First Global Vaccination Summit sounds the alarm on access and hesitancy

BRUSSELS — Politicians, policymakers, and pro-vaccine campaigners met Thursday at the first Global Vaccination Summit to raise the alarm about the resurgence of measles, share plans to tackle misinformation in the age of social media, and reiterate the need to reach the 19.4 million infants worldwide who missed routine immunization last year.

“It is inexcusable that in a world as developed as ours, there are still children dying of diseases that should have been eradicated long ago. Worse, we have the solution in our hands but it is not being put to full use,” said Jean-Claude Juncker, president of the European Commission. “Vaccination already prevents 2-3 million deaths a year and could prevent a further 1.5 million if global vaccination coverage improved.”

Peter Salama, executive director for universal health coverage and the life course at the World Health Organization, said that “for the last many years, [immunization] coverage globally has stagnated at around 86%,” pointing to rising cases of measles worldwide as one result. As of March 2019, WHO’s Europe region reported 83,540 cases of measles and 74 related deaths for 2018, up from 5,273 cases and 13 deaths in 2016.

Those attending the summit in Brussels heard that the people least likely to be vaccinated are those on low-income in remote rural areas, as well as the urban poor and displaced people. “When you look at the countries which have more than half of the remaining unimmunized or under-immunized 20 million children in the world, they are in places like Afghanistan, Central African Republic, Somalia, South Sudan, Sudan, Niger, Nigeria, Ukraine, Syria, Yemen, Iraq,” Salama said. “They are the countries which need a global movement of international solidarity to address remaining issues in immunization,” Salama continued.

Soraya Narfeldt, CEO of RA International, which provides services in remote areas of Africa, argued few mothers would walk 20 kilometers to receive something they know little about.

“I would walk 20 kilometers if you told me that you were going to give me a shot, my children a shot, some deworming, an antiseptic cream, basic health care, maybe some family planning — something else in addition that can actually help the whole family,” Narfeldt said. “But not for two drops of water that I don’t know what they do because I’ve never seen it before.”

Meanwhile, South African singer and health advocate Yvonne Chaka Chaka told the audience that if most African children are not vaccinated because of lack of access to services, in Europe the greatest impediment is vaccine hesitancy — the reluctance or refusal to use vaccines despite their availability, which has been declared one of the top 10 threats to global health in 2019 by WHO.

Facebook’s public policy manager Jason Hirsch outlined steps it is taking to limit misinformation about the safety of vaccines, and increase exposure to authoritative information.

Hirsch said Facebook groups or pages that repeatedly post hoaxes or claims that have been debunked via consensus of expert organizations will see all their posts subject to limited distribution on the platform. The groups or pages will be reduced in search results and removed from recommendation engines designed to suggest content to users. Any advertising containing such information will be rejected. And pages falling foul of the policy will have their fundraising functionality revoked.

Earlier this month, Facebook launched educational units that will appear in relevant parts of Facebook and Instagram with information on why WHO and the Centers for Disease Control and Prevention believe vaccines are important, with links to authoritative information.

“Hesitancy exists in a lot of different kinds of people for a lot of different reasons,” Hirsch said. “Among the things we learned were that people who are hesitant want to feel legitimized in the questions that they have. Empathy goes a long way, and ultimately what they really crave is access to information. And sometimes the hesitance stems from the inability to access information and so they are swayed by the wrong kinds of information.”

Communicating on vaccination is also one of the priorities that incoming European Commission president Ursula von der Leyen identified for her health commissioner for 2019-2024 this week, charging her with “explaining the benefits and combating the myths, misconceptions and scepticism that surround the issue.”

This year, Devex has been exploring the rise of vaccine hesitancