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Spain must succeed where others have failed in vaccination debate

Por: | 18 de junio de 2015

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Spain’s first confirmed case of diphtheria in almost 30 years has rekindled a national discussion on vaccines — and the country should look to the U.S., U.K. and Chile for insight into how not to hold this debate.

Cases in these nations show us that the sciolistic, erroneous and sensationalist work of members of the mainstream media can affect the decision-making of thousands of people who might otherwise be sceptical of the anti-vaccine movement.

This subculture holds vaccines responsible for a number of health problems, in contradiction with scientific consensus. The movement also views side effects disproportionately in comparison with the graveness and historical frequency of serious illnesses.

While in the current debate, Spanish media has yet to adopt the hack health reporting that is the scourge of the British tabloid press, a downward trend in vaccination coverage in Spain suggests those with the ear of the public must be more rational and vigilant than ever.

Earlier this month, a six-year-old boy from Olot fell ill with diphtheria, and remains in hospital in a serious condition. So unexpected was the eventual diagnosis, to arrive at it the boy’s physician Dr. Stephan Schneider says he rounded up his colleagues for a brainstorm “like in the TV show House.”

The child’s parents had not inoculated him as they subscribed to the anti-vaccine movement, something they have now expressed regret over.

So far, eight children and an adult who were in contact with the child have tested positive to exposure, though all are asymptomatic and were previously vaccinated against the disease that kills 5-10 percent of victims.

On national television last week Teresa Forcades — a Benedictine nun, high-profile political activist and big pharma critic — publicly backed parents who opt-out of vaccine use, while content from the anti-vaccine movement has been promoted from the blogosphere to mainstream media.

While such groups have failed to generate hysteria in Spain, vaccine coverage is 3 percent lower than it was in 2002. This is concerning, as a continued downward trend would lead to a lack of herd immunity. Such immunity prevents outbreaks and protects many people who cannot be vaccinated, including newborns and those with immunodeficiencies.

Spain’s current vaccination coverage of 95 percent remains above the herd immunity threshold for measles, but only by a few percentage points. Lack of herd immunity among individuals aged under 35 is thought to have been a factor in the 2006-7 measles outbreak in Catalonia.

Those who refuse to vaccinate undermine herd immunity, and vaccination coverage plummets past thresholds when the media mismanages its role as moderator in the debate on jabs.

In 2002, the MMR vaccine was the most frequently reported on subject in Britain. That year, Tony and Cherie Blair declined to reveal whether or not they had inoculated their son — the MMR vaccine was under scrutiny in the media at the time due to a minor and fraudulent 1998 study that linked it to autism.

Inexpert journalists exploited layman’s level knowledge in their readership with stories that fed off health-related paranoia and political and celebrity intrigue.

Soon after the furore, MMR vaccination coverage in the U.K. hit a nadir of 80 percent, below the herd immunity threshold for measles, mumps or rubella. In 1998 there were 56 confirmed cases of measles in England and Wales. In 2008 there were 1,348. Out of all the news articles on MMR in 2002, less than a third pointed out that the safety of the jab was supported by overwhelming evidence.

A similar downturn in vaccination rates and subsequent disease outbreaks occurred in the 2000s in the U.S., where actress Jenny McCarthy and the medical research community were afforded equal footing by the media in the vaccine debate.

Irresponsible reporting triggered an incredible series of events in Chile between 2009 and 2014. Last year, Chile came close to being the only nation to ban by law vaccines containing the preservative thimerosal. Several parents of autistic children unsuccessfully sued the state over accusations the disorder was brought on by the mercury found in these shots, at odds with the scientific consensus. Riding the tide of sensationalist media coverage, two members of congress championed the families’ cause and drafted a bill aimed at outlawing the use of the vaccines.

The bill cited the effect of the toxicant methylmercury on humans. The catch is, thimerosal metabolizes in the body to ethylmercury, not methylmercury. The latter is toxic in low doses, the former isn’t. Interestingly, this detail was not widely reported on — what did catch the media’s attention was a portion of the bill that was copy and pasted from Yahoo Answers, presumably because this was seen as more embarrassing for the parliamentarians than basing the premise of their legislation on the effects of an irrelevant substance.

