Woman's Hour - Parenting: Vaccinations

Episode Date: February 20, 2019

Measles cases in Europe have tripled between 2017 and 2018. It's the highest number recorded this decade, according to the World Health Organisation and in America, two states are experiencing an outbreak of measles. Jane is joined by Helen Bedford, Professor of Children’s Health at UCL Great Ormond Street Institute of Child Health and Samantha Vanderslott, social sciences researcher at Oxford Vaccine Group to discuss parental attitudes to vaccinating children.

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BBC Sounds. Music, radio, podcasts. Hi, this is Jane Garvey and this is the Women's Hour Parenting Podcast, which this week is about vaccinations. Measles cases in Europe have tripled between 2017 and 2018 and that's the highest number recorded this decade, according to the World Health Organisation. In America, two states are currently experiencing an outbreak of measles. Helen Bedford is Professor of Children's Health at UCL, Great Ormond Street

Institute of Child Health. And Samantha Vanderslot was on the programme too, Social Sciences Researcher at Oxford Vaccine Group. I talked first to Helen and asked her why some people these days really are against vaccinations. Most people get their children immunised, that's the first thing to say. But those who don't, it tends to be the big issue for parents is, are these vaccines safe? So safety of vaccines has always been prominent right since vaccination came in. Some people are very vehement in their beliefs about vaccination and they have no vaccinations for their children at all. But actually, that's a very small proportion.

What proportion? It's only about 2% and it's been the same for decades. So most people get their children immunised and think it's the normal thing to do. Does that suggest then, bearing in mind it is such a tiny proportion, that there's over publicity of that minority who go against the general, the majority feeling, the anti-vaxxers? Certainly there's a very powerful anti-vaccine sentiment on social media. So they have a very loud voice, but they don't reflect the majority view. And you don't think they ever will or ever come close to reflecting it? I think the problem is that some parents have concerns and questions

about immunisation and it's totally unsurprising. And the worry I have is that they may be influenced by these more extreme views. Samantha, what do you think influences parents or just concerned people? Yeah, I definitely think there's an over-representation of anti-vaccine sentiments. So you often see in media stories a portrayal of there's an increase in anti-vaccine movements and groups, but it doesn't really drill down to the many complex issues why people might refuse vaccination. And that is attached to not trusting the government, not trusting pharmaceutical companies, also having an appeal of other very persuasive ideas such as alternative health and natural products. So there are lots of reasons why people might not vaccinate and that differs over time in different countries

and in relation to different vaccines. Yeah, tell me first of all about the different approaches in various different countries. Yeah, so either you have compulsory vaccination where it's the law, it's a legal requirement to vaccinate or you have mandatory vaccination where vaccination is associated with state services. So going to school, getting childcare. And then finally, what we have in the UK is vaccination being recommended by the government.

Recommended but not insisted upon. Exactly. But what about panic or hysteria or campaigns against immunisation? How do countries differ in that area? There's been a lot of controversies over vaccination and the government responses do vary. Whenever a government decides to look into ideas about problems with vaccination, that tends to be labelled as a ban. So you do see governments listening to populations

about having adverse effects from vaccination. And during that time, the government might recommend that vaccination to be better explored. But then that gets labelled as a ban. And we've seen that in Japan. We've seen that in France. Okay, what's happened in Japan? So in Japan, the HPV vaccine, the human papillomavirus vaccine, which protects against cervical cancer and other types of cancers. In 2013, the government didn't recommend that vaccine while it was exploring claims of adverse effects of the vaccine. So neurological effects that were reported by girls who were taking the vaccine.

And then that got widely reported as a ban. I see okay some vaccines get a free pass it would appear nobody worries much about diphtheria for example is that is that true? Yeah in in the past there was a scandal about diphtheria so nearly every vaccine has had some concerns. So I was wrong. In fact, there have been questions about it. Yeah, it was quite a long time ago. So in the 1970s in the UK, where a possible link with, again, a neurological condition was raised. But nobody's mentioned it recently. Yeah, no one's mentioned it recently.

However, I think it's important to say this. And Helen, you're a good person to answer this question. Sally on Twitter says, there is a vaccine damage payment unit because vaccines are not 100% safe. That's true, isn't it? It's true that there's a unit. 100% safe. But vaccines have a very high safety profile and they have to have that because they are given to healthy children, to all healthy children. So more than many medications, you have to be absolutely certain that the vaccine is as safe as possible. And before a vaccine comes into use, there will be lots of trials. And after it comes in, safety monitoring continues. And it's really important. And there are lots of examples of things continues. And it's really important. And there are lots of examples of things happening.

So in America, there was a vaccine introduced, rotavirus vaccine. And it emerged very quickly that some children were getting a particular bowel complication. And the vaccine was withdrawn. So these safety monitoring is taken very, very seriously. Let's go back to what measles, for example, can do to a child or to a person. So these safety monitoring is taken very, very seriously. Let's go back to what measles, for example, can do to a child or to a person. I didn't have it because I had the vaccinations. I don't actually know anyone who did.

But what does measles do? Well, I did have measles because I was too old to be vaccinated. And I remember it now. I was very unwell. It makes children very unwell. So it's a viral infection. And what it does is it gives you a high fever, a rash, a cough, and complications can occur. So about one in 200 children will have febrile fits. About one in a thousand will have inflammation of the brain. And it kills about a one in a thousand people with measles. And we've seen a lot of deaths.

We've seen 70 deaths in Europe last year from measles, which is a shocking statistic. But you say that because that tiny number of people are not getting their kids vaccinated, how is that, forgive me, I'm not a statistician or a medical person, how is it possible then? We need to have about 95% of the population immune to measles. Oh, is it gone?

But we have pockets where there's much lower uptake. So although across the board about 2% decline, if you go to certain areas, there will be a lower uptake. And what we've also got is because some people were scared about the safety of MMR about 20 years ago, lots of young adults, older teenagers were never vaccinated and they are pockets of susceptibility and we've had outbreaks amongst those groups. I also know that around that time, because my eldest child is 19, so I'm in exactly that group of parents, people were having the single jabs, weren't they?

They were having the three separate jabs instead of MMR. Presumably those children are entirely, they're fine, they'll be all right if they've been immunised that way. If they've had two doses of measles vaccine, then they will be protected. But some of the other single vaccines that were available at that time weren't so effective. And this is part of the problem, why the government never introduced single vaccines. So these clusters then, Samantha, that Helen refers to, the places where there are more likely to be more people who haven't had their children vaccinated, where are they in Britain? So in Britain, the lower uptake happens in London, but there's quite a lot of disparity across London. So some parts of London will have very high rates and others quite low rates. But what sort of parts of London and what sort of parts of Britain are susceptible to these

sorts of views? So it can be certain groups which are deprived, so travelling communities, and also religious groups where you might not have that much of an outside influence coming in. And then you could get carried by anti-vaccine views. Linda has a question for you, Helen. This is on Twitter at BBC Women's Hour. Why aren't kids vaccinated against chickenpox? A vaccine does exist and that can be pretty serious. It is complicated. Lots of countries do vaccinate against chickenpox. And this is one of the vaccines that's on the list that the Independent Advisory Committee that advises on vaccination looks at from time to time. One of the issues with chickenpox is if you introduce the vaccine

and you don't get very good heart uptake of the vaccine, what you tend to do is get more people getting it when they're older. And chickenpox is much more severe in adulthood. So you have to be very, very sure that you're going to have very high uptake in young children. Another question from a listener here. What about those who have recently died from measles? Actually, were they vaccinated? Most of the cases of measles that have occurred have been in unvaccinated people. Though not all? Not all. Some of them have had one dose, but you really need two doses to be best protected against measles.

Herd immunity is an expression that people will be familiar with, but what can you strictly define it for us, Helen? Well, I prefer the term community immunity because our children aren't little cows. Basically, it means when you immunise somebody, they are protected. If enough people in the community are immunised, then you have community protection. So people who can't be immunised, maybe very young babies or old people or people with severe conditions that suppress their immune system will be protected because there's so little disease around. And actually, that means that herd immunity will protect, sorry, I've carried on using the expression you don't like,

will protect those individuals whose parents didn't vaccinate them. Absolutely. It's very powerful. So they get that protection too. And importantly, it also protects the people who didn't get full protection, even though they've been immunised because no vaccine is 100% effective. This is very sad from Sally. When I was six in 1967, my best friend died of measles and I've never forgotten about her. That was my first experience of somebody dying. Measles still very dangerous and the vaccine is very important. From Fiona, I lost my hearing in one ear because of measles at the age of six. It was a big decision to give my children the MMR in 2001 with adverse publicity around at the time.

But my own experience meant that it was a no brainer. To what degree, Samantha, is the panic around vaccinations restricted to pampered Western societies? You can get it in a lot of different societies. It doesn't have to be just in the West, especially rising middle classes. They're very influenced by views that are held in other countries. And you see anti-vaccine ideas travel right across countries. So in Japan, the panic about the HPV vaccine, that spread to the Philippines and even further away to Nigeria. It's interesting, isn't it? I'm looking at Twitter and this is totally honest because it's live and it's right in front of me. This is from Hannah. One sided discussion. There's no balance amongst your guests on this subject. Helen?

Well, there's no balance because the science is firmly in favour of vaccination. There's absolutely no question. And if we think about in the period between the year 2000 and 2017, measles vaccination prevented 20 million deaths. There's no argument that vaccine is the best thing to do. It is interesting. I mean, fundamentally, I guess we're now, you could argue, and many will, that we're being sidetracked into worrying about the possible side effects of a vaccination because we aren't seeing the illnesses and the diseases anymore, are we? Absolutely. Now, I've got two children. They're young adults. And I was just reflecting on their childhood. The worst thing they got as children were coughs and colds. And they had chickenpox, but they weren't really ill with that, although you can be, obviously. We are not used to seeing children being really ill at all because of vaccination. They just don't experience these childhood diseases anymore. We're incredibly fortunate. Helen Bedford, Professor of Children's Health and Samantha Vanderslot, Social Sciences Researcher.

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