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Countering the negative public health impacts of the anti-vaccination movement

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This blog post was authored by Javier Saladich, a Summer Research Intern at the O’Neill Institute. Javier is a third year law student at ESADE Business and Law School in Barcelona, Spain. Any comments or questions can be emailed to

In light of recent measles outbreaks in Europe and the United States and a European Court of Justice decision in a vaccine-liability case, this blog post considers the importance of public health laws and messaging to strengthen societal consensus and compliance with vaccination programs. It argues that governments and public health advocates should continue to counter the growing presence of the reactionary anti-vaccine discourse, which threatens to erode community immunity and public health gains.

Vaccination and the importance of societal consensus

There are very few public health issues in relation to which societal consensus is taken as granted, but none as misleading as vaccination. Every so often, new data reminds us of the fragility of such consensus and the peremptory challenge non-vaccination and incomplete vaccination pose to public health, including recent outbreaks of measles in Europe and the United States. Even though anti-vaccine responses can be traced back to a purported atavistic fear of chemicals, as brilliantly portrayed by Eula Biss in her essay On Immunity, the devastating consequences of infectious epidemics throughout history and the steady effectiveness of vaccines finally brought parents and societies together around a sort of collective trust in each other’s child vaccinated status. This allowed for what the medical community calls the “immunization of the herd”, a social contract whereby the group stays protected only insofar as no significant share of members opts out.

Concerning measles outbreaks in Europe and the United States

The core of this status quo, though, has come under question in recent decades. Take measles, for instance. Immunization coverage to prevent measles outbreaks – 95% is needed, according to global standards – has fallen to risky levels in some communities within the United States. Even more worryingly, up to 15 European Union/European Economic Area (EU/EEA) member states are not complying with the minimum threshold. These countries’ failure to have their population immunized despite availability of safe and affordable vaccines has been closely followed by the WHO, which launched a 2017 campaign with the goal of showcasing “immunization’s role in sustainable development and global health security”.

In the United States, measles outbreaks are due to an insufficient rate of infant vaccination. While 2016 data shows vaccination coverage of roughly 91% population, coverage is distributed unevenly throughout the country. Under US law, states are free to adopt non-medical exemptions based on personal and religious beliefs, which contributes to lower coverage in many communities. Recent studies show that despite the improving levels of vaccination, unvaccinated persons appealing to state-level exemptions tend to cluster geographically in schools and communities, “so vaccine-preventable disease outbreaks can still occur”. For example, in 2014/5, a measles outbreak traced to Disney theme parks in California sickened 147 people. A 2016 outbreak originating in rural Minnesota has sickened more than 70 people to date.

In Europe, measles are still endemic. Italy and Romania the two major hotspots, with thousands of new reported cases. Why are higher-income countries, often considered as leaders in public health, still experiencing outbreaks of preventable diseases?

The anti-vaccine movement: weakening societal consensus and public health

An important contributing factor is the anti-vaccine movement, which promulgates messages that vaccines are unnecessary and harmful. In some ways, vaccines have been victims of their own success. Low incidence of measles outbreaks thanks to vaccine inoculation has been used by these groups to spread the belief that there is no longer a public health threat that justifies this intervention. The intersection of the traditional anti-vaccine movement and winning populist parties, whose discourse openly questions the safety of vaccines and in turn the whole pharmaceutical industry, could be another reason. Yet, these theories have been repeatedly dismissed by public health advocates and the international community, who recently endorsed a joint resolution to support vaccination.

The Disney outbreak in late 2014, highlighted the problem of misinformation and complacency, in the air since 2000, when measles ceased to be a native infection in the U.S. After the 2014 outbreak many hesitant parents soon understood that these seemingly eliminated threats were not over, but just waiting for vaccination rates to drop again.

However, this may not always be the case. Minnesota’s measles outbreak originated in a large Somali immigrant community that had been successfully targeted by anti-vaccine theories, including personal visits from Andrew Wakefield, who founded the modern anti-vaccination movement. This situation in Minnesota reveals how misinformation that conjures fear and emotion can take hold, with serious ramifications for the public’s health.

Strengthening public health laws and public confidence

Following major measles outbreaks in Western countries, political leaders have strengthened legal requirements for vaccinations. In California, where the Disney outbreak started, tough new legislation was passed, which removes non-medical exemptions (religious and personal beliefs) from the requirement to vaccinate children prior to their enrollment in kindergarten. In France, the Macron administration has promised to reverse low-vaccination rates and it will follow the path of California and Italy, by enforcing vaccination and making it a prerequisite to access public schools. To date, France has shown the worst performance in vaccination (around 75%). In France, there is a strong negative perception of vaccines, aggravated by bureaucratic and a confusing legislation, which labels only three vaccines as mandatory and the rest recommended.

Although legislative efforts are a step in the right direction, laws should be accompanied by public health education aiming to counter misinformation around the safety and necessity of vaccines. The need for pedagogy is evidenced by the recent controversy surrounding the European Court of Justice’s judgment on a liability claim for Hepatitis B vaccine harm. At the request of French Supreme Court, the EU’s highest court made a preliminary ruling, which has been wrongly interpreted as endorsing liability of vaccine manufacturers for vaccine-related injuries in the absence of scientific proof of causation. Instead, the ruling confirms that, in the absence of medical or scientific consensus on a specific cause of harm, causation may be established based on serious circumstantial evidence. The court noted that a mere temporal relationship between the vaccine and the harm would not be enough. Controversy emerged among public health experts, who fear this decision may be manipulated by the anti-vaccination movement. This reinforces the importance of public education and messaging to create a counter-narrative strong enough to impede manipulation of this ruling and other scientific questions.

It’s time for policy-makers to deploy not only an enforceable agenda for immunization, but also a persuasive battery of arguments to convince families that vaccines are safe, effective, and necessary for personal and public health. To this end, the credibility of institutions such as the Centers for Disease Control and Prevention and the WHO should be reinforced against bizarre conspiracy theories. Primary health care providers and pediatricians, who work at the front line of children’s health care, should be empowered to educate misinformed parents on the risks that non-vaccination entails.

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  • Prof. L. Dayeng says:

