We have to improve access to vaccines - both in the UK and abroad
Vaccines are critical for health both at home and abroad. They must be made more accessible, says Philippa Whitford
Vaccines remain one of the most transformative and cost-effective public health initiatives of all time, saving over two million lives every year and protecting millions more from permanent disability. However, vaccine uptake across parts of Europe and the USA dropped in the early 2000s in response to discredited claims regarding risks from the MMR vaccine. While it did recover, it is now drifting down again, leaving significant cohorts of young people unvaccinated and vulnerable. This was seen recently in Swansea when a fall in MMR uptake from 94% in 1995 to 67% in 2003 led to a measles outbreak in 2012-2013 which caused the death of one young man. Last year alone there were over 82,000 cases of measles across Europe, leading to 72 deaths.
Despite high quality immunisation programmes, there have been variable drops in vaccine uptake across the nations and regions of the UK. In England, coverage declined to below the World Health Organisation (WHO) recommended level of 95% for community protection in nine of 12 routine vaccinations. Measles cases in England are increasing every year. Scotland, Wales and Northern Ireland have also seen decreases in vaccine uptake in recent years, but still tend to be several percentage points higher than England and no measles outbreaks have been seen in Scotland or Northern Ireland. It is therefore important to understand the impact of any differences in policy, accessibility or societal confidence.
Whilst high profile anti-vaccine campaigns on social media contribute to parental anxiety, other causes appear to have a bigger cumulative impact on uptake. A report by the Royal Society for Public Health showed that the most common barrier to getting vaccinated was simply ease of access related to the timing and availability of appointments. Complacency is another contributor. Most people have never seen someone paralysed by polio and are not aware that measles used to kill over two million children each year. It is therefore easy to think these are just minor childhood illnesses and that vaccines are not necessary or at least not an immediate priority. In order to explore some of the issues affecting vaccine uptake, the All-Party Parliamentary Group on Vaccinations for All plans to conduct an inquiry into vaccine confidence and resilience in regions like the UK, Europe and the USA.
'In England, coverage declined to below the WHO recommended level in nine out of 12 routine vaccinations'
While uptake is drifting down in countries with full access to vaccines, only 7% of children in the poorest countries receive the full range of WHO recommended vaccinations and 1 in 6 children receive none at all. Meanwhile, research organisations such as the International AIDS Vaccine Initiative are still working to develop new vaccines against other life-threatening diseases like malaria, tuberculosis and HIV. The devastating Ebola outbreak in West Africa persisted from 2013 to 2016 due to the lack of any vaccine with which to fight the disease. An Ebola vaccine is currently being developed but without routine vaccination such infectious diseases pose a real threat to global health.
Vaccines can also make a major contribution in tackling other health challenges. The WHO identifies the increase in antibiotic-resistant infections as one of the top ten threats to global health. However, viruses and bacteria do not appear to develop resistance to vaccines so immunisation, particularly against common respiratory conditions like pneumonia, could reduce the need to use antibiotics in the first place.
Vaccines are also contributing to the fight against cancer. Recent research in Scotland has shown an 85% reduction in pre-cancerous cervical lesions in young women since the introduction of the Human Papilloma Virus (HPV) vaccine. This holds out the promise of virtually eliminating cervical cancer within a generation – however confidence in vaccines is critical to realising their full potential.
The UK is one of the foremost funders of global immunisation projects including the Global Polio Eradication Initiative and Gavi, the Vaccine Alliance, which provides affordable vaccines for low income countries. It is therefore imperative that the UK government continues to prioritise immunisation in domestic and international policy and encourages other governments to do the same.
To find out more about the APPG Vaccinations for All inquiry, please go to: www.appg-vfa.org.uk.
Dr Philippa Whitford is SNP MP for Central Ayrshire and health and social care spokesperson
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