Vaccine uptake is critical for public health
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When I read the 1998 study falsely claiming there was a link between the measles, mumps and rubella (MMR) vaccine and autism, I was shocked. Shocked by how bad the paper was, shocked that it was published in a high-status journal and shocked that journalists reported it so uncritically. And back then, I didn’t even know the study was fraudulent.
Nearly three decades later, the consequences of those bad decisions by doctors and journalists are still reverberating around the world. Due to low vaccination rates driven at least in part by the anti-vax movement, fuelled by that fraudulent paper, six countries have lost their measles-free status, according to the World Health Organization (WHO), including the UK (for the second time), Spain and Austria. Meanwhile, the US is battling its worst outbreak in many decades, and would have lost its own measles-free status soon, had it not withdrawn from the WHO.
Measles is one of the most contagious viruses on the planet. It causes severe complications in around 1 in 5 children, including breathing difficulties, deafness, blindness and brain swelling that can lead to permanent brain damage. Globally, measles killed about 95,000 people in 2024.
It also kills off some of the immune cells that protect us against other infections, lowering people’s immunity for around five years, so its true toll is even higher. Measles is absolutely not an infection that you want to take chances with.
Luckily for us, measles has a weakness: the virus first infects immune cells and travels to the lymph nodes, before spreading more widely around the body. This convoluted route means there are far more opportunities for our immune system to intercept it before people become infectious than with respiratory viruses that mainly infect the cells lining our noses and throats.
This is why the measles component of the MMR vaccine is so effective. It is also clear beyond any doubt that children are much better off being vaccinated than not, and that there is no link with autism. Numerous studies show this, but the one I personally found most convincing is the fact that when the MMR vaccine was withdrawn in Japan, it made no difference at all to the incidence of autism.
But because the measles virus is so contagious, at least 95 per cent of children have to be vaccinated to ensure each infected person will infect fewer than one other person on average, meaning the virus can’t spread. Put another way, if only a small proportion of parents fail to vaccinate their children, measles can make a comeback.
Globally, the picture isn’t too bad – but it could be better. The proportion of children getting a first dose of a measles vaccine rose from 71 per cent in 2000 to 84 per cent in 2010. It then levelled out and dropped a bit during the covid-19 pandemic, but has since recovered. The WHO estimates that between 2000 and 2024, 60 million deaths globally were averted by measles vaccination – a huge triumph.
But in rich countries, we are going backwards. After the false claims made in 1998, MMR uptake levels fell to as low as 80 per cent in England and Wales. By 2013, uptake was back above 90 per cent, but it has been slowly falling ever since. According to a report last year, this latest decline in the UK is due in part to it becoming harder for parents to get their children vaccinated – an issue that needs to be urgently addressed.
But the resurgence of the anti-vaxxers in many countries is definitely part of the problem, with the issue now closely linked to right-wing extremism and promoted on certain social media platforms. I did a quick search for “mmr measles” on Bluesky, and didn’t spot a single anti-vax post in the top results. When I repeated this search on X, many of the results were ludicrous anti-vax nonsense.
When the billionaire owners of social media platforms are in cahoots with the habitual liar who leads the richest country in the world, and who has made an anti-vaxxer health secretary, it is hard to know how to combat all this disinformation.
What’s clear is that this goes way beyond vaccines, with climate science being another crucial area where the lies can crowd out the truth. Governments in Europe and beyond need to get a lot more serious about controlling the infosphere and finding ways to promote sound science and silence the charlatans. No less than the future of humanity is at stake.
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