    Open letter to all physicians and doctors of classical medicine
    By Professor Lupus Dayeng. I am the founder of the Dayeng Foundation. Integrated is a scientific research center and a therapy center for the treatment of many so-called civilization diseases.
    For many years, as a team of scientists in collaboration with other international scientists, we have investigated the causes of these civilization diseases internationally.
    The results were clear and irrefutable. The causes of diseases such as cancer, multiple sclerosis, Parkinson’s disease, AIDS, skin diseases, allergies and many more, are for the most part pharmaceuticals that destroy the natural immune system. Other responsible are the food industry and the chemical industry for cosmetic products and personal care products.
    We have managed to successfully treat many of these diseases.
    Other international physicians, professors, doctors and therapists have come to similar conclusions, including Nobel Prize laureates.
    But what happens in classical medicine? Doctors’ offices, hospitals, specialty clinics and so on. It is hardly ever investigated for the causes of diseases. The anamnesis is no longer known to the medical profession, and the Hippocratic oath has lost its importance. The profit is important. For everyone seeking help from a medical doctor first kam the question of a health insurance number or the financial resources.
    I know a lot of examples where the patient was denied the treatment because they did not have enough money. Many emergency clinics have not treated patients with life-threatening injuries because the injured people had no money.
    What’s happening here? The Hippocratic oath was exchanged in favor of a slavery for the pharmaceutical industry. This behavior can also be found in the normal medical practices. A doctor’s office must make profits, otherwise credit rates can not be paid and so on.
    The pharmaceutical industry gives doctors commissions for recommended and sold medicines. Professors receive money and expensive material for recommending certain medications.
    But what do pharmaceuticals actually do? First, you always hear and read something about so-called side effects. What should be the side effects? What is that supposed to mean?
    Does this mean that a positive main effect, however, is accompanied by negative side effects? Has no doctor ever thought about this nonsense? There is an effect or there is no effect. Point. One can not divide effects in medicine, either it is something positive or even negative. If, therefore, a drug that can possibly only alleviate a symptom, but has so-called side effects which permanently damage the organism, then I speak of negative effects as a whole.
    If something is not 100% positive for the organism, it does not belong in the human body. But almost all doctors prescribe antibiotics as a panacea without thinking about the consequences. Almost all physicians destroy the still evolving immune system already of the babies through vaccinations which do nothing positive, but which damage the small organism irreparably. Hardly any doctor knows or has ever studied the contents of vaccination sera.
    There is another virus, this virus has the name profit, dependency, unscrupulousness. This virus has, in the past 80 years, more and more physicians and doctors infected. The virus affects the logic of all medical professionals and turns them into unwilling drug addicts of the pharmaceutical industry. 99% of all physicians now believe themselves that pharmaceuticals actually cure diseases.
    Then these medical practitioners should name such a drug that would ever have done. Chemistry can not positively influence a diseased biological organism. This assertion is a crime against every patient.
    Officials are talking about 12.8 million people worldwide who die of pharmaceuticals annually. I think this sum is very understated. Older people in particular are so well manipulated in our time that almost every human being consumes several different pharmaceuticals, over 60 years, per day. A good business for physicians and the pharmaceutical industry. However, in most countries, elderly people are not usually autopsied after death, because one assumes a natural death. This is probably the reason for at least 50 million deaths. Many of my international colleagues are of the same opinion.
    If we were to imagine that these people were not killed by pharmaceuticals but by a virus, then you can be very sure that the pharmaceutical industry would immediately provide a vaccine against this virus. The profit would be incomprehensible. If we now remain in the name of Virus, then the name of the real virus that kills these millions of people every year is PROFITGIER equal to PHARMAINDUSTRIE.
    In our therapy center, we heal about 84 thousand people annually who had suffered from an illness which mainly resulted from pharmaceuticals. Many international doctors who have freed themselves from the bondage of the pharmaceutical industry have already joined us. These physicians have one thing in particular, they have character. What about your character? You are welcome to benefit from our scientific research. Remember the Hippocratic oath and begin to really want to heal people.
    Now some doctors in Europe say that the Hippocratic oath was replaced by the “Declaration of Geneva”. Here is an excerpt from this declaration: “I will not be affected by age, illness or disability, belief, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social position or other factors, when facing my medical duties. I will respect the highest respect for human life. Even under threat, I will not use my medical knowledge to violate human rights and civil liberties.”
    When a doctor gives a child a vaccination, the doctor deliberately destroys the child’s natural immune system. What has the doctor sworn before? If a doctor tells a cancer patient that chemotherapy is the best or even the only one to fight this disease, then he has again violated his oath. If a doctor refuses an emergency treatment because a person has no money, then he has violated the oath again. Oaths are thus always broken, for reasons of profit.
    The background of this human-despising system of the pharmaceutical industry is coming to light more and more quickly, and many international professors are now openly discussing this. So how do you want to be viewed by people later? As a real medical doctor or an unscrupulous businessman? You make this decision, meet the right one. All people should look a bit more behind the scenes. For example, the World Health Organization (WHO) is paid directly by the pharmaceutical industry. Does that make you think? Yes, think, this is urgently required. Whenever the profits for vaccines are declining, the World Health Organization (WHO) announces that, for example, a measles epidemic once again exists. There is no evidence of this, but all people believe this statement. Look better behind the scenes of an incredibly powerful and rich industry.
    Prof. Lupus Dayeng
    Independent, scientific research center of the Dayeng Foundation

  • The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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