Vaccines: Level of mistrust remains high despite overabundance of data

  • Vaccines are best public health tool in the world.
  • Mistrust in vaccines remains high despite well documented misinformation.
  • COVID-19 pandemic has raised the visibility of vaccines.

VANCOUVER. Some 224 years after the first vaccine was developed, there is still a surprisingly high number of people that distrust vaccines at a gut level. Some of these people have even developed big megaphones to sow distrust on what may be the single most important weapon in the world’s public health arsenal.

In Canada, between 5% and 10% of the population disagree that vaccines are safe, according to the Wellcome Trust Global Monitor. In the U.S., the number is higher at between 10% and 15%. In France, the number is as high as 30%. In Russia, it is as high as 25%. Latin America is generally more trusting of vaccines as is Asia, particularly south Asia.

One of the biggest arguments of antivaxers is a baseless link between vaccines and autism, specially a vaccine for measles, mumps and rubella (MMR). The link was first put forth in a paper published in 1998 that was later discredited. The author, Andrew Wakefield, was found to have cherrypicked data and falsified facts. He lost his license to practice medicine.

The number of studies that support vaccines far, far outnumbers those who create any doubts. One such study published in April 2019 in the Annals of Internal Medicine was done over 10 years with 657,461 children in Denmark and found no significant link between the MMR vaccine and rates of autism.

Still, despite the well-established benefits of vaccines in general there are concerns that antivaxers and people with “vaccine hesitancy” have gained unsupported ground.

One finding put forth at the Global Vaccination Summit in September 2019 was that “(d)espite the availability of safe and effective vaccines, lack of access, vaccine shortages, misinformation, complacency towards disease risks, diminishing public confidence in the value of vaccines and disinvestments are harming vaccination rates worldwide.”

This despite the fact that vaccination “is indisputably one of public health’s most effective interventions.”

The first vaccine was developed by Edward Jenner in 1796 to prevent smallpox. Smallpox killed about a third of all people it infected, with a mortality rate of 30% reported in China as far back as the 16th Century. Jenner used pus from cowpox to inoculate an eight-year-old boy. He later exposed the boy to smallpox 20 different times.

The term vaccination comes from the Latin for cow: “vacca”. Roughly 3,000 people per million people in England died of smallpox in 1796. A century later, the number was down to just 10.

The next big advance was almost a century later, when Louis Pasteur, a French biologist, treated a 13-year-old boy that had been bitten by a rabid dog by injecting a weak rabies virus into him every day for 13 days.

In the decades that followed, the number of vaccines in circulation multiplied. A vaccine for whooping cough came out in 1914, one for diphtheria in 1926, tetanus in 1938, influenza in 1945, mumps in 1948, polio in 1955, measles in 1963, rubella in 1969.

By the 1990s, most countries in the world had put in place big-scale immunization programs. It is now standard for kids to get their shots and never, ever have to worry about a host of diseases that have killed millions of people.

Vaccines take time to develop. The world is now hanging out hope that a vaccine for Covid-19 will be developed and circulated in less than 18 months.

There are two basic approaches to vaccines. One is to use a weak version of the virus or bacteria to show the body what it is and how to fight it. The other uses genetic platforms like DNA or RNA and combines it with the virus that is grown inside eggs or cell cultures.

The problem to getting a vaccine to people is that it has to be tested but vaccines are not treatments. They are tools to prevent disease so any testing has to show that something (a person contracting a disease) did not happen. And this takes time.

At their most basic, vaccines prepare a person’s immune system to identify, fight and destroy specific bacteria and viruses. Vaccines give the body information it may not have had before. In the case of Covid-19, nobody’s immune system has the information needed to fight the virus.

Most vaccines go through at least three studies before approval and are tested first on tens of people, then hundreds and then thousands. This is followed by a regulatory review for approval and then post approval studies to monitor how effective a vaccine is or isn’t.

Developing and getting approval for a vaccine is only the first step. After that, manufacturing has to be put in place and then distribution. Getting any product to billions of people around the world is not an easy or cheap feat.

Technology is helping. There are a couple of projects underway to tap into crowd computing to develop vaccines faster. One project at Stanford University is tapping into a distributed computing model to develop a vaccine. The Folding@Home projects opens up unusued computing power in laptops everywhere to better understand the virus.

If the first vaccines took decades to be developed and widely distributed, a first batch for a vaccine for Covid-19 took about six weeks. There are several vaccines under development for Covid-19 and the first to get a candidate into trials was a U.S. company called Moderna.

The company used an mRNA platform to develop a vaccine in 25 days from the moment it accessed the genetic sequence for the novel coronavirus shared by Chinese authorities on 11 January 2020. Moderna completed a first clinical batch of a vaccine by 7 February.

A trio of Chinese companies have moved forward with vaccines, a couple in cooperation with global counterparts.

 

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