The truce in humanity’s war against measles and other highly contagious but otherwise “forgotten” diseases has an asterisk. And if he is ignored, then a “short-circuit” in the peace process inevitably results. This asterisk is none other than the vaccination coverage of the population, which however is not a given while there are ups and downs in people’s love-hate relationship with vaccines.
This is how one could summarize the reason behind the dynamic come back of measles in European countries. And as we have learned well from the recent experience of the COVID pandemic, when a health fire breaks out it is only a matter of time before it spreads. Unfortunately, our country currently has at least five confirmed adult cases, while during the previous outbreak (2017-2018) more than 3,200 cases were recorded.
The increase in morbidity
“Measles is one of the diseases that is very effectively prevented by vaccination. When the measles vaccination regimen is complete, its effectiveness is over 99%. Therefore, the outbreak of measles in Europe is due to the fact that in some groups childhood vaccination has not been done or has not been completed” the associate professor of Hygiene and Epidemiology of the University of Athens explains speaking to “Vima”, Gikas Mallorca.
In more detail, the increase in the diseased population (that is, that can fall ill) occurs in two ways: due to insufficient vaccination and, at the same time, the loss of older people who had fallen ill in the past, with the result that the immunity wall is left open.
The retreat
Under these circumstances, it is not surprising when Mr. Majorkinis warns that, potentially, a similar… setback can occur with other diseases as well, if humanity’s relationship of trust with vaccines is broken or vaccination programs are disrupted for other reasons. “Diseases prevented by childhood vaccination are relatively forgotten, for example whooping cough, diphtheria, tetanus, mumps, hepatitis A. However, with the decline in childhood vaccination we are likely to start seeing cases of all these forgotten diseases”.
He himself, however, invokes another characteristic example. That of the recent increase in whooping cough in England. Once again and according to the Oxford Vaccine Group (vaccine research group in the Oxford Department of Pediatrics) the drop in vaccination rates due to the COVID pandemic is the most likely reason for this particular outbreak.
Unfenced areas
Returning to measles, the data regarding our country are not alarming, but show that there are unfortified areas, fertile for epidemic outbreaks. According to the official data of the European Center for Disease Control and Prevention (ECDC) for 2021, vaccination coverage with the measles vaccine in Greece was at 97% for the first dose, but dropped to 83% for the second dose (held in child population usually in the 2nd or 3rd year).
Also, as shown by the results of a seroepidemiological study of immunity against measles in the period 2020-2021, the immunity of the Greek population reaches 89.8% (through past illness or through vaccination). But an important detail is that the same data show geographical disparities in terms of vaccination coverage rates, with all that this entails.
Prevention
The data of another survey regarding the attitude of parents to the regular vaccination of their children reveals the gray areas in this critical field of prevention. From September 2019 to June 2020, the Medical School of the University of Patras studied relevant questionnaires completed by a total of 1,227 parents, with children in primary education, living in Western Greece.
Their answers were revealing: About a third of them (33.5%) expressed doubts about a possible link between vaccines and autism. The authors of the same survey also highlight the fact that 44% of study participants believe that unvaccinated children could attend school. On the positive side, however, it should be included that 84.6% of parents had fully vaccinated their children, while the main source of information about vaccines was their pediatrician (90.8%).
Accordingly, another study published in 2022 in the scientific journal “Frontiers in Pediatrics” and in which approximately 900 mothers living in Attica, Central and Western Greece and Crete participated concluded that nine out of ten believe that vaccines protect their children from serious and life-threatening diseases.
However, half admitted that they have delayed getting their children vaccinated as recommended by the National Immunization Committee. In fact, in 16% this delay was due to their anxiety about possible side effects.
The wave of doubt
In their related article, professors of the University of Athens recall how the wave of doubts broke out. In 1998, the prestigious scientific journal “Lancet” made false claims about a link between the MMR vaccine (measles, rubella, mumps vaccine for children and adults) and autism. Of course, in 2010 the paper was retracted by the journal and its main author removed from practicing medicine in the UK. However, despite numerous studies confirming both the effectiveness and safety of MMR and the failure to find any link to autism, this case has caused many people to have second thoughts about whether they should vaccinate children their.
Fatefully, vaccination reluctance has helped measles make a comeback, with global deaths expected to reach 130,000 by 2022.
Under these circumstances, another question that arises is whether the COVID pandemic and the public “disinformation” about the safety of vaccines against SARS-CoV-2 contributed to intensifying the anti-vaccination movement. “I find that people who were very negative about vaccination before the COVID period have remained so. On the contrary, people who did not have any strong opposition to vaccines are largely convinced of the usefulness and above all of the safety of vaccines.” is the assessment expressed by Mr. Majorkinis.
The numbers
- 954 new confirmed cases of measles were reported on 9-10 January from six EU countries.
- 2.6 million young children died each year and millions more lived with deafness or brain damage before measles vaccination was available
- Deaths dropped to 73,000 after intensive vaccination in 2014.
- 2,242 confirmed cases of measles were reported from 1 January to 30 November 2023 in 22 EU countries.
- 91.7% of Greek mothers believe that vaccines protect their children from threatening diseases.
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