The days when measles was a killer disease affecting thousands are firmly in the past thanks to mass immunisations. However, a fall in vaccination rates means the disease is starting to make an unwelcome comeback in Europe – and European scientists have found a way to help.
‘There’s a hesitancy about vaccinations because people in Europe do not know about the original disease any more – they do not know what they are being vaccinated against,’ Dr Miriam Sturkenboom, the scientific coordinator of the ADVANCE project, said.
The five-year ADVANCE project involves more than 60 scientists working to maintain public trust in immunisation programmes by giving regulators and public health authorities the facts they need to make decisions on vaccines.
Many Europeans have stopped vaccinating their children due to scare stories such as claims – now discredited – that the MMR (measles, mumps and rubella) vaccine was linked to autism. That means that more people are now contracting the diseases these vaccines were designed to prevent.
Figures from Public Health England, a UK government body, reveal there were just 56 measles cases in England and Wales in 1998, the year when Dr Andrew Wakefield claimed there may be a link between the MMR vaccine and autism in the Lancet medical journal.
‘There’s a hesitancy about vaccinations because people in Europe do not know about the original disease any more – they do not know what they are being vaccinated against.’
Dr Miriam Sturkenboom, the scientific coordinator of the ADVANCE project
By 2008, the number of measles cases was up to 1 370 and the number of mumps cases was up to 2 405. In 2013, there were 2 030 cases of measles and 2 564 cases of mumps.
Dr Wakefield was struck off the medical register and the study fully retracted in 2010, but much damage had already been done. In November 2012, an outbreak centred in the Welsh city of Swansea – where vaccination levels were particularly low – saw 1 200 people fall ill and one person die.
Oubreaks have also occurred in unvaccinated populations in Austria, Belgium, Denmark, France, Germany, Italy, Spain, and Switzerland, according to the World Health Organization.
Even now, nearly four years after the retraction, uptake of the MMR vaccine in the UK remains below the recommended threshold of 95 %. In September, the World Health Organization said outbreaks of measles and rubella among EU Member States in the first part of 2013 seriously threatened the region’s 2015 elimination goal for these diseases.
Other unfounded scare stories have linked different types of vaccinations to sudden infant death syndrome, dyslexia – and even sexual promiscuity among teenage girls.
One of the EUR 10.7 million project’s main tasks will be to encourage vaccine manufacturers, academics, regulators and health bodies to share more data with each other. It’s a sensitive issue, vaccine firms are worried about giving away secrets to competitors, and public health bodies are keen to maintain their independence from manufacturers.
‘Collaboration between these diverse groups is very sensitive,’ said Michel Goldman, the executive director of the Innovative Medicines Initiative (IMI), a partnership between European drugmakers and the EU, which is supporting the project.
‘By bringing them together around the neutral platform offered by IMI, ADVANCE is in a unique position to pave the way for a framework that will make it easier to rapidly assess the benefits and risks of vaccines.’
Cases of measles in England and Wales 1996 to 2012 (select graph to open in new window).Researchers at the project are beginning the task of collating data on the risks and benefits of different vaccines for diseases including diphtheria, tetanus, pertussis (whooping cough) and measles. The team of scientists hopes to build a new platform where data can be analysed and results disseminated to members of the public, especially in moments of crisis.
‘We need more data available so that we can inform people about the risks and benefits of vaccines – so that we have a risk/benefit ratio,’ Dr Sturkenboom said. ‘In the MMR vaccine case, the new platform would have enabled scientists to test the data faster – it would have been easier to determine if the benefit outweighed the risk.’
A platform providing access to data would also have allowed scientists to test links between a vaccine for the 2009 pandemic influenza outbreak and the sleeping disorder narcolepsy much faster.
The pandemic – also known as swine flu – was caused by the H1N1 virus and is thought to have killed 200 000 people around the world, after first appearing in Mexico. Retrospective studies – some published four years after the outbreak – observed there was a link between the Pandemrix vaccine and narcolepsy in children.
‘In this case, studies were done in eight centres across European countries ... but it took a long time to do, with long approval processes,’ Dr Sturkenboom said. ‘With better collaboration, studies such as this can be done more quickly and the public informed.’
For some people the issue of vaccination isn’t about facts, it’s a matter of faith, and this unshakable belief has become an opportunity for health workers to prepare for potential outbreaks.
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