animal research is an essential step in vaccine development, both for safety and efficacy. It is not possible to take a new experimental drug or vaccine into human testing without doing safety testing in animals first,” says McShane.
Mcshane and her team are working to find the best vaccine candidate to challenge Tuberculosis (TB)—a disease that poses a serious threat to the health of individuals and public not only in the developing world, but in the European region as well. In her most recent paper, Mcshane reviewed the efficacy in animal models of a vaccine candidate in light of recent human efficacy data and proposed refinements to the preclinical models.
“TB is a hard pathogen to make a vaccine for—it is the same for HIV and malaria—and that’s why there are none that exist. It is critical then that we constantly refine and review the models and the assumptions we make about vaccine selection,” says McShane.
She tells EARA that it is through an iterative loop of refinement that the vaccine development process gradually improves. After human efficacy trials, researchers loop back and look at the assumptions that were made about both the animal model and the early human studies to see if the vaccine were effective. This then allows researchers to refine and improve those models for the next candidate vaccines.
But, many continue to dismiss vaccines as unsafe, even arguing that animals are poor models for human disease.
“The critical point is that there are hundreds of vaccines being developed throughout the world, some of those get to be tested in mice. If they fail at that stage, then they drop of the radar. It isn’t the case that something that wouldn’t work in mice would work in a human. The bar of efficacy gets higher at every stage— if it works on mice then it might be tested on guinea pigs or non-human primates,” Says McShane.
Though there has been wide coverage on the anti-vaccination movement, many of us are left questioning what impact—if any—they could have on society. Nothing, however, answers this question better than the MMR scare.
In 1998, Britain was gripped by Dr Andrew Wakefield claims that there was a link between the MMR jab and autism. As the media uncritically reported the now discredited research, there was a significant drop in vaccination rates. This was followed by increased cases of measles and mumps, which resulted in permanent injuries and deaths.
“The MMR scare showed the importance of challenging junk science when it starts to have a public impact. What was obviously from the beginning a scientifically unsubstantial claim about the link between MMR and autism ended up having a major public impact and that needed to be challenged more forcefully and effectively by scientists and doctors at an early stage. Unfortunately, it was not and it gathered momentum,” says Fitzpatrick.
But, how do we get concerned parents to understand the development process of vaccines and the rigour to which that is done? The key—according to McShane—is public education, she says:
“It is critical that scientists communicate their research in a way that it’s understandable to a lay population. The only way we can improve the scientific debates we have in society is if we as scientists are prepared to openly discuss what we do.”