UK Vaccination – Is history repeating itself?
Whilst it may sound like a ‘no-brainer’, the UK has had a tumultuous relationship with vaccination
Being able to treat an illness before symptoms occur and any damage is incurred has been a possibility for centuries.¹ Vaccines train the body’s immune system to fight diseases and have saved a countless number of lives since their discovery. To this day, evidence shows that vaccines are one of the most successful and cost-effective ways of preventing disease.² It is important we recognise there may be warnings/side effects associated with vaccines and there will be a small number of serious cases. However, it is important to understand that these are isolated, and that significant research and testing is done to ensure a vaccine’s safety and efficacy.
Great! What’s the problem then?
Whilst it may sound like a ‘no-brainer’, the UK has had a tumultuous relationship with vaccination and its merits have more than once been called into question.³ The last time the UK’s commitment wavered significantly was following the now infamous 1998 Lancet paper, published by Andrew Wakefield, in which he suggested a causal link between the measles, mumps and rubella (MMR) vaccine and the development of autism.⁴ Whilst the scientific community quickly responded to disprove any such link, publishing comprehensive data demonstrating the contrary, for some, the mere suggestion was enough and uptake of the MMR vaccine fell from its peak of 92% in 1995 to only 81% in 2004/5.⁴ Although vaccination rates have since seen a recovery, we have recently experienced history repeating itself in the form of COVID vaccine uptake hesitancy.
COVID’s hidden symptoms
The onset of COVID-19 at the beginning of 2020 saw normal life grind to a halt, our streets deserted, and offices shut in favour of home working. Despite this lockdown, the scientific community rallied together to produce not one, but multiple viable vaccines in record time, cutting what is usually a 4+ year development timeline to less than a year.⁵ However, although these vaccines were put through rigorous testing and approvals, for some, the alure of conspiracy theories, self-appointed online health experts and social media echo chambers were just too good to resist. Once again we saw the ‘antivax’ movement raise its voice, and in the age of social media – potentially louder than ever before.
A rising tide of missed vaccinations
Vaccination rates in the UK have seen a steady decline over the past decade, with many of the key childhood vaccinations now below the World Health Organization’s target coverage.⁶ Whilst it is too early to determine what COVID’s impact on vaccination is going to look like, what is clear, is the COVID vaccine once again stirred up considerable antivax sentiment. This time, with influential supporters from the worlds of sport, acting, politics, and many more.
The ‘Andrew Wakefield incident’ in 1998 should act as a warning as to what we could be approaching with regards to vaccine uptake, however, we must not ignore that we are living in a very different age. More and more, people are turning to ‘Dr. Google’ and social media for their medical advice, where misinformation has resulted in many becoming convinced that vaccination isn’t right for them or their children, instead relying on the immunity of others for their protection.⁷
Diseases II: Return to the UK
But why does this matter? Well, we might just be starting to see the impact that diminished vaccination coverage is having. There hasn’t been a recorded case of polio in the UK since 1984 and the UK was declared polio-free in 2003, however, the discovery in June 2022 of the virus in London sewage samples has resulted in public health officials scrambling to ramp up vaccination in an effort to avoid an outbreak.⁸ Polio, however, is by no means the only infectious disease of concern. Measles has been seeing a steady rise in recent years, both in the UK and across Europe, with many countries experiencing serious outbreaks and as many as 60% of confirmed cases becoming hospitalised.⁹
Polio and measles may feel like diseases of a bygone era and maybe that is why some aren’t as convinced of the importance of vaccination against them. I, for one, have never seen someone with either disease, or anyone dealing with the lasting effects they cause. Maybe the old adage ‘what you don’t know can’t hurt you’ rings true in this instance, with many of us oblivious to the potentially deadly effects of these diseases.
Why is vaccination important
Whilst you might hope the offer of protection against what are potentially deadly diseases would be enough of a convincing argument for vaccination, it is also important we remember that for many vaccines to work effectively, herd immunity is also required.
What is herd immunity? Herd immunity is the indirect protection that a vaccinated population offers through the prevention of disease spread.¹⁰ And no, herd immunity doesn’t require 100% vaccination coverage, and therefore, for many the argument is that they personally don’t want their child or themselves to be vaccinated and that they will rely on herd immunity for protection. On the face of it, a valid argument: one person being unvaccinated is unlikely to remove herd immunity and its protection, right? Not quite, this argument falls down when you consider it isn’t just one person or family that is thinking this and for diseases like measles, where herd immunity requires 95% coverage, the decision not to engage in vaccination programmes can have devastating effects.
We have largely presented vaccination as a choice up to now, however, it is paramount we recognise that for some individuals the choice isn’t theirs. Those with compromised immune systems, new-borns, severe allergies and many more rely on herd immunity for protection as they physically aren’t able to get vaccinated.10 Whilst that may feel strong, it highlights the importance of making the right choice, if not for you, for those who aren’t able to make the choice for themselves.
References
[1] Riedel, S., 2005. Edward Jenner and the History of Smallpox and Vaccination. Baylor University Medical Center Proceedings, 18(1), pp.21-25.
[2] Vanderslott, S., Dadonaite, B. and Roser, M., 2019. Vaccination. Our World in Data. Available at: https://ourworldindata.org/vaccination [Accessed October 2022].
[3] Historyofvaccines.org. 2018. History of Anti-Vaccination Movements. Available at: https://historyofvaccines.org/vaccines-101/misconceptions-about-vaccines/history-anti-vaccination-movements [Accessed October 2022].
[4] The Guardian. 2010. MMR timeline. Available at: https://www.theguardian.com/society/2010/jan/28/mmr-doctor-timeline [Accessed October 2022].
[5] The Guardian. 2022. The history of Covid vaccine development. Available at: https://www.theguardian.com/world/2021/dec/08/the-history-of-covid-vaccine-development [Accessed October 2022].
[6] The Nuffield Trust. 2022. Vaccination coverage for children and mothers. Available at: https://www.nuffieldtrust.org.uk/resource/vaccination-coverage-for-children-and-mothers-1#background [Accessed October 2022].
[7] Chu, J., et al., 2017. How, When and Why People Seek Health Information Online: Qualitative Study in Hong Kong. Interactive Journal of Medical Research, 6(2), p.e24.
[8] GOV.UK. Press release: Poliovirus detected in sewage from North and East London. Available at: https://www.gov.uk/government/news/poliovirus-detected-in-sewage-from-north-and-east-london [Accessed October 2022].
[9] Vk.ovg.ox.ac.uk. 2022. Measles | Vaccine Knowledge. Available at: https://vk.ovg.ox.ac.uk/vk/measles [Accessed October 2022].
[10] Who.int. 2020. How do vaccines work?. Available at: https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work?adgroupsurvey={adgroupsurvey}&gclid=CjwKCAjwmJeYBhAwEiwAXlg0AaEz-JHAu09H4olnapJSSX0Lb7Rzmxo3vmaUhQr_C36MBPEci51dZhoCgY4QAvD_BwE [Accessed October 2022].
