Gangarosa, E. J. et al. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet 351, 356-361

Gangarosa International Health Foundation and Rollins School of Public Health, Emory University, Atlanta, GA, USA.
The Lancet (Impact Factor: 45.22). 02/1998; 351(9099):356-61. DOI: 10.1016/S0140-6736(97)04334-1
Source: PubMed

ABSTRACT To assess the impact of anti-vaccine movements that targeted pertussis whole-cell vaccines, we compared pertussis incidence in countries where high coverage with diphtheria-tetanus-pertussis vaccines (DTP) was maintained (Hungary, the former East Germany, Poland, and the USA) with countries where immunisation was disrupted by anti-vaccine movements (Sweden, Japan, UK, The Russian Federation, Ireland, Italy, the former West Germany, and Australia). Pertussis incidence was 10 to 100 times lower in countries where high vaccine coverage was maintained than in countries where immunisation programs were compromised by anti-vaccine movements. Comparisons of neighbouring countries with high and low vaccine coverage further underscore the efficacy of these vaccines. Given the safety and cost-effectiveness of whole-cell pertussis vaccines, our study shows that, far from being obsolete, these vaccines continue to have an important role in global immunisation.

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Available from: Robert T Chen, Sep 28, 2015
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    • "The FSM statements about the impact of complementary medicine on public health ('…delays in effective treatment, side effects, drug interactions, health misinformation and distrust of conventional medicine', '... public harm being done to patients', '… there's a lot of harm being caused in women's and children's health', '… the threat is to society in general' and '(l)ives have been lost over this') are also factually true and can be verified. Numerous recent outbreaks of infectious disease in the developed world can be traced to anti-vaccine sentiment arising from distrust of conventional medicine and misplaced trust in complementary medicine (Gangarosa et al., 1998; Maltezou Helena & Wicker, 2013). There have also been numerous cases of patient deaths caused by delays in obtaining effective treatment where the patient relied on complementary medicine,(Mashta, 2009; Smith, Stephens, Werren, & Fischer, 2013) and deaths directly attributable to the effects of treatment with complementary medicine (Farley, 2010; Iwadate et al., 2003). "
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    • "However, vaccines have been the object of controversies and opposition since the beginning of their use [2]. The past twenty years have seen a resurgence of vaccine related controversies which translated into declining immunization rates [3] [4] [5] [6] [7] [8]. Since 2007, the HPV vaccine has fueled a heated debate in many different countries including France [9] [10]. "
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    ABSTRACT: The internet is playing an increasingly important part in fueling vaccine related controversies and in generating vaccine hesitant behaviors. English language Antivaccination websites have been thoroughly analyzed, however, little is known of the arguments presented in other languages on the internet. This study presents three types of results: (1) Authors apply a time tested content analysis methodology to describe the information diffused by French language vaccine critical websites in comparison with English speaking websites. The contents of French language vaccine critical websites are very similar to those of English language websites except for the relative absence of moral and religious arguments. (2) Authors evaluate the likelihood that internet users will find those websites through vaccine-related queries on a variety of French-language versions of google. Queries on controversial vaccines generated many more vaccine critical websites than queries on vaccination in general. (3) Authors propose a typology of vaccine critical websites. Authors distinguish between (a) websites that criticize all vaccines (“antivaccine” websites) and websites that criticize only some vaccines (“vaccine-selective” websites), and between (b) websites who focus on vaccines (“vaccine-focused” websites) and those for which vaccines were only a secondary topic of interest (“generalist” websites). The differences in stances by groups and websites affect the likelihood that they will be believed and by whom. This study therefore helps understand the different information landscapes that may contribute to the variety of forms of vaccine hesitancy. Public authorities should have better awareness and understanding of these stances to bring appropriate answers to the different controversies about vaccination.
    Vaccine 01/2015; 33(8). DOI:10.1016/j.vaccine.2014.12.064 · 3.62 Impact Factor
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    • "Even those who are vaccinated can harbour hesitancy towards certain aspects of vaccination. The policy concern is that hesitancy soon becomes refusal, as suggested by theory and experience (Salathé and Bonhoeffer, 2008), and unvaccinated clusters emerge in which disease outbreaks can occur (Gangarosa et al., 1998; Jansen et al., 2003). For example, a UK study of 14,578 children found that three-quarters of parents whose children were not vaccinated with MMR made a conscious decision to not vaccinate (Pearce et al., 2008). "
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    ABSTRACT: This paper provides a consolidated overview of public and healthcare professionals' attitudes towards vaccination in Europe by bringing together for the first time evidence across various vaccines, countries and populations. The paper relies on an extensive review of empirical literature published in English after 2009, as well as an analysis of unpublished market research data from member companies of Vaccines Europe. Our synthesis suggests that hesitant attitudes to vaccination are prevalent and may be increasing since the influenza pandemic of 2009. We define hesitancy as an expression of concern or doubt about the value or safety of vaccination. This means that hesitant attitudes are not confined only to those who refuse vaccination or those who encourage others to refuse vaccination. For many people, vaccination attitudes are shaped not just by healthcare professionals but also by an array of other information sources, including online and social media sources. We find that healthcare professionals report increasing challenges to building a trustful relationship with patients, through which they might otherwise allay concerns and reassure hesitant patients. We also find a range of reasons for vaccination attitudes, only some of which can be characterised as being related to lack of awareness or misinformation. Reasons that relate to issues of mistrust are cited more commonly in the literature than reasons that relate to information deficit. The importance of trust in the institutions involved with vaccination is discussed in terms of implications for researchers and policy-makers; we suggest that rebuilding this trust is a multi-stakeholder problem requiring a co-ordinated strategy.
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