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Possible polio resurgence and the anti-vax movement

Last month was the 100th anniversary of the birth of Jonas Salk who developed the first effective polio vaccine. Prior to its widespread use in the West from the mid 1950s on, seasonal polio outbreaks in North America and Europe killed some children and caused life long paralysis in others. In the 1952 polio epidemic in the United States, 57,628 cases were reported with 3,145 fatalities and 21,269 cases of paralysis. Indeed those of us attending school before the advent of routine polio vaccination saw some of our fellow pupils returning after the summer break in leg braces; sadly occasionally a desk would remain empty. Now the global polio eradication effort has essentially eliminated the disease from all but three countries where it remains endemic, namely Nigeria, Afghanistan and Pakistan. In 2013 there were just 416 cases worldwide; so far this year there have been 306 cases. The aim is to totally eradicate the disease by 2018, but this goal may be thwarted because of the increased international spread of wild polio virus from endemic countries. The situation in Pakistan is causing most concern as the number of cases has more than quadrupled from 53 last year to 260 so far this year, and a major factor has been the ruthless militant violence against Pakistani teams vaccinating children against polio. More than 65 healthcare workers and supporting staff have been killed in the last two years, the latest shot dead in late November.

The anti-vax movement in the West is less immediately perilous, but is unfortunately growing, greatly facilitated by misinformed pressure groups disseminating dangerously misleading information using social media. One reason is that medical success has bred complacency: thanks to effective vaccination programmes polio is no longer endemic, and the former childhood scourges of measles, pertussis, tetanus and diphtheria are currently rare. Parents thus focus on the possible health risks of the vaccines – and most of these perceived risks have no scientific basis – rather than on the morbidity and mortality rate of the diseases themselves and the increasing danger of epidemics in non-immune populations. A common fallacy is that parental decisions have no repercussions for other families. But we know that 95% of children must be vaccinated against a disease to achieve ‘herd immunity’; this allows even hypersensitive children who cannot be vaccinated to be safe. If Western parents can’t be persuaded by means of pertinent information to protect their nation’s children from disease, it is high time for some coercion.