March 01, 2019
For a long time, I thought anti-vaxxers (those skeptical of vaccination) were mythical creatures, unicorns with tinfoil hats and fanatics using essential oils and garlic cloves instead of antibiotics. However, as the news continues to come in, it is becoming more and more apparent that the anti-vaccination movement is an international epidemic that is far more commonplace than I presumed.
It struck me with a particularly maddening irony that some of the wealthiest in the world are able to dismiss standard preventative healthcare. Their blasé attitudes based on fad pseudosciences reflect their relative safety within an imagined bubble. Meanwhile, the growing measles outbreak in Madagascar is causing mass casualties because of low vaccinations. According to the World Health Organization (WHO), infection cases have reached more than 68,000, with more than 900 deaths since the epidemic began last September. This is undoubtedly caused by a lack of vaccinations in the area, with international estimates claiming that less than 60 percent of the population is vaccinated (for reference, the Netherlands is closer to a 90-95 percent vaccination rate).
The situation in Madagascar shows the world without vaccines. This is the condition that occurs when vaccinations do not take place throughout the population. Privilege has blinded people into believing their alternative lifestyle won’t cause great changes in the world. Recently, Costa Rica had its first suspected case of measles in several years, brought by French tourists who never had vaccinations (for reasons unknown). It was carried by their infected son who presented with a measles rash. With this ability to spread without detection to other countries, it isn’t surprising that the WHO urges member states to maintain at least a 95 percent vaccination rate.
The epidemic in Madagascar and other areas is different from the cases breaking out across countries like Italy, France, and the United States. Systemic economic and social conditions have caused a lack of appropriate healthcare and disease prevention for many in Madagascar; this is different to groups of naturalists and conspiracy theorists refusing jabs in countries where vaccinations are generally routine and easier to access. What is the solution for Madagascar? Unicef and the WHO have initiated a mass scale plan to manage high-risk areas and provide care for infected persons as well as vaccinations. But this presents another sad paradox: people are dying on one side of the world waiting for a known cure, while others across the ocean are turning up their noses at what is readily available – because it’s inorganic, unnatural or against their faith.
“Of course, no one wants to take away religious rights or civil liberties. But once again, culture cannot supercede the endangerment or direct harm of others”
I first encountered anti-vaxxers when I began working for a school in the United States. This alone should be concerning; I was regularly meeting non-vaccinated people in a public setting. A co-worker once began talking to me about the dangers of vaccinations and regularly shared misinformed articles on Facebook that propagated the belief that vaccines had poisonous components in them and were harmful or caused autism. I soon discovered that many of the schoolchildren were not vaccinated, their parents deciding to focus on alternative medicines instead of vaccines. I was shocked and concerned about potential exposure; measles cases had been recorded across the country.
Here in the Netherlands, it seems there are similar issues. A Dutch companion confided that she has never received vaccines and that there are small communities with certain naturalist or religious lifestyles that tend to favor what are perceived as organic or natural medicines. A popular Dutch foundation Stichting Vaccinrij has created an online platform for Dutch parents to encourage optional vaccination and to share their stories against routine vaccinations. The amount of posts and supporters seem endless.
Despite these groups, The Netherlands has been relatively successful at keeping near the 95 percent rate for measles vaccination over the years. However, an outbreak of preventable meningitis has occurred as people are not getting vaccinated for meningococcal type W disease. Estimates from the RIVM, range that about 14% of young people recommended for the vaccinations have not received one. 41 have died from the infection. Motivations haven’t been explicitly reported in this case, but there seems to be a correlation between areas with stronger religious identifications or vaccination skepticism and the number of people not going in for the jab. Zeeland and Amsterdam had the lowest rates of vaccination in this particular case. Historically, religious reasons have dominated vaccination reports on anti-vaxxers in the Netherlands, as elsewhere. Beyond this, anti-vaccination reasoning is complex, including many reasons of religion, philosophical arguments, and ethics.
The WHO has declared vaccine hesitancy one of the top ten greatest threats to human health for 2019. The European Center for Disease Prevention and Control has identified ongoing measles outbreaks in France, Italy, Romania, and Greece as well as identifying that most countries in the EU are no longer at the 95 percent vaccination rate. It is necessary to begin exploring stricter vaccination policies.
Of course, no one wants to take away religious rights or civil liberties. But once again, culture cannot supercede the endangerment or direct harm of others. If a person is to grow up, attend schools, hospitals, daycares, or be in public spaces, they should be required to be vaccinated. An enforcement of this sort needs to be treated with the utmost respect, focussing on education rather than belittling religious or cultural backgrounds. This perspective is beginning to gain cross-party support in various countries. In fall, 2018, a large majority of the Dutch House of Representatives supported a bill that would allow daycares and nurseries to refuse unvaccinated children.
Protecting the lives of those that could be affected by anti-vaxxers and preventing the resurgence of once-extinct illnesses is vital to stopping these epidemics. If someone prefers not to vaccinate for personal reasons, they should have a right to do so as long as they are not attending public institutions. Many would not agree on this harsh stance and, so far, the global community seems to favor recommendation rather than enforcement. Currently vaccination is not required, but recommended in the Netherlands and many other countries, but if anti-vaxx influence grows we may have to turn to stricter measures.
Ivy Wade is a Master’s Student at the University of Amsterdam. The views expressed here are not necessarily those of the Amsterdammer.