Shutterstock/Montebasso. All rights reserved.While the World Health
Organisation warns of major
measles outbreaks spreading across Europe, vaccination has
stepped into national and EU political debate as a major health issue. Looking
at the 2018 Italian general election, some candidates scrambled to deliver
a clear position on this matter. Adopted last summer, a new Italian law
on vaccines introduced 10 mandatory (and free of charge)
vaccinations for preschool and school-age children. Parents now have to present
vaccination certificates to schools which must notify the local health
authorities when they fail to present those documents. The Democratic Party and
Forza Italia political parties champion the so-called ‘Lorenzin Law’ while the
right-wing Northern League and the 5 Star Movement call for immunizations to be
left to parents’ discretion, regardless of WHO warnings on measles outbreaks.
France followed in Italian
footsteps and made 11 vaccinations
mandatory from January 1, 2018. As it was stated by French
Prime Minister Édouard Philippe, it is unacceptable that children
are still dying of measles in a country where some of the earliest vaccines
were pioneered. Indeed, south west France has been recently hit by a measles
epidemic: in the region of
Nouvelle-Aquitaine since November the outbreaks have resulted
in 269 confirmed cases of measles, of whom 66 were admitted to hospital for
treatment. Even more worrying, the region has a too low vaccination rate to
cope with the epidemic (between 70% and 81% of people are vaccinated, lower
than the level recommended by the World Health Organisation – 95%).
The fall in public confidence in
vaccines has become more and more of a challenge which has contributed to
low rates of immunisation against the rise of highly contagious disease across
Europe. Media controversies, some political propaganda and the spread of fake
news (from big pharma conspiracy to autism) have fuelled a dangerous mistrust
of vaccines.
Does the EU want to play a role on
this issue? The European Commission is currently exploring ways for Member
States to work together on immunizations. Vaccination policy is a competence of
national authorities; however, a lot can be done with the support of Brussels.
President Jean-Claude Juncker has singled out the issue in his State of the
EU address, where no other reference to health policy was made.
Reading through Juncker’s White
Paper, vaccines hold a significant position in EU political debate
and policies. To prove that, a proposal for a
Council recommendation on national vaccination policies is
expected in the months to follow.
President Juncker commented on
the measles epidemic in Italy and Romania: “It is unacceptable that in 2017
there are still children dying of diseases that should long have been
eradicated in Europe (…) This is why we are working with all Member States to
support national vaccination efforts. Avoidable deaths must not occur in
Europe”. So, what can the EU do to tackle vaccine hesitancy across
Europe? EU incentives and best practice sharing could tackle vaccine
hesitancy, especially in the frame of the increasing impact of digitalization
(e.g. countering fake news messages on social media, promoting aware-raising
campaigns). Also, it is likely that better aligned vaccine schedules can help
to increase trust and confidence in immunisation programmes.
Article 168 of the Treaty on the
Functioning of the European Union (TFEU), provides that Union action must complement
Member States policies and cover monitoring, early warning, and combating
serious cross-border threats to health, by coordinating national policies
accordingly. Epidemics are by definition cross-border and shared threats.
No single country can cope with them alone. Vaccination is one of the most
important medical measures developed in the twentieth century and the best
defence we have against contagious and serious (sometimes deadly) diseases.
Thanks to vaccines, smallpox, polio and many other fatal diseases have been
eradicated. Vaccines hesitation and the related decreasing immunization
coverage represent a shared European threat. They put at risk human health by
causing resurgence of infectious diseases long since considered under control
(in 2017, Europe observes a 4-fold increase in
measles cases compared to 2016).
There are several areas where EU can
and must act:
- – First,
the EU could strengthen its surveillance capabilities to better assess vaccines
benefit (as well as potential risks) and infectious disease patterns. An
effective EU surveillance and data collection system (possibly coordinated by
the European Centre for Disease Prevention and Control) would also provide a
needed support to national immunisation strategies and to deter further
outbreaks;
- – Second,
the European Commission should investigate the causes of vaccine hesitancy and
put in place policy programs to increase awareness by enhancing fact-based
information about vaccination.
Many stakeholders look forward to the
Council Recommendation. I believe that many companies and organisations will
then have the chance to prepare in advance policy solutions to the EU’s
imminent drive to coordinate national policies.