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Vaccines: inoculating against fear

14 November 2019

Vaccination is one of the most effective ways to prevent diseases. A vaccine helps the body's immune system to recognise and fight pathogens like viruses or bacteria, which then keeps us safe from the diseases they cause. Vaccines protect against more than 25 debilitating or life-threatening diseases, including measles, polio, tetanus, diphtheria, meningitis, influenza, typhoid and cervical cancer.

The history of vaccines is a long and fascinating one.

The Australian story

In Australia, the Therapeutic Goods Administration regulates vaccines, and we have been lucky enough to be the recipients of one of the most robust and well-regulated childhood vaccination programs in the world.

And Australia has played its part in the scientific advances in vaccine medicine.

Australian scientists have been world leaders in the research to advance the science of vaccines.

Some of the best known, Sir Frank McFarlane Burnet and Sir Gustav Nossal, helped establish Australia and the Walter and Eliza Hall Institute of Medical Research as a pre-eminent site of immunological research and have contributed to advancements in the treatments of influenza, herpes, polio and Q Fever, all the way through to cancer and malaria treatments.

Australian scientist, Professor Ian Frazer, with his colleague, the late Dr Jian Zhou, developed a vaccine for cervical cancer, and Australia is now on track to eliminate cervical cancer altogether.

Most recently, Dr Laura Mackay was named as Australian Life Scientist of the Year 2019, for her work on how the immune system works. Her research promises advances in cancer and allergy treatment, and includes two new vaccines for malaria and HIV going to early human trial.

This is enormously significant if we stop to consider that every two minutes a child dies of malaria, mostly in sub-Saharan Africa, where the disease claims an estimated 450,000 lives each year.

The past and the future; a conundrum to grapple with

Vaccinations, along with penicillin, are the two most transformative health developments in the history of medicine. Millions and millions of lives have been saved because of vaccinations alone.

Our grandmothers and grandfathers may recall a time when diseases such as tuberculosis, influenza or small pox could decimate families and communities.

The New Zealand Health Ministry has gathered stories of those who lived through times when vaccinations were not available, and disease could be swift and brutal.

But now in Australia, New Zealand and many other first-world countries, we have not had to face this calamity for many decades.

In other countries of the world, the picture is not so rosy.

According to the World Health Organisation (WHO) an estimated 1.5 million children die each year - one every 20 seconds - from vaccine-preventable diseases such as diarrhoea and pneumonia. Tens of thousands of other children suffer from severe or permanently disabling illnesses.

At the same time, some remarkable achievements continue to occur - just last week on World Polio Day, it was announced that two of the three wild poliovirus strains have been eradicated from across the whole globe.

Growing scepticism; fear and conspiracy in the age of fake news

So with all the evidence before us, we now face a new question - why are people in Australia and across the developed world demonstrating a growing scepticism in some small pockets of the community, about the value of vaccination?

As the Washington Post noted in February of this year, as American reject vaccines, health workers abroad risk death to deliver them.

And WHO has named vaccine hesitancy as one of its top 10 threats to global health for 2019.

So what to do?

Most Australian parents do vaccinate their children, but there is still a minority who choose not to.

What is the best way to get them on side and is our current approach of shaming them into changing their views the best way forward?

What would compassion towards vaccine hesitant or refusing parents look like?

A recent discussion on ABC Radio National showcased Australian research that helps medical practitioners communicate with parents who are worried about vaccination, in order to bring them to participation.

And Australia is leading the way on an international level to address the issue of vaccine hesitancy through the International Coalition of Medicines Regulatory Authorities.

Recent research indicates that communicating with vaccine hesitant people in ways that acknowledge their fears, and the cautious use of social media to avoid clustering uninformed views, will help address the hesitant and resistant attitudes.

Here as elsewhere the essence of an effective approach is to help people find good information about vaccination to allay their fears.

Fears about vaccination come from a very deep moral place of wanting to care for and protect children, and working with parents to understand the value of vaccination is the best way forward.

In some parts of the world, suspicion about vaccine programs run dangerously deep.

There are several instances over the last few years of the murder of health workers administering vaccines in countries like Pakistan.

A final parable: the case of Francis Folger Franklin (1732-1736)

Whatever the case, the issues of vaccination are perhaps distilled in the poignant story of Benjamin Franklin, one of the Founding Fathers of the United States and drafter of the Declaration of Independence.

On November 21, 1736, Franklin's four-year-old son, Francis Folger Franklin, died of smallpox. Rumours sprang up that he had died because of being inoculated by a very nascent version of the smallpox vaccine.

Franklin subsequently published a refutation, and a heartfelt advocacy of inoculation:

"In 1736 I lost one of my sons, a fine boy of 4 years old, taken by the Small Pox in the common way. I long regretted that I had not given it to him by inoculation, which I mention for the sake of parents, who omit that operation on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that therefore the safer should be chosen."

Benjamin Franklin, quoted in Franklin on Franklin by Paul Zall

These matters remain as active today as they did nearly 300 years ago. Only now we know so much more.

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