Research Paper on Vaccine Hesitancy: A Global Health Threat in the XXI Century

Introduction

In the XX century, vaccines saved tens of millions of lives, but today, experts in many countries see a trend towards refusing vaccination. The World Health Organization (WHO) is so concerned about this situation that it has included vaccine hesitancy in the list of ten major threats to global health in 2019 alongside such major issues as antimicrobial resistance, HIV, dengue, as well as Ebola and other high-threat pathogens. The WHO clearly states that "vaccine hesitancy - the reluctance or refusal to vaccinate despite the availability of vaccines - threatens to reverse progress made in tackling vaccine-preventable diseases" ("Ten Health Issues WHO Will Tackle This Year"). Though the WHO is vehement in its appeal to vaccinate children all over the world, the controversy between parents, doctors, journalists and 'independent experts' has not subsided for several years. To vaccinate or not to vaccinate children, that is the question! The disputants can be provisionally divided into three groups: those, who advocate for vaccination, vaccinate themselves and vaccinate their children; those, who are categorically against it: these people were vaccinated in childhood, but their children are not vaccinated or vaccinated with a violation of the vaccination calendar; finally, those, who have not yet decided and are looking for an answer. Unfortunately, many parents from the second and the third groups believe everything they hear about vaccinations from friends, see on TV, read in the media and consequently refuse to vaccinate their children. Over the past few years, refusal to vaccinate children has become 'fashionable'. However, the defenseless children fully dependent on their parents' decision become hostages of this trend. It would be much better to listen to the opinion of professionals in the field - pediatricians, immunologists, and microbiologists. Vaccinations should be required and there should only be medical exemptions, not personal ones: being highly effective and extremely safe, vaccines help build the herd immunity and defeat dangerous diseases.

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First, it is extremely important for the parents to realize how highly effective vaccines are. The WHO calls immunization "one of modern medicine's greatest success stories" ("Immunization"). Susan L. Plotkin and Stanley A. Plotkin point out, that "despite its relative youth, the impact of vaccination on the health of the world's peoples is hard to exaggerate. With the exception of safe water, no other intervention, not even antibiotics, has had such a major effect on mortality reduction and population growth" (Plotkin and Plotkin 1). Vaccination is a process that strengthens the immune system. During vaccination, harmless antigens are introduced into the body. The immune system produces protective cells - lymphocytes - that produce antibodies. So, when ultimately a live microbe enters the organism, the immune system is ready to prevent the disease (Brunson). Working in such a way, vaccines have helped significantly reduce the harm caused by many diseases over the past century.

According to the WHO, vaccination is one of the most cost-effective ways of preventing disease: it currently helps avoid 2-3 million deaths a year, and a further 1.5 million could be prevented if global coverage of vaccinations improved ("Ten Health Issues WHO Will Tackle This Year"). The vaccination campaign against measles is an illustrative example of the effectiveness of vaccination. About 2.6 million people died of measles annually until the first vaccine for the disease appeared in the 1960s. According to WHO, from 2000 to 2017, the global measles mortality rate fell by 73% (from an estimated 536 000 deaths in 2000 to 142 000 in 2018) ("Immunization"). Thus, it is obvious that accelerated immunization activities have had a major impact on reducing the number of deaths from measles. Another bright example is the fight against polio. Just a few decades ago, millions of people fell victim to polio - those who got sick were threatened with paralysis and death. Today, this disease has virtually disappeared. Based on the latest WHO data, 85% of infants around the world receive three doses of polio vaccine. Over the past few years, the individual cases of transmission of wild poliovirus have been registered in just three countries: Afghanistan, Pakistan, and Nigeria ("Immunization"). Many infectious diseases such as measles, diphtheria, whooping cough, tetanus are deadly. Children are especially susceptible to these diseases. Thus, without vaccines, the child runs the risk of becoming seriously ill, which may result in complications, disability, and even death. Vaccines are not just effective, they actually save lives.

Second, it is essential for the modern parents to know that vaccination is extremely safe. In the process of production, vaccines are cleaned of unnecessary and sometimes harmful substances, and only those ingredients are left that are required to create protection against the disease. This significantly reduces the risk of adverse reactions. Some vaccines have special substances added to stimulate the production of immunity, as well as a small amount of a harmless preservative. In addition, scientists have unequivocally proven that the immune system of a child from birth is able to withstand many infections at the same time. Thanks to this, it is possible to create combined vaccines against several diseases at once (for example, pertussis + rubella + tetanus + diphtheria or measles + rubella + mumps and others). The use of such vaccines can reduce the number of injections. Many parents worry when children are vaccinated against several diseases at once. However, our body is able to easily process the first 10 million antigens and create antibodies to them ("Combination Vaccines"). Therefore, there is no need to be afraid of the number of the vaccine components. Combination vaccines are completely safe and equally effective.

Moreover, the complications after vaccination are extremely rare. Usually, the issues at hand are reactions to vaccination - redness, and itching of the skin at the injection site, a small and short-term increase in body temperature. These reactions do not have long-term health effects. Complications for the most part also pass without a trace. Serious complications with persistent consequences can develop if contraindications are not observed. It should be remembered that vaccination complications are thousands of times less likely to develop than complications of infections. The vast majority of serious diseases that developed after the injection of the vaccine are not complications of immunization but are 'ordinary' diseases that coincided with vaccination. One should always remember that 'after' does not mean 'because of.' Serious side effects of vaccination in the form of a severe allergic reaction are very rare, occurring in 1-2 cases per million ("Making the Vaccine Decision"). Thus, the prophylactic benefits of vaccination are far greater than the potential complications of an infection. It is important to start vaccination in a timely manner and protect the child from infectious diseases and the risk of complications.

Third, it is crucial for everybody to know that in the event of a mass rejection of vaccinations, epidemics are inevitable. In the words of Walter A. Orenstein and Rafi Ahmed, "vaccines not only provide individual protection, they can also provide community protection, by reducing the spread of disease within a population" (4031). Medical scientists have proven that when the vaccinated population is less than the estimated immunity threshold percentage (from 83 % to 95% for different diseases), there is a danger of an uncontrolled spread of the infection (Orenstein and Ahmed 4032). In this case, people who evaded vaccinations become transshipment points for pathogens, with their 'help' the circulation of viruses and bacteria among the population is maintained. In order for epidemics not to arise, so-called herd immunity, i.e. collective immunity, must be sustained in society. Otherwise, even some of the vaccinated children may become ill. Herd immunity breaks the transmission of infection and lessens the chances of susceptible individuals coming in contact with an infected person, thus providing protection to "individuals who are not personally immune to the disease - for instance, individuals who, because of their age or underlying medical conditions, cannot receive vaccines or individuals who received vaccines but remain susceptible" (Brunson). Herd immunity has made successful eradication of smallpox possible, and it also plays a crucial role in preventing the spread of polio and measles (Brunson). The WHO insists that "not only do vaccinations prevent sickness and death associated with infectious diseases such as diarrhea, measles, pneumonia, polio, and whooping cough, they also hold up broader gains in education and economic development" ("Immunization"). Thus, a decision not to vaccinate your child is not only ungrounded, but it is also irresponsible and can lead to disastrous consequences. Herd immunity is not an abstract idea, it can be formed only if every citizen takes charge of the children's health. William Muraskin writes in his paper "The power of individuals and the dependency of nations in global eradication and immunisation campaigns,"

At one time historians emphasised the 'Great Man in History' concept. That idea was later pushed aside by the realisation that larger, more important forces were at work. The individual's importance shrank as the role of massively expanded governments, multi-national corporations, and institutional science took centre-stage as the movers and shakers of world events. Without denying the importance of such forces and institutions, I have made it my concern to study the continued centrality and indispensability of individuals in making things happen in international public health (321)

In the face of the increased danger of the spread of epidemics, humans can stand only united.

Finally, it should be mentioned that vaccination is especially important today when the world has become one global village. Due to the dynamic and ubiquitous development of air travel, prophylactic vaccination has become more important than ever, as this way of traveling has triggered the rapid spread of contagious pathogens. Tak W. Mak et al. offer an illuminating example of the way infections can travel by air: in 2010, an unvaccinated child with measles transmitted the virus to a fellow passenger during a flight from Europe to the U.S, then the infected passenger exposed 270 other individuals to the disease at a conference which he unwittingly attended (Mak et al.). Modern travelers should also be aware of the need in vaccination against destination-specific diseases: the licensed vaccines recommended for an international traveler are deemed to be safe, well-tolerated, and effective (Torresi and Kollaritsch 101). Sheila M. Mackell and Mike Starr draw the public attention to the necessity of keeping the vaccine status of traveling children up-to-date: "updating all routine vaccinations and accelerating those in the primary series should be done if possible" (Mackell and Starr 125). When traveling the world has become an integral part of modern civilization, vaccination has acquired truly global significance.

The aforementioned arguments are rather convincing and based on research evidence, and yet many parents are still opposed to such a game-changing medical practice as immunization. These parents argue that hundreds of children go to hospitals every year, need long-term treatment, and sometimes even become disabled after visiting the vaccination room. They believe that if personal hygiene products are very affordable...