Eoin Stynes investigates the impact that anti-vaccination groups are having in the wake of the most recent measles outbreak in Ireland

Since the beginning of 2018, fourteen people have been diagnosed with the measles virus. So far, 13 of the cases have been confirmed in Limerick with a further single case in Dublin.

The outbreak began in early January. The virus was brought into the Limerick area as the initial infected case carried in the virus from the Middle East after they travelled there over the Christmas period. An email sent to doctors on February 9 by the Health Protection Surveillance Centre (HPSC) outlined that “onward transmission occurred in the Limerick area following transportation”.

Dr Rose Fitzgerald, a public health specialist for the HSE, addressed the possible spread of measles throughout the country on RTE’s Morning Ireland: “We know that when we get the introduction of measles infection in a community where there’s low uptake of the MMR vaccine, we will get further cases.” Dr Fitzgerald continued to say that “the only way to stop the outbreak is to have a very high uptake of the MMR vaccine. You need to have herd immunity*, where 95% of the population are immune”.

As it stands, uptake rates hover between 90% and 94%, leaving the country short of the 95% vaccination rate that is required by the World Health Organisation [WHO] to gain herd immunity against the measles virus, leaving many of the most vulnerable at risk to contracting the virus if they come in contact with someone who is infected.

And this brings us to our main story. Vaccinations.

Other than providing clean water, there has been no other development in science or medicine that has made more of a positive impact on the health of humankind than vaccines. Vaccines have helped to wipe out illnesses such as smallpox and polio, saving millions upon millions of lives while doing so. Still, to many from the White House to our own Dáil, scepticism still surrounds the use and effectiveness of vaccines.

The MMR [measles, mumps and rubella] vaccine’s effectiveness was most prominently brought in to question in a – now redacted – study published in The Lancet, a British peer-reviewed medical journal, in 1998. The study was undertaken by Andrew Wakefield which linked the MMR vaccine as a causing factor in autism in young children. Wakefield was struck off the British medical register in 2010, after their study was scrutinised, for his “irresponsible and misleading reporting of findings potentially having such major implications for public health” according to the General Medical Council.

In the ensuing vaccine panic, medical professionals scrambled to discredit the study. It took twelve years for the paper to be redacted and for the doctor to be sanctioned for their study that – as Fiona Godlee, Editor in Chief of the BMJ put it – was “a deliberate fraud” and was riddled with “clear evidence of falsification of data”.

Vaccination rates fell in Britain to below 80% and still haven’t recovered to the recommended levels to ensure herd immunity. According to The BMJ [British Medical Journal]: “An outbreak in a school in Essen, Germany, attended by children whose parents were opposed to vaccinations. Of the 71 children infected with mumps, 68 had not been immunised”. We would be remiss to think that this couldn’t happen in Ireland.

Ireland is already in the midst of its own battle against anti-vaccine campaigners in relation to the HPV vaccine. HPV vaccines are vaccines that prevent infections by the human papillomavirus and according to the Irish Cancer Society: “For women, ongoing HPV infections can cause abnormal changes in the lining of the cervix. These changes, if left untreated, can lead to cervical cancer.”

In opposition to the the HPV vaccine are Regret, a “support group set up by parents of Irish teenage girls who have developed serious health problems after entering secondary school. These parents are certain that the HPV vaccine [Gardasil] is the cause of their daughters’ otherwise unexplained illness”.

Gardasil was introduced in to Ireland in 2010 and between then and 2015 a reported 590,694 doses of the vaccine have been administered to girls in first- and sixth-year of secondary school. During the same period 948 girls experienced “adverse reactions or events notified in association with the use of HPV vaccines” according to Leo Varadkar in 2016 when he was the Minister for Health.

It is widely reported that uptake rates fell dramatically since the 2014-15 academic year due to these fears.  In that year, 86.9% of girls in their first year of secondary school were fully vaccinated against the virus. A year later the uptake had fallen to 72.3% in the 2015-16 year and fell even further during the 2016-17 academic year when rates plummeted to 51.0%. A far cry from the minimum requirement for herd immunity to protect against the spread of the virus.

 

These are just two cases of many out there that could serve as the precursor to the spread of a virus that we thought we had seen the end of. In recent years Europe has seen a massive increase in cases of measles in Romania. The United States has seen an increase in numbers of people diagnosed with whooping cough. Parts of Africa have just gotten through an ebola outbreak and are now having to face up against cases of plague in Madagascar and cholera in Kenya and Zambia. However, the future does not have to seem so bleak. These are easily preventable diseases with the right care and treatment for the people who need it most. Just remember that magic number: 95%.

*The Centres for Disease Control and Prevention (CDC) defines herd immunity – or community immunity – as “a situation in which a sufficient proportion of a population is immune to an infectious disease [through vaccination and/or prior illness] to make its spread from person to person unlikely. Even individuals not vaccinated [such as newborns and those with chronic illnesses] are offered some protection because the disease has little opportunity to spread within the community”.