In other words, an underfunded public health infrastructure may be more to blame for the uptick in measles than anti-vaxxers. “The [public health spending] cuts were mainly on prevention — like preventive clinics and also staff,” the study’s lead author, Veronica Toffolutti, a health economist at Bocconi University in Milan, told me. “Many people were not hired anymore as staff.” And without staff and services in place to vaccinate people, more people aren’t getting vaccinated, and measles is spreading.
The measles problem that’s surfaced across Europe might mean that even more vaccine-preventable diseases — rubella, mumps, diphtheria, hepatitis — could begin to rise, since measles is typically the first to start spreading when people aren’t getting their shots.
That’s because measles is incredibly infectious and needs the highest amount of coverage to give the population something called herd immunity: In order for any vaccine to be effective, you need to have a certain percentage of people in a population immunized. This means diseases can’t spread through populations very easily, and it protects even those who aren’t or can’t be vaccinated.
With measles, 95 percent of people need to get the shot to prevent the virus from spreading. “So it’s one of the first vaccine-preventable diseases to show its face when there’s under-vaccination,” Larson said.
And many countries in Europe are under-vaccinated. “Italy, France and Serbia, for example, have lower child-vaccinations rates than Burundi, Rwanda and Senegal,” the Economist recently reported.
To boost vaccination rates, many countries in Europe have been cracking down on vaccine-refusing parents, experimenting with fines and sanctions. And, to be clear, vaccine refusal is a problem. France, for example, has one of the highest rates of vaccine skepticism in the world: According to one study, 41 percent of people there disagreed that vaccines are safe. In Germany, it’s not unusual to go into pharmacies and find homeopathic “cures” for many ailments, or even homeopathic hospitals.
“The vaccine acceptance issues are a bigger piece of the pie than they were historically,” Larson said.
But Europe’s vaccine problems are much larger than anti-vaxxers. And the story of measles may be the canary in the coal mine for an infectious diseases problem that’s even more dire than it appears right now.
Author: Julia Belluz
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