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Vaccine jabs on time could save your life

Some deadly diseases are making a comeback, decades after scientists had largely eliminated them with vaccines. Recent outbreaks of the oldest vaccine-preventable diseases such as measles, pertussis, diphtheria and polio in developed and developing countries call for global vigilance on immunisation programmes. Public health officials attribute recent outbreaks in developed countries to vaccine hesitancy, a phenomenon as old as vaccines themselves. The World Health Organization defines vaccine hesitancy as "delay in acceptance or refusal of vaccines despite availability of vaccination services" and suggests, "It is influenced by factors such as complacency, convenience and confidence."
Vaccine hesitancy - also referred to as vaccine refusal, anxiety, social resistance and more - is "complex and context specific varying across time, place and vaccines," according to WHO. Vaccines save millions of lives, and yet researchers point out that vaccine hesitancy is a dangerous global trend - in populous emerging economies like India and China as well as advanced economies including the United States and Europe. Concerns about vaccine safety are growing in countries such as Russia, Japan, France, Italy, Greece, Vietnam, and Saudi Arabia.
With scientific breakthrough discoveries in vaccine-preventable diseases since the late 18th century, public health officials worldwide endorse immunisation as the single preventive and cost-effective health intervention. The international community promotes vaccinations as an essential factor for ensuring health equity, especially in low- and middle-income countries.
Immunisation has proven to be cost-effective with immunisation of 116.2 million infants with three doses of combined DTP3 vaccine for diphtheria, pertussis and tetanus in 2017. Despite these efforts, global vaccination coverage remains at 85 per cent, with 19.9 million infants not receiving three doses of the vaccine that year. Improvements in global immunisation coverage are required to prevent vaccine-preventable deaths of children worldwide every year.
A common reason given for vaccine hesitancy is lack of trust among communities and parents for immunisation campaigns. Less trust in government, vaccine researchers, the vaccine industry, and fear around safety and efficacy of vaccines are among the factors driving parents' decisions to delay or refuse vaccinations for their children.
With the rise of the anti-vaccination movement in the West, countries such as the US have seen surge in parents resisting and delaying vaccines for their children despite mandatory immunisation regulations by schools and the government. Countries like India also report hesitancy in some parts. Despite eradication of smallpox and polio, India reports other diseases long prevented by vaccines such as diphtheria in parts of the country. In 2018, the Ministry of Health and Family Welfare in collaboration with Bill and Melinda Gates Foundation commissioned a study on vaccine hesitancy in India.
There are some similarities in factors driving vaccine refusal in western countries and developing countries. Fear of risks associated with vaccines are common factors associated with vaccine hesitancy. A complex web of historical, political, sociocultural and economic factors including everyday community social networking processes shape parents' choices not to vaccinate their children in developing countries, especially among the poor and socially marginalised populations.
With the measles and rubella campaign underway in India, reports of parents refusing to vaccinate their children have surfaced. One major objection is lack of parental consent before the vaccine is given to children at schools. The courts supported parents and stalled the campaign in Delhi. There were also reports of more than 70 schools in Mumbai not supporting the measles-vaccination programme based on parent objections.
Vaccine-hesitant parents are labelled as ignorant, backward, selfish, shameful and more. Yet little attention is directed to the various sociocultural, economic and political factors, and many health-system gaps shaping community and parental choices on vaccinations. Building trust in the health system takes time and requires catering to unmet socioeconomic and health needs of communities as well as seeking parental consent and addressing the many concerns around vaccines.
-Yale Global
Madhurima Shukla is a PhD candidate at the Centre of Social Medicine & Community health, Jawaharlal Nehru University