Freedom from fear of deadly disease is a luxury by historical standards, enjoyed by most British people. But luxury cultivates complacency. That is one explanation for a decline in the number of children receiving routine vaccinations. NHS data published this week showed a drop in uptake for the first dose of the measles, mumps and rubella (MMR) jab from 91.2% to 90.3% in England. It is the fifth consecutive annual decline. It takes the UK further from the World Health Organization target of 95% coverage – the point of “herd immunity” where collective defence can snuff out contagion. Last month the WHO rescinded Britain’s “measles free” status only two years after that milestone was achieved. There were around 1,000 cases last year – double the number recorded two years previously. Mumps is having a similar resurgence.
There is something uniquely disturbing about a society choosing to make itself vulnerable to infection. There is no new pathogen to defeat. The means of prevention are available on the NHS. Their rejection points to a different trend – the spread of toxic misinformation online and disregard for science in a culture that has devalued rationalism and expertise. Suspicion of the MMR jab peaked around the turn of the century and scare stories about an association – thoroughly debunked – with autism. That falsehood was beaten back by facts at first, but now enjoys a second life online as part of a much bigger apparatus of fear and fraud. Parents looking to Google or Facebook for information about vaccinations encounter mounds of deceit, camouflaged in pseudoscience. Some of it channels profits to quacks and charlatans. Some is a gateway to paranoid sites on the extreme left and right of the political spectrum. Some people, for whatever reason, just don’t trust vaccines, even though we wish they would. Tech giants have been reluctant to police this realm because the “anti-vaxx” culture feeds a lucrative advertising market in hokum. Social media companies’ claims to be responsible corporate citizens clash with their commercial interest in clickbait poison. Anti-vaxx content might not contain hate speech or glorify terrorism, but it is still a public health hazard and needs to be regulated accordingly. Belatedly, some firms are acting on the menace, but the measures are not enough.
Meanwhile, the need to restore herd immunity is forcing the government to consider more assertive measures: compulsory vaccination or a requirement for proof of immunisation as a condition of taking up places at nurseries and schools. Such measures would bring additional bureaucracy and risk of a counterproductive anti-state backlash. Those are significant objections, but not insuperable when the associated benefit is averting epidemics and saving lives. Ideally, information campaigns, coupled with more efficient postnatal care, would be sufficient to shore up defences against disease. Not all vaccine refusers are anti-science militants. Many are just bewildered and amenable to persuasion. With the right methods, more can be done to help facts win this battle before compulsion becomes necessary. But there could yet come a point when the government may have to draw a line and declare a minority’s refusal to be vaccinated is a luxury that our society can no longer collectively afford to indulge.