People in rich nations have least trust in vaccines

LONDON, 19 June 2019: 

Trust in vaccines – one of the world’s most effective and widely-used medical products – is highest in poorer countries but weaker in wealthier ones where scepticism has allowed outbreaks of diseases such as measles to persist, a global study found.

France has the least confidence of any country in the world in the safety and effectiveness of vaccines, with a third believing vaccines are unsafe, according to the study published today.

While most parents do choose to vaccinate their children, varying levels of confidence expose vulnerabilities in some countries to potential disease outbreaks, the study’s authors said, recommending that scientists need to ensure people have access to robust information from those they trust.

Public health experts and the World Health Organisation (WHO) say vaccines save up to 3 million lives every year worldwide, and decades of research evidence consistently shows they are safe and effective.

But to achieve “herd immunity” to protect whole populations, immunisation coverage rates must generally be above 90% or 95%, and vaccine mistrust can quickly reduce that protection.

“Over the last century, vaccines have made many devastating infectious diseases a distant memory,” said Charlie Weller, head of vaccines at the Wellcome Trust health charity, which co-led the Wellcome Global Monitor study.

“It is reassuring that almost all parents worldwide are vaccinating their children. However, there are pockets of lower confidence in vaccines across the world.”

The spread of measles, including in major outbreaks in the US, the Philippines and Ukraine, is just one of the health risks linked to lower confidence in vaccines.

In Afghanistan and Pakistan, false rumours about polio vaccines being part of a Western plot have in recent years hampered global efforts to wipe out the crippling disease.

The study, led by Wellcome and polling company Gallup, covered 140,000 people from more than 140 countries.

It found 6% of parents worldwide – equivalent to 188 million – say their children are unvaccinated. The highest totals were in China at 9%, Austria at 8% and Japan at 7%.

The study also found three-quarters of the world’s people trust doctors and nurses more than anyone else for health advice, and that in most parts of the world, more education and greater trust in health systems, governments and scientists is a also sign of higher vaccine confidence.

In some high-income regions, however, confidence is weaker. Only 72% of people in North America and 73% in Northern Europe agree that vaccines are safe. In Eastern Europe it is just 50%.

Heidi Larson, director of the vaccine confidence project at the London School of Hygiene and Tropical Medicine, worked with researchers on this study. She said it “exposes the paradox of Europe” which, despite being a region with among the highest income and education levels, also has the world’s highest levels of vaccine scepticism.

In poorer regions, trust levels tend to be much higher, with 95% in South Asia and 92% in Eastern Africa feeling confident that vaccines are safe and effective.

For Marie-Claire Grime, who works in a pharmacy northeast of Paris, questions about vaccines are a daily challenge. They come mainly from parents who say they’re worried about “a lot of chemicals” being put into their children, she says.

She does her best to allay such fears. “We spend time deconstructing the myths. We try hard to convince them of the huge advantages vaccination brings,” Grime said at her shop in the town of Bobigny. “It is sometimes discouraging to find ourselves repeating the same things all over again.”

The study found one in three French people think vaccines are unsafe – the highest rate in the world – and almost 20% believe they are not effective.

Researchers say the picture in France is the result of factors that have undermined public confidence – not only in vaccines, but also in science more broadly, in the government and in the pharmaceutical industry.

This “cumulative breakdown” of trust in turn has led some French people to delay or refuse vaccines, says Larson.

The WHO says making vaccines mandatory is one of the best ways to boost immunisation rates. France decided last year to up the number of compulsory vaccines to 11 from three for babies under two years old.

David Zumino, a 47-year-old intellectual property consultant and father of three children – including a one-year-old – says that rule change means he and his wife are again “constantly trying to assess whether vaccination is really worth it”.

“Of course, we understand there are medical benefits for the children,” he said as he visited the Paris pharmacy where Grime works.

“But …I can’t help thinking that there is a huge pharma lobby operation to convince the public there is a threat that needs to be addressed. And that sounds suspicious.”

David Loew, an executive at the drug- and vaccine-maker Sanofi Pasteur, puts French scepticism down to misinformation.

“There have been in the past years a lot of theories connecting vaccines to various health issues. There is also fake news circulating on social media which poses a real problem.”

Loew said the best way to address the issue was to ensure health professionals – who the Wellcome study showed are broadly trusted by members of the public in France – are equipped with robust information and accessible to those who have concerns.

Yet one such health worker – Helene Salliet, a 35 year-old mother and social worker at a hospital in southwest Paris – says government officials need to avoid a top-down approach.

“Authorities must take into consideration that we are not just subjects that have to obey. We, parents, must get the right tools to understand and make well-informed decisions.”

– Reuters