A growing anti-vaccine movement in Europe, fuelled by social media and anti-establishment populists, is putting lives at risk and may be to blame for measles outbreaks surging to a 20-year high, health experts are warning.
A fresh Guardian analysis of WHO data shows that measles cases in Europe will top 60,000 this year - more than double that of 2017 and the highest this century. There have been 72 deaths, twice as many as in 2017.
Health experts warn that vaccine sceptics are driving down immunisation rates for measles, HPV against cervical cancer, flu and other diseases - and that their opinions are increasingly being amplified by social media and by rightwing populists equally sceptical of medical authorities.
The European Union’s health commissioner, Vytenis Andriukaitis, accused rightwing populist politicians of irresponsibility, peddling “fake news” about vaccine safety and stoking the climate of doubt.
Andriukaitis, a former heart surgeon, said he was very worried, adding: “Not just me – all of scientific society is concerned – epidemiologists, paediatricians, infectious disease experts and a lot of health ministers.
“It is unimaginable that we have deaths because of measles – children dying because of measles. We promised that by 2020 Europe would be measles free.”
Seth Berkley, the head of the global vaccine alliance Gavi, said scepticism was as infectious as a disease. He said: “It is very hard to inoculate against, given there is no stable authority in the world right now, where institutions and facts are being questioned routinely and lying is OK.”.
“We’re in a very vulnerable place right now,” said Heidi Larson, the director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine.
“There’s more hyperbole in the US. But I don’t know a country in the world that doesn’t have some questioning going on,” she said. Different vaccines trigger opposition in different countries, from MMR (measles, mumps, rubella) to the flu vaccine to HPV against the virus that causes most cervical cancers.
The World Health Organization, the EU and the US have all set up groups to investigate the causes of vaccine hesitancy and look for ways to help reassure people. Larsen said: “The reason WHO changed their tune about how important and serious this is was because they had so many member states coming to them and saying: can you help us.”
Populist rightwing politicians, from the US to Italy, Poland and France, have jumped on the anti-vaccine bandwagon, supporting the sceptics and championing the right of parents not to immunise their children in countries where it is mandatory before starting school.
“They are very irresponsible,” said Andriukaitis. “ What can we see in this populist movement? Irresponsibility. Now it is very important to see [what they will do in power]. Let’s see what happens with these measles outbreaks when you have those [in charge] who from the beginning used fake news.”
Recent data has consistently shown a tight correlation between vaccination rates and outbreaks of measles.
A sharp slump in vaccination rates in France in 2010 was followed by a spike in measles cases the following year. In Italy, when immunisation rates fell back in 2014, cases surged from a few dozen a month to hundreds. In Romania, vaccination coverage fell below 90% in 2014. By 2017, it was experiencing more than 1,000 cases a month, up from just one or two.
Populist rightwing politicians and others leading anti-establishment parties have said they were against globalisation and profiteering multi-national corporations, the commissioner noted. They give credence to “fake news” stories on social media claiming drug companies are disseminating viruses into the population in order to sell vaccines. And they support calls to overturn mandatory vaccination where it could win them votes.
Andriukaitis said: “It is very dangerous. My message is very simple now – you elected a lot of anti-vaccine politicians into parliament and now you have them in some governments. Are you ready to follow their decisions based on fake news or decisions based on evidence? There are only two options – fake news or evidence-based.”
In Italy, members of the anti-establishment Five Star Movement (M5S) and its government ally, the far-right League, proclaimed vaccines unsafe before they came to power in a populist coalition government. In 2015, M5S proposed a ban, citing a spurious “link between vaccinations and specific illnesses such as leukaemia, poisoning, inflammation, immunodepression, inheritable genetic mutations, cancer, autism and allergies.”
Once in government, facing what last year was the second biggest measles outbreak in Europe after Romania, M5S appeared to have softened its line, although observers said it was not clear exactly where Italy’s populist coalition stands. Earlier in December, the M5S health minister, Giulia Grillo, sacked the entire board of the country’s most important committee of technical-scientific experts.
In Poland, a small but vocal number of populist politicians support the anti-vaxxers who want an end to mandatory vaccination. The most prominent have been members of Kukiz’15, an ‘anti-systemic’ political party similar to Italy’s M5S. It has backed Justyna Socha, the leader of an anti-vax group called Stop NOP (a Polish acronym for “undesirable post-vaccine reactions”), who has claimed there was a conspiracy among doctors taking money from pharmaceutical companies to hide vaccine side-effects.
Anti-vaxxers in the US celebrated the presidential election of Donald Trump, who has expressed scepticism over vaccines and invited Andrew Wakefield – the discredited gastroenterologist who has claimed the MMR vaccine was linked to autism – to his inaugural ball. Trump was also said to have been considering setting up a committee to investigate vaccines under the vocal anti-vaxxer Robert F Kennedy Jnr.
Scepticism has been highest in France, according to research by the Vaccine Confidence Project. Doubts about vaccination have been fuelled by suspicion of the pharmaceutical companies. The populist far-right leader Marine Le Pen has backed those who wanted to overturn mandatory vaccination, saying not enough was known about the long-term consequences of multiple vaccinations, and pointing to the profits made by vaccine firms.
Lisa Menning, who works on global vaccine acceptance at WHO, said some populists and anti-vaxxers “share a mistrust in authorities and even scientific expertise”.
She added: “We have seen how vaccination is increasingly an easily politicised issue, whether around elections, in opposing mandates, even being exploited by religious or other individuals or groups that have an interest in using vaccination for financial or political gain or for building their own prestige or celebrity.”
It could go both ways, she said. Other populist politicians have pressed for mandatory vaccination as an easy, often reactionary, solution to low immunisation rates.
Larson said global vaccine coverage had stagnated. She said: “It’s going down in some places and we have these pockets [of low immunisation] and this is not going to get easier, especially as more and more vaccines and combinations of vaccines are being brought on board.
“Part of the challenge is that it’s various things and many of them are outside the scope of an immunisation programme – it’s political, it’s religious and it’s increasingly part of identity for people.”