Immunisation: the facts

A parent holding their child's hand

Professor Helen Bedford from University College London gives advice for parents on vaccinations and looks into the spread of misinformation about vaccines on social media.

Measles is on the rise

With measles breaking out around the world, vaccination is back in the news. The cause of the outbreaks varies from country to country - not all measles cases can be blamed on ‘anti-vaxxers’ - but in some places, people are catching measles because parents have decided not to vaccinate their children. 
 
This decision may have resulted from beliefs that:
  • Measles is not serious

  • Natural immunity is superior to vaccination

  • The vaccine may be harmful, 

  • Or, in more extreme cases, mistrust of the government or ‘Big Pharma’. 

In the UK, we know that many parents report seeing negative immunisation messages on social media or online forums, though it’s not clear what impact this is having on their vaccination decisions. 

Most UK children are immunised

In the UK, nine in 10 children have the baby vaccines, as well as the measles, mumps and rubella (MMR) vaccine at 12/13 months. 
 
Deciding whether to have your baby vaccinated can be difficult: vaccination comes at a time when you may be feeling tired and overwhelmed, when you’re getting used to having a new person in your life. If you’re seeing stories on social media or online forums suggesting that vaccination is harmful or unnecessary, the decision can seem challenging, scary, even upsetting.

Why vaccinate?

Vaccines are given to protect against diseases that can be serious. An important benefit of vaccination is that if enough people are protected, others who are too young to be vaccinated, or who have health problems or are pregnant, are protected by so-called ‘herd immunity’, the protection of the wider community.
 
Vaccination is a victim of its own success because vaccine-preventable diseases have become so rare we forget how serious they can be. All the diseases we vaccinate against can cause complications that can last a lifetime and can even lead to death. Take measles: it’s really infectious and spreads very quickly among unprotected people. At best it’s a nasty illness that makes you feel really ill with a high fever, cough, cold and rash - but lots of people get complications, such as fits, pneumonia, and even inflammation of the brain. Measles is more serious in the very young and adults and, even in rich countries like the UK with good health services, it can kill. Last year in Europe alone over 80 people died from measles.

What vaccines are offered in the UK?

Vaccines are offered against 13 serious infections in the first 13 months of life - including four types of meningitis, diphtheria, tetanus, polio, whooping cough, and measles, mumps and rubella, with booster doses and additional vaccines offered at older ages.   

What vaccine misinformation is circulating?

Misinformation on social media and online forums focuses on people’s beliefs rather than scientific evidence about the harms of vaccines. Unbelievably, a US mother whose four-year-old died from flu was accused by anti-vaxxers on Facebook of faking the story. It was even suggested that the child had never existed. Finding an appropriate response to this sort of thing is very hard. 
 
As parents, our first priority is to protect our children so it’s natural to want to be reassured that vaccines don’t do more harm than good, especially if there is apparently no disease around. Why would you give a potentially harmful vaccine to prevent something that’s not a threat? 
 
Before any vaccine comes into use, it goes through careful trials to assess its safety as well as how effective it is. This careful monitoring continues once a vaccine is in use. Evidence shows that vaccines are very safe. This does not mean they never cause adverse reactions. In fact, mild reactions such as redness and swelling at the injection site, feeling ‘off-colour’, and fever, are common, and usually last 24-48 hours. After MMR, the reaction is delayed until about a week later and the person can develop ‘mini-measles’ with a rash and fever (which is not infectious). About one in 3,000 people will have a fever fit after MMR, but this figure needs to be compared with the 15-times-higher risk of having a fever fit with natural measles infection.
 
Misinformation also suggests that multiple vaccines overload the immune system, causing all sorts of chronic conditions. This issue has been well researched and there is no good evidence that giving multiple vaccines is harmful. From the moment they are born, babies encounter thousands of bacteria and viruses on a daily basis – through the foods they eat, the air they breathe, and the things they put in their mouths. There are far fewer antigens (the things that stimulate the immune system) in vaccines than in the environment naturally. In addition, developments in vaccine manufacture mean that even though more vaccines are given nowadays they contain fewer antigens than they did some years ago. 
 
The myth that MMR is linked with autism is circulating widely on social media and is probably one of the major reasons for parents rejecting the vaccine. There is no such link; no good research links the vaccine and autism. The original paper that triggered the concerns, published 21 years ago, has been thoroughly discredited on the basis of ethical issues and the undeclared financial interests of the lead researcher. The many good studies conducted over the past 20 years show that there is no evidence of a link whatsoever. 

Impact of vaccines globally

Vaccines have had a massive impact globally in improving children’s health, with 20 million deaths from measles prevented since the turn of the century. In the UK alone, it’s estimated that 4,500 deaths from measles have been prevented since the vaccine was introduced. These statistics are staggering,  so it is a major concern when we forget what a difference vaccination makes. 
 
If we see a fall in vaccine uptake, the diseases that have become so rare in the UK will re-appear, as we are seeing with measles, which is so highly infectious that it doesn’t take a huge decline in uptake to result in outbreaks. As a result, measles acts as an early warning system for what could happen if anti-vaxxers’ myths are believed. This is a potentially major public health problem. We still have time to avoid it. And the solution is simple: ensure that our children are vaccinated. 

Speak to a health professional

Deciding whether to have your child vaccinated is an important decision, too important to make on the basis of the material you may see online. Do please speak to your healthcare professional about any questions or concerns you may have.
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