Tuesday, September 04, 2018

A sociology of measles - Michael Briguglio

Image result for measles statistics europe june 2018
Times of Malta, 4 September 2018

Sometimes society creates panics which spread like wildfire. They may refer to all sorts of issues, ranging from health to security. Media coverage, word of mouth, sensationalism and popularisers fuel the news. Some people become believers to the cause, others remain sceptical; some news are factual and others are fake.
Politicians, policymakers, journalists and civil society have a duty to be factual and combat scepticism based on falsity, even if facts may sometimes not fit their respective agendas. Sure, there are different ways to interpret facts like statistics, but this does not mean that knowledge forms such as science and should be treated as mere random chatter at the pub.
In such a context, it is imperative to acknowledge that contemporary society is one based on opportunities and risks which we ourselves create. We create modes of transport that give us endless opportunities, but which paradoxically have unintended consequences such as pollution and accidents.
Similarly, medicine has provided lifesaving remedies, but sometimes it can also have side effects. Consequently, it is imperative that citizens are equipped to navigate through the everyday challenges, and that the knowledge we receive is as factual as possible. We can then make informed choices. Very often, not choosing is itself a choice.
This takes us to a current panic which is spreading across Europe: measles. Before I proceed, let me make it clear that I believe that the panic is legitimate and is based on scientific evidence, which I trust. 
The World Health Organisation recently released data which shows that the 41,000 European measles cases between January and June this year exceeded the annual total for each of the preceding five years. In 2016 there were only 5,000 cases. Half of these cases were in the Ukraine, but hefty increases and outbreaks also took place in other countries. Europe also reported 37 deaths during the first half of this year.
The main reason given for such increases has to do with low child vaccination rates in some countries. A small number of European countries have lower rates than some African countries. The low rates may be due to two main reasons: in countries such as Ukraine and Serbia supplies of the MMR (measles, mumps, rubella) vaccine has been irregular in recent years, hence affecting vaccination uptake.
In the Ukraine, vaccination take-up plummeted from 95 per cent a decade ago to 31 per cent in 2016, partly due to the geo-political troubles but also due to certain governmental decisions.
On the other hand, in countries such as France, Greece and Ukraine there are also significant numbers – ranging from 40 per cent to 25 per cent of the population – who are sceptical of vaccines.
There are various reasons for scepticism on different vaccines, ranging from belief in hoax news to governmental opinions on whether certain vaccines should be compulsory or not.
In Italy, for example, the new populist government has added fuel to the existing measles fire when it stopped 10 compulsory vaccinations for kids entering schooling.
It is clear that scepticism on the MMR vaccine is based on fake news following a fraudulent study in 1998 by Andrew Wakefield, who has since then lost his medical licence. A cursory look at evidence and scientific literature will show why his conclusions were false. But still, there are quite a lot of people who believe them.
In such contexts people who may be confused should give more importance to expert advice than to doomsday prophets, some of whom excel in social media sensationalism.
This takes us to Malta. Our country has a very good vaccination system, though certain vaccines must be purchased from the private sector. The government is now taking steps to prevent an increase in measles infections. Given Malta’s island status and its obvious links with other societies, it is obvious that the health authorities should be concerned.
Five out of the very few six cases this year were imported, and this validates the wisdom by successive governments to ensure compulsory MMR vaccination. Yet measles is highly contagious and the political consensus on the current situation is justified.