Vaccines: Low trust in vaccination ‘a global crisis’

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Just half of people in eastern Europe think vaccines are safe, compared with 79% worldwide

The biggest global study into attitudes on immunisation suggests confidence is low in some regions. The Wellcome Trust analysis includes responses from more than 140,000 people in over 140 countries. The World Health Organization lists vaccine hesitancy as one of the top 10 threats to global health.

A global survey of attitudes towards science has revealed the scale of the crisis of confidence in vaccines in Europe, showing that only 59% of people in western Europe and 50% in the east think vaccines are safe, compared with 79% worldwide. Around the globe, 84% of people acknowledge that vaccines are effective and 92% say their child has received a vaccine. But in spite of good healthcare and education systems, in parts of Europe there is low trust in vaccines. France has the highest level of distrust, at 33%. There have been major measles outbreaks in a number of countries, which have spread across the continent, linked to vaccine hesitancy. The first Wellcome Global Monitor survey, which canvassed attitudes among 140,000 people worldwide, shows clear links between people’s trust in doctors, nurses and scientists and their confidence in vaccines. It also shows that mistrust in government institutions goes hand in hand with doubts about vaccines’ safety.

The link was clearest in the field of vaccines. “There are increasingly populations and entire countries around the world where confidence in vaccines is dropping and uptake is dropping. That does pose a huge public health risk.”

Where was trust high?

Bangladesh and Rwanda have the highest confidence in vaccines in the world, the Global Monitor shows. Rwanda also has the highest trust in its healthcare, at 97%, against a global average of 76%. “In developing countries, where deadly diseases like diphtheria, measles or whooping cough are more common, I’ve seen mothers queue for hours to make sure their child is vaccinated,” said Seth Berkley, the chief executive of Gavi, the Vaccine Alliance. “It is in wealthier countries, where we no longer see the terrible impact these preventable diseases can have, that people are more reticent. This reticence is a luxury we can ill afford.” Northern Europe, which includes the UK, has more confidence in the safety and effectiveness of vaccines than the western or eastern regions. In northern Europe, 73% of people think they are safe, the same figure as in northern America, and 84% think they are effective (83% in northern America). Only 65% of eastern Europeans think they are effective. In Ukraine, which had more than 53,000 measles cases last year, the figure is 50%.

What makes people sceptical?

In the survey, people with more trust in scientists, doctors and nurses tended to be more likely to agree that vaccines were safe. Conversely, those who had sought information about science, medicine or health recently appeared to be less likely to agree. The Wellcome report does not explore all of the reasons behind low confidence but researchers say there are likely to be many factors involved.

Some of it may be complacency – if a disease has become less common, then the need to get immunised may feel less pressing when weighing the benefits against any possible risk. All medicines, vaccines included, can have side-effects. But vaccines are thoroughly tested to check they are safe and effective. The internet means beliefs and concerns about vaccines can be shared in an instant, spreading information that isn’t necessarily based on fact. Similarly, in France, there was controversy about a pandemic influenza vaccine – accusations that the government bought high quantities of the vaccine and unsubstantiated claims that it had been made too quickly and couldn’t be safe. In the UK, there has been misinformation circulating about the MMR jab and autism.

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