Vaccination against COVID-19 (when we have a vaccine) is one of the alternatives to face it, probably the most important. This does not imply that if an effective treatment of the most serious cases arrives, it is not another essential alternative.
The best example is in the case of AIDS, where effective and affordable treatments came long before the vaccine, which does not yet exist. Thanks to them, the survival and quality of life of the treated cases has improved very significantly. But even so, we still have a global AIDS pandemic out of control in many countries. And we are still waiting for a vaccine like May water. Because vaccination, when it offers broad and long-term protection, is the best option.
That is why it is desirable in the case of the SARS-CoV-2 coronavirus to find one (or several) vaccines to combat COVID-19. The downside is that, while hundreds of scientists around the world scramble to find them, anti-vaccine movements (and celebrities who publicly oppose vaccination, such as tennis player Novak Djokovic or singer Miguel Bosé) can jeopardize their credibility. .
Worrying vaccine skepticism
It should be remembered that these anti-vaccine attitudes are speculative opinions, they are not data, much less information. They frequently reflect skepticism towards the system in general and towards the public powers, be they health authorities or the pharmaceutical industrial establishment. In this sense, to create mistrust it is not necessarily necessary to provide new confirmed veracity: it is enough with suspicions thrown into the air.
The COVID-19 vaccine, before existing and knowing its indications, already has detractors with outlandish speculations. The most talked about, associated with microchips (never seen) injected together with vaccines, linked to the deployment of 5G (without any technical documentation) and the specter of technological crowd control.
WHO is concerned about the matter. So much so that vaccine skepticism made his top ten health priorities list last year. It has good reasons. Without going any further, the elimination of polio has been a goal of the WHO for more than two decades. Anti-Western positions in Afghanistan and other areas controlled by the Taliban power put a stop to vaccination campaigns in these countries, where a certain level of transmission and new cases is maintained among individuals in poorly vaccinated populations. From these sources, new cases of imported polio have appeared in Africa and Southeast Asia associated with unvaccinated travelers.
To make matters worse, in recent years we have seen outbreaks of hundreds of measles cases in Europe and the United States, caused by bags of poorly vaccinated – or unvaccinated – individuals who are partially protected by the rest of the people around them who are. massively vaccinated. Viral circulation is present and fatally ends up turning unvaccinated people into cases in populations that have not had any for years.
The solution is to educate
For the discourse of anti-vaccines to fall on deaf ears, especially in order to solve the current pandemic, the ideal would be to improve and maintain health education from schools and throughout life, including very importantly the social media . It is necessary to generate knowledge and trust in science, to teach to distinguish between information and opinion, to verify the source and consistency of the communicated data, to move away from the spectacularities and false controversies between unequals.
Safety experts who have investigated vaccine skepticism identify a small group of irreducible (less than 5% of the population in the United States) qualifying as “highly convinced anti-vaccines”, active activists on the Internet. Then there is the social group of “undecided” for various reasons, which can reach 30% of some populations. The latter are the most influenced by negative opinions, and capable of being well informed to avoid drifting to the fraction of the anti-vaccines that ultimately do not vaccinate their children.
How to rebut the anti-vaccine arguments in COVID-19
This is how three of the most recurrent arguments of anti-vaccines against COVID-19 are countered:
“It could be that the final vaccine was partially effective.”
And it is true. But, even in this case, if vaccination were able to reduce transmission and mortality by a significant percentage, it would already be very useful to mitigate the impact of outbreaks.
Without going any further, each winter’s flu vaccine is an example of vaccines that have modest efficacy (60-70%). It is due both to the fact that the dominant influenza virus is different in each campaign (new vaccines must be made every year) and to the fact that there are always different flu circulating in different proportions in each country (and only some of the types are covered by the recommended vaccines ). The result is that there are still cases even among those vaccinated, generating a feeling of ineffectiveness and confusion. But they are vaccines that every year save many lives among the adult and elderly population.
Global regulatory offices grant licenses for use only after independently verifying that vaccines meet efficacy and safety requirements and that indications (who to vaccinate first, how many doses, etc.) are balanced by the number of cases they prevent (or mitigate the severity) and cost of vaccination campaigns.
Most vaccines have very high efficacy (90-95%) and in well-vaccinated countries there are multiple infectious diseases that have practically disappeared.
“There is a lack of transparency about conflicts of interest.”
The collaboration of the academic world with the industrial world is essential, but at the same time it generates potential situations of conflict of interest. Information transparency is a necessity in health matters and especially in ambiguous situations: moderately satisfactory results, debatable conclusions, interpretations of doubtful data, inconsistencies between different studies, etc. But it must be admitted that it is complex and must be resolved by committees of independent experts.
The academic world has developed mechanisms for controlling conflicts and managing conflictive situations, for example making explicit in each public intervention (conferences or publications) what are the relationships between the professional and the industry that produces the medication or the vaccine. This issue is important, especially in the development phases and in the face of initial results, when information is scarce.
Something different happens when a vaccine has passed all the efficacy and safety controls and the indications have been established by all the national and international scientific and health committees, as is the case with the expanded vaccination calendar and the latest vaccines introduced (the of the human papillomavirus, HPV). So it is essential that doctors and health workers inform the population and support the introduction of vaccination as directed.
“Vaccines are unsafe.”
The criteria of (in) safety of vaccines or their adjuvants – that is, the substances included in the vaccine injection that enhance the antigenic stimulus – have always been used by the anti-vaccine movement. And this despite the experience accumulated by hundreds of millions of doses both in controlled studies and in generalized vaccination programs in all international contexts.
But the truth is that the regulatory bodies of vaccine products closely monitor vaccine efficacy and safety before authorizing or indicating public use, and continue to monitor safety for years after introduction. An unwanted side effect is highly unlikely to go unnoticed by routine surveillance networks.
Despite this, we continue to see open attacks on vaccination without any new studies to justify it. The investigation is long, complicated and expensive. The doubt, on the contrary, is gratuitous.
Organized Fake News
Anti-vaccination is organized disinformation. The rivalry between parties and the politicization of health decisions such as vaccination tend to take emotional and extreme positions (both for and against) in times of crisis.
In fact, governments like Donald Trump’s have already had in the past advisers skeptical about vaccination such as Andrew Wakefield or Robert F. Kennedy, although they have not ultimately followed their theses. And fake news and conspiracy theories about COVID-19 already circulate abundantly on social media, representing an ideal breeding ground for any skeptical or clearly anti-vaccine opinion.
Despite massive scientific evidence, anti-vaccine attitudes rarely acknowledge or justify their mistakes. This is part of a strategy to be able to repeat erroneous arguments over and over, which are often related to other interests.
Simplifying a bit, the perpetuation of anti-vaccine positions is based on two economic pillars: the sale of alternative medicine and lawsuits against multinational pharmaceutical companies. And in a political one: distrust of the system.
But, no matter how much it may weigh them down, vaccines are the most important health resource after water sanitation and basic nutrition. Between 2 and 3 million lives are saved each year among child populations through routine vaccination of newborns and children. Recommended vaccines are our safest option, and nothing can compare to their effectiveness and improved quality of life.
Francesc Xavier Bosch José. Professor of Health Sciences Studies. Senior Consultant of the Cancer Epidemiology Research Program of the ICO, UOC – Universitat Oberta de Catalunya
This article was originally published on The Conversation. Read the original.
