Anti-vaxxers: Vaccine hesitancy rears its head around the world as agencies work to reach everyone

  • Antivaxxer movement is not coordinated globally and may lack resources and funding but still growing and making headlines.
  • COCONEL Group: Many experts have warned against a worldwide decline in public trust in immunization and the rise of vaccine hesitancy during the past decade.
  • Understanding and confusion about ingredients like thimerosal, which is linked to mercury, add to the concerns and misunderstandings.
  • Vaccine prices and legal settlements vary between regions, causing concerns and raising calls for some uniformity.

CAJICA, Colombia. Even as the world waits anxiously for a vaccine that can do away with COVID-19, the number of people who are hesitant about using vaccines may be growing. And this rising number of vaccine hesitant people at this particular point in time could have an outsized impact on global health for years to come.

“If they have heard that it is a plot, or vaccines in general are bad, and we don’t have people willing to take the vaccine, then that will let the disease continue to kill people,” Bill Gates,  the Microsoft founder, said during an interview with BBC Radio 4. He was talking about the impact of vaccine hesitancy in the midst of the COVID-19 outbreak.

Even as a pandemic makes its way around the globe, the number of people unwilling to use vaccines or vaccinate their children is on the rise.

Gates, founder of the Bill & Melinda Gates Foundation has taken a stand against the bold moves promoted by antivaxxers – people that oppose vaccination – and could, in his view, threaten the progress being made by groups like the GAVI Alliance that promote vaccines around the world.

GAVI is a public-private partnership that claims to have helped “vaccinate half the world’s children against some of the world’s deadliest diseases”. It was founded in the year 2000 with sponsorship from the Bill & Melinda Gates Foundation.

The antivaxxer movement is not coordinated at a global scale, nor does it have the types of resources and funding that entities like GAVI have. Still, often on the back of little evidence, less science and much fear it is growing and is making headlines.

The movement is growing even as researchers and drug developers around the world work on developing a vaccine to tackle the novel coronavirus known as SARS-CoV-2 or COVID-19. There are currently at least 118 vaccine prospects under development.

“Many experts have warned against a worldwide decline in public trust in immunisation and the rise of vaccine hesitancy during the past decade, especially in Europe and in France,” noted the highly regarded publication The Lancet in research published on 20 May 2020.

The research, conducted by the COCONEL Group, a French research initiative, found that as many as 26 percent of the French population in isolation in March would not use a COVID-19 vaccine if one becomes available.

“Early results from a survey done in late March in France suggests that this distrust is likely to become an issue,” the research says.

The situation in France is not unique.

Across Latin America, a growing number of parents are opposing mandatory vaccination, although there is no data as of yet about how many people in the region would oppose a COVID-19 shot.

Among them is Mercurio, a father of two girls aged 12 and 18 living in Bogota, Colombia, who did not want his real name disclosed.

“I had to inform myself and watch hours and hours of documentaries to reach a conclusion because, one way or another, I think about the life of my daughters. By giving them a shot [of any vaccine], there are some risks, and by not doing so, there are others,” he told Anticentric.

The pseudonym he chooses, Mercurio, is itself a thinly veiled shot at vaccines, referring to one of the ingredients that has sometimes been used in vaccines called thimerosal.

Thimerosal has been used as something of a preservative in vaccines. At least in the U.S. it is no longer used in most vaccines for children except some flu shots. On the other hand, while mercury is dangerous to the brain or kidneys, the science community agrees that the type of organic mercury that is part of thimerosal does not have those effects.

“Thimerosal is a mercury-based preservative that has been used for decades in the United States in multi-dose vials (vials containing more than one dose) of medicines and vaccines,” says the Centers for Diseases Control (CDC) in the U.S.

The CDC also notes that some reactions like redness and swelling at the injection site could happen.

Still, the CDC says that in 1999 the public health service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure.

The World Health Organization (WHO) also suggested that thimerosal does not constitute a problem and that no link has been verified between thimerosal and conditions that antivaxxers often point to like autism.

“Thimerosal contains ethyl mercury, not methyl mercury, and ethyl and methyl mercury are quite different,” says the WHO. “Studies have subsequently shown that withdrawal of thimerosal-containing vaccines had no effect on conditions, such as autism, which had been linked by some advocates to use of thimerosal-containing vaccines,” says the WHO.

Still, Mercurio does not buy it. He still wonders why large pharmaceutical companies have settled multi-million-dollar lawsuits with patients and parents of vaccinated kids if the vaccines are truly harmless.  

“Pharma companies are granting large amounts of money [to the injured] that can go up to $3 million or $5 million. The companies give that money and recognize that something serious is taking place,” he said.

In this fiscal year alone in the U.S., more than US$199 million have been awarded to 521 injured patients or their relatives, according to data published by the Health Resources & Services Administration (HRSA) that runs the National Vaccine Injury Compensation Program.

“In the majority of cases, vaccines cause no side effects, however they can occur, as with any medication but most are mild. Very rarely, people experience more serious side effects, like allergic reactions. In those instances, the National Vaccine Injury Compensation Program (VICP) allows individuals to file a petition for compensation,” says the HRSA.

According to HRSA, about 70 percent of all the compensations awarded is the result of negotiated settlements between patients or their relatives and pharma companies.

“At the beginning, vaccines cost just a few cents. Nowadays, they cost hundreds of dollars for each dose, and a great part of that cost is associated to the legal risk,”said Mercurio.

The cost of vaccines ranges significantly and can vary from one country or region to another.

Research published in the journal Human Vaccines & Immunotherapeutics suggests that vaccinating a person living in Sweden over a lifetime and in compliance with the recommended vaccine calendar does not exceed €443 (US$500), about €44 for each disease prevented. A woman with an underlying condition living in England, on the other hand, can expect to pay as much as €3,395 or €226 per disease.

The research acknowledges that a simplification of access to vaccinations must occur in accordance with the safety standards and the legal context of the countries concerned. 

In Latin America, where Mercurio lives, vaccines are sold much cheaper than in the U.S. and Europe. Also, it is unlikely for the pharma companies to have to deal anywhere near as many legal cases in Latin America as they do in the U.S.

For instance, a Hepatitis A pediatric vaccine was listed by the Pan American Health Organization (PAHO) in 2019 at a cost of US$8.14. The U.S. CDC lists the same vaccine manufactured by Merck, from Kenilworth, NJ, as costing US$20.6, including US$0.75 for a federal tax.

The CDC also lists the varicella vaccine as costing US$82. PAHO lists the vaccine at US$16.5.

Vaccines distributed by PAHO are mainly acquired by Latin American governments who then distribute them through national vaccination programs.