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January 16, 2019

Anti-vaxxers listed among top global health threats for 2019

Measles cases have spiked by 30 percent worldwide

Vaccinations prevent more than 2 million deaths worldwide every year. And another 1.5 million lives could be saved with enhanced global vaccination coverage.

But the anti-vaccine movement poses a troubling problem, according to the World Health Organization.

WHO named vaccine hesitancy as one of its 10 threats to global health in 2019. The list also includes the threat of a global influenza pandemic, antimicrobial resistance and climate change.

There are various reasons that people choose not to vaccinate. A WHO vaccine advisory group identified complacency, inconvenient access and a lack of confidence as the key reasons driving the hesitation to vaccinate.

But the danger posed is clear. According to WHO, it "threatens to reverse progress made in tackling vaccine-preventable diseases."

Cases of measles – a preventable disease – have increased by 30 percent around the world, according to WHO. That surge cannot be attributed to vaccine hesitancy alone, but it is playing a role.

The United States – a country where the vast majority of people are vaccinated against measles – recorded 349 measles cases last year, according to the U.S. Centers for Disease Control and Prevention. That marked the second-highest total since 2000, when the disease was eliminated in this country.

These cases are caused by unvaccinated travelers who bring measles back to the United States or the spread of the disease within communities with large percentages of unvaccinated residents. 

In 2015, a measles outbreak occurred at Disneyland in Los Angeles, affecting 147 people.

Still, the percentage of unvaccinated American children continues to increase. According to the CDC, the percentage of American children who have not received any vaccinations by the time they turn age 2 has quadrupled since 2001.

Many parents do not vaccinate their children because they believe the vaccinations cause autism. (They have been nicknamed "anti-vaxxers" by critics.) The autism myth persists online despite 17 studies finding no link between autism and the MMR vaccine, which prevents measles, mumps and rubella. Another nine studies have shown other vaccines do not cause autism, either.

"The internet is unaccountable," Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, previously told PhillyVoice. "It's unverifiable. Therefore, it's full of great and awful information."

Since 2009, the number of vaccine non-medical exemptions issued for philosophical beliefs has increased in 12 of the 18 states that permit the exemption, including Pennsylvania, according to a 2018 study published in PLOS Medicine. The researchers listed Pittsburgh among several "hotspots" for high exemption rates.

In Europe, measles cases were expected to exceed 60,000 last year – more than double the 2017 total, according to an analysis conducted by The Guardian. There were at least 72 deaths attributed to the disease, which also doubled the 2017 total.

The European Union's health commissioner, Vytenis Andriukaitis, accused right-wing populist politicians of spreading misinformation on vaccine safety, stoking doubts.

"It is unimaginable that we have deaths because of measles – children dying because of measles," Andriukaitis told The Guardian. "We promised that by 2020 Europe would be measles-free."

WHO, which directs and coordinates international health within the United Nations system, plans to address vaccine hesitancy as part of its new five-year strategic plan.

This year, the organization pledged to increase coverage of the HPV vaccine this year as part of its efforts to eliminate cervical cancer. It also pledged vaccination efforts in Afghanistan and Pakistan, where poliovirus can potentially be stopped. Less than 30 polio cases were reported last year in both countries.

The other nine global threats highlighted by WHO include air pollution and climate change, noncommunicable diseases, global influenza pandemic, fragile and vulnerable settings, antimicrobial resistance, Ebola and other high-threat pathogens, weak primary health care, dengue and HIV.

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