The “thimerosal bill” passed through both chambers of government, and only a presidential veto prevented it from becoming law.

The media in general is far from even-handed when it comes to the vaccine debate. Deaths that occur some time after a vaccine is administered are widely covered — medical examiners’ official cause of death reports are not. Profile pieces on the families of victims of rare and serious vaccine side effects are common — similar portrayals of parents watching their children succumb to, for example, measles encephalitis, are hard to come by.

There is no doubt that we need to monitor side effects and their frequency, as well as promote debate on vaccination policy and the conduct of pharmaceutical companies.

There is already a discussion underway in Spain on the merits of mandatory vaccination. Over the past week, a Change.org petition calling for the obligatory vaccination of children has gathered 111,000 signatures. Health Minister Alfonso Alonso came out against such a move on Thursday, saying vaccination should be promoted through medical recommendation rather than government mandate.

Such healthy discourse should be encouraged. We must remain aware, however, that this debate has on some occasions opened the door for the systematic exploitation of our greatest fears.

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Authors (Bloggers)

Chris Finnigan is a freelance journalist based in Barcelona. He writes for Barcelona Metropolitan and is a book reviewer and reader for The Barcelona Review. He is a graduate of the London School of Economics. You can find him on twitter @chrisjfinnigan

Ben Cardew is a freelance journalist, translator and teacher, now resident in Barcelona after growing up gracefully in Scotland via Norwich. He writes for The Guardian, the NME and The Quietus, among others, on everything from music to digital media. You can find him on Twitter @bencardew

Fiona Flores Watson is a freelance journalist, guide and translator who has lived in Seville since 2003, and has been a writer and editor for more than 20 years. She writes for the Guardian, Telegraph and Sunday Times Travel Magazine. Originally from Essex, Fiona is also Consulting Editor of Andalucia.com and has her own blog, Scribbler in Seville. She has been contributing to Trans-Iberian since 2014 and tweets at @Seville_Writer

Jeff Brodsky is a freelance writer. He arrived in Barcelona in 2013 via an admittedly indirect route, living in Chicago, Arizona, Seville, Amsterdam, North Carolina and Madrid. Despite not having stepped foot in Seville for over five years, he still speaks Spanish with an Andalusian accent. Jeff’s writing has been published in newspapers and magazines in America and Europe.

Koren Helbig is an Australian freelance journalist and blogger enjoying a life of near-eternal sunshine in Alicante. She writes for publications in Australia, the United States and the United Kingdom, focusing on stories exploring smart and positive approaches to social issues. She hangs out on Twitter at @KorenHelbig and keeps a selection of her favourite stories at korenhelbig.com.

Julie Pybus lives in a small off-grid house on a hillside in Catalunya. She usually focuses on helping charities and social enterprises with their publications and websites, but has also written for The Guardian, Country Living and The Observer. Julie launched and runs a hyperlocal website which endeavors to increase understanding between the different nationalities in her area perelloplus.com. @JuliePybus

Paul Louis Archer is a freelance photographer, multimedia storyteller and artist educator. A cross-disciplinary worker, who endeavors to encompass the mediums of photography, audio design and writing. Born in Hertfordshire of an English father and Spanish mother. Based in the United Kingdom. @PaulLouisArcher

Vicki McLeod is a freelance writer and photographer. She has lived in Mallorca since 2004. Vicki writes about her beloved island for The Majorca Daily Bulletin, the only daily English language paper in Spain; produces regular columns for the Euro Weekly News, and articles for Spain-Holiday.com. Vicki runs PR strategies for several businesses in Mallorca and London as well as working on her own blogs and projects. She and her husband, Oliver Neilson, supply photo and text content for private clients via @phoenixmediamlr. She tweets at @mcleod_vicki.

Born in Newcastle upon Tyne and based in Barcelona, Alx Phillips writes about contemporary art, dance and theatre in a way that human beings can understand. For more previews, reviews, interviews and extras, check: www.lookingfordrama.com.

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