How vac­ci­na­tion pro­grammes got nee­dled by the free mar­ket

Free mar­ket ide­ol­ogy has con­trib­uted to ‘vac­cine hes­i­tancy’, en­dan­ger­ing us all, says Harry Collins

THE (Times Higher Education) - - CONTENTS - Harry Collins is dis­tin­guished re­search pro­fes­sor in the School of So­cial Sciences at Cardiff Univer­sity.

Im­mu­niza­tion: How Vac­cines Be­came Con­tro­ver­sial

By Stu­art Blume Reak­tion Books, 272pp, £25.00 ISBN 9781780238371 Pub­lished 28 July 2017

This is a fas­ci­nat­ing history of vac­ci­na­tion and its trou­bles, with a less con­vinc­ing con­clu­sion about the de­clin­ing take-up of vac­ci­na­tion.

Vac­ci­na­tion started with dis­eases like small­pox, which killed mil­lions. Then it was dis­cov­ered that, even in the case of very in­fec­tious dis­eases, if only 90 per cent or so of a pop­u­la­tion were vac­ci­nated, there would be too few hosts left for the mi­crobe to sur­vive and “herd im­mu­nity” would re­sult. Af­ter a time, the whole pro­gramme could be shut down be­cause the ter­ri­ble dis­ease would have been erad­i­cated from our planet.

Blume makes it clear that he is all in favour of tri­umphs like this. At­tempts to erad­i­cate po­lio are dealt with at length, com­plete with the early ar­gu­ments over the best kind of vac­cine to in­tro­duce – live or dead – and the sus­pi­cion that, in the first years of the cam­paign, some chil­dren were dam­aged or killed by vac­cines that were not fully un­der­stood. Yet this model of dis­ease erad­i­ca­tion sur­vived, to ev­ery­one’s ben­e­fit.

Then came the 1980s stress on free mar­ket ide­ol­ogy, when vac­ci­na­tion be­came the pre­rog­a­tive of the pri­vate sec­tor. In­evitably, there fol­lowed a profit-driven trend for vac­ci­na­tion against rel­a­tively mild childhood dis­eases such as mumps. Measles seems to be on the cusp for Blume – a killer in de­vel­op­ing coun­tries but far less se­ri­ous in de­vel­oped coun­tries.

Ac­cord­ing to Blume, the causes of “vac­cine hes­i­tancy” are mul­ti­fac­eted, and na­tion­ally spe­cific, from protest against state au­thor­ity to sus­pi­cion of the drug com­pa­nies. The med­i­cal pro­fes­sion prefers to blame the an­ti­vac­cine cam­paign­ers, be­cause this

Par­ents are jus­ti­fi­ably fear­ful for their chil­dren but vac­ci­na­tion is spe­cial be­cause my next-door neigh­bour’s re­fusal to vac­ci­nate puts my own child at risk

is sim­ple and they would not know what to do if they had to face up to the true causes. But Blume does not say what should be done and some­times seems to cham­pion par­ents’ sus­pi­cions about vac­ci­na­tion. Af­ter all, the drug com­pa­nies are af­ter profit and mumps doesn’t do much harm; when the drug com­pa­nies use ad­ver­tis­ing to con­vince ev­ery­one that it does, they can make a lot of money from vac­ci­na­tion.

My touch­stone for analy­ses of de­bates over vac­ci­na­tion is the sci­en­tif­i­cally base­less re­volt over the mumps, measles and rubella vac­cine (MMR) and I don’t think Blume han­dles it clearly. He helps us un­der­stand par­ents’ doubts but not that pan­ics like this can be based on triv­ial sus­pi­cions (what about a panic over con­sump­tion of kiwi fruit?) when the news me­dia am­plify the fears in the way they did in the case of MMR. Par­ents are jus­ti­fi­ably fear­ful for their chil­dren – plenty of par­ents are quoted – but vac­ci­na­tion is spe­cial be­cause my next-door neigh­bour’s re­fusal to vac­ci­nate puts my own child at risk.

Blume does not ask who, in the world we live in, should make the de­ci­sion to vac­ci­nate widely. While he con­demns the drug com­pa­nies’ highly ef­fec­tive use of the me­dia to ad­ver­tise the dan­gers of mild dis­eases, anti-vac­ci­na­tion cam­paigns, am­pli­fied by what we now know are fright­en­ingly ef­fec­tive so­cial me­dia, are treated as only a su­per­fi­cial prob­lem. Please, govern­ments, for the sake of my grand­chil­dren, counter anti-vac­ci­na­tion move­ments and their me­dia am­pli­fiers with of­fi­cial in­for­ma­tion cam­paigns, ir­re­spec­tive of any deeper, his­tor­i­cal, causes of re­sis­tance. Even in de­vel­oped coun­tries, measles is deadly dan­ger­ous for the weak and un­der­nour­ished.

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