The Economist explains

Why vaccination rates in the West are too low

By S.C.

IN ANY list of life-saving discoveries, vaccines come near the top. In America, more than 700,000 children born in the two decades to 2013 have avoided premature death because of vaccination. Yet in many Western countries vaccination rates are faltering and diseases that had nearly disappeared are re-emerging. In America, Britain and France, among others, vaccination against measles has fallen below the 95% threshold that stops the highly infectious disease from spreading. This trend is often blamed on hardline “anti-vaxxers”, or parents who refuse all vaccines for their children, but they are not the main culprits. Why are vaccination rates in the West on the decline?

In most countries, anti-vaxxers make up only 2-3% of parents. They shun vaccines for reasons that range from the belief that diseases strengthen a child’s physical and mental development, to fears that vaccines cause autism or interfere with God’s divine will, to the view that good nutrition alone confers “natural immunity” against disease. Anti-vaxxers are a problem because they tend to live in clusters, which can make them the source of outbreaks as the local population as a whole becomes more vulnerable.

A bigger problem, however, is the growing number of parents who delay or pick and choose jabs even though they are not against vaccination in general. About a quarter of parents fall in this category. Some believe that a child’s immune system is “overloaded” by too many jabs. Others worry about the safety of particular vaccines, usually in the aftermath of vaccine scares. Doctors and nurses are their most trusted source of information. But they can fail to soothe their patients—some because they are pressed for time during appointments; others because they are not trained to counsel questioning parents who come brandishing dodgy information found online. Worse, recent research from several European countries shows that many doctors and nurses have also become hesitant about vaccines, for the same reasons as their patients. In a survey conducted in 2014, 16-43% of French family doctors said they never or only sometimes recommended some specific vaccines.

In America, some poor children have no regular relationship with a family doctor. As a result they miss out on vaccines despite a federal programme to provide them at no cost. In eastern Europe, Roma (gypsies), a poor and ostracised minority, often go unvaccinated, in part because health workers shun them. There are many places where vaccination rates would probably be high enough to cross the 95% threshold if only governments did a better job helping those who skip jabs because they are poor or hesitant. Once that happens, the anti-vaxxers can rightly shoulder all the blame.

Read our full report about vaccination rates here

Update: The headline of this piece has been changed from "Why vaccination rates are declining in the West", which suggests this is a continuing trend rather than one that has plateaued

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