Vaccine concern, not just a shot in the dark

In a recent debate, US Presidential aspirant Donald Trump raised the hackles of the scientific community by linking vaccines to autism.

Trump’s done this before. And his opinion on vaccines was trounced by the scientific community who warned that such disinformation would have damaging consequences. Consequences like people choosing to not vaccinate their children, leading to a dangerous public health situation that would fan the spread of infectious diseases.

In fact, this debate comes even as the US was recovering from one of its worst measles outbreaks witnessed at the Disneyland theme park, California. Over 50 people were infected with measles. And according to the US Centres for Disease Control and Prevention, the outbreak was possibly caused by a traveller who may have been infected overseas and visited the park while still infectious. People are protected against measles by the MMR (measles, mumps, and rubella) vaccine, but the disease spread from the amusement park was largely in the unvaccinated population.

Back in India, still glowing from the accolades of being officially declared polio-free, are there lessons to be learnt from this high-profile vaccine related debate in the US?

“A key learning from the US experience is to get the messaging right on vaccines and increase awareness around it,” says Raj Shankar Ghosh, Deputy Director (vaccines delivery) with the Bill & Melinda Gates Foundation in India.

“The fact that small pox and polio have been eradicated in the country is proof enough that vaccines are good,” says Ghosh, whose organization supports international vaccination campaigns.

“But studies reveal that two key features affect immunisation: the fear of adverse events (or side-effects, in common parlance) and the lack of awareness (when and where to take the child for routine immunisation),” he says.

“As the Indian government increases the number of vaccines in the immunisation programme, it is also focusing on strengthening cold chain and storage facilities to reduce adverse events and the fear it triggers,” explains Ghosh.

In fact, there is no room for complacency on vaccination, say experts, since the global landscape holds multiple challenges. Though India is polio-free, for instance, its vigil needs to continue as neighbouring Pakistan still has to achieve that status. Vaccination goes off-track in strife and war-torn regions as Governments there find it difficult to rollout a scheduled programme. Vaccination also get disrupted by religious considerations in different regions. A backlash against cervical cancer vaccines had hit the headlines in India following lapses when the HPV vaccine was tested on young girls in Andhra Pradesh and Gujarat.

Paediatrician Jacob Puliyel agrees that “basic vaccines do a fantastic job in controlling bad diseases.” “The concern is when vaccines are introduced that may not be required in the local population,” he adds. 

Ghosh allays fears that children are becoming pin-cushions, subjected to one too many vaccines. “The best way to judge this is by defining the public health goals of the country and map it against the vaccines introduced,” he explains.

“India is far from a vaccine overuse situation,” he says. Underlining the importance in building herd (or community) immunity, he adds, “no child is protected unless a there is high coverage in society.”

As the scientific community brainstorms on vaccines, its use and abuse, the Government has its task cut out. It needs to ensure that parents get the right information on vaccines and support in case of side-effects. Else, even a baseless fear can topple a public health initiative, and with damaging consequences. 

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