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Vacunar, un derecho individual con consecuencias colectivas

Vaccination, an Individual Right with Collective Consequences

[This article has been written by Clara Menéndez, Director of the Maternal, Child and Reproductive Health Initiative at ISGlobal, and Vicky Fumadó, Unit of Infectious and Imported Diseases. Pediatric Service. Hospital Universitari Sant Joan de Déu. It has been published in Spanish in La Vanguadia - Big Vang]

Cambodian boy receiving measles vaccine. Author: CDC Global.

Can you imagine a world in which we might be infected with smallpox and die? Most people living in the world today do not even know that a disease called smallpox once existed, in part because the virus was eradicated from our planet (officially in 1980) following an unprecedented global vaccination campaign led by the World Health Organisation.

Can measles be eradicated? Yes, it can because a very effective vaccine exists

The same thing could happen with measles if it were eradicated from the planet. That disease could also cease to be a health concern and fade to being no more than a bad memory. Can measles be eradicated? Yes, it can because a very effective vaccine exists. Measles is, however, highly contagious and in order to achieve herd immunity at least 92% (and ideally 95%) of the population must be vaccinated against the disease. Herd immunity is a form of immunity that occurs when a large proportion of the population has been vaccinated and their immunity protects those who have not.

In wealthy countries, the most significant and fastest growing obstacle is the decision of parents not to vaccinate their children

In poor countries, the greatest obstacle to achieving high vaccination coverage is the lack of resources and the fragility of health systems, something that international health agencies are working hard to improve. In wealthy countries, however, despite their ample resources, the most significant and fastest growing obstacle is the decision of parents not to vaccinate their children. The resulting decline in vaccination coverage is responsible for epidemic outbreaks of measles in many European countries, some so serious that they have prompted unprecedented recommendations from European health authorities regarding travel in the region.

In Europe, the number of cases of measles and related deaths increased by 400% between 2016 and 2017.

Convincing parents who have decided not to vaccinate their children against measles of the advantages of vaccination and the problems caused by their refusal to vaccinate is a major public health issue in many affluent European countries and in the United States of America. The decision whether or not to vaccinate your child could be considered to be an individual right, but it is a right with negative, and even fatal, consequences for other people (and for all of humanity). Similarly, the refusal on the part of some to vaccinate their children is preventing the eventual eradication of measles from the planet.

Before the introduction of the measles vaccine in 1963, large epidemics occurred every two or three years

At this point, it could be useful to review some of the facts about measles supported by scientific evidence. First, before the introduction of the measles vaccine in 1963, large epidemics occurred every two or three years, involving an estimated thirty million cases worldwide, leading to over two million deaths every year. Second, thanks to vaccination, the number of cases was reduced by 79% between 2000 and 2015. Side effects associated with the measles vaccine are generally mild and transient. While more serious adverse effects, such as shock or septicaemia, have been reported in rare cases, they are usually related to a failure to follow the manufacturer's recommendations for reconstituting or administering the vaccine. Severe allergic reactions to the vaccine are very rare (4-10 cases per million doses) and no increased risk of permanent neurological sequelae has ever been demonstrated. Neither is there any scientific evidence to support the claim that the measles vaccine is associated with autism, a concern often cited by parents as the reason they decided not to vaccinate their children.  

A child receives a measles vaccination carried out by Save the Children in Leyte, Philippines. Author: DFID - UK Department for International Development

In Europe, the number of cases of measles and related deaths increased by 400% between 2016 and 2017

All of the above should provide sufficient evidence to convince everyone to vaccinate their child against measles. The problem is that the opinions clearly supported by the evidence are largely ignored by the people who do not wish to hear them, whose refusal to vaccinate, based on opinions unsupported by any evidence whatsoever, is responsible for recurring and increasingly numerous epidemic outbreaks of measles in Europe. One significant statistic is that the number of cases of measles and related deaths increased by 400% between 2016 and 2017. In 2010, there were two outbreaks of measles in Spain, involving around 1,000 cases; fortunately, no deaths occurred.

It may now be safer to holiday with our babies in a country like Gambia in West Africa where 97% of children are vaccinated against measles

In a modern paradox the recent measles outbreaks in certain European countries, such as Italy and France (both common tourist destinations for many Europeans, including Spaniards) suggest that it may now be safer to holiday with our babies in a country like Gambia in West Africa where, despite the country’s scant resources, 97% of children are vaccinated against measles. In those countries, the risk of our child contracting measles, with potentially serious consequences, is very low or almost nil.



Nota: Las personas que integran ISGlobal persiguen ideas innovadoras con total independencia. Las opiniones expresadas en este blog son, por tanto, a título personal y no necesariamente reflejan el posicionamiento institucional.

Clara Menéndez

Director of the Maternal, Child and Reproductive Health Initiative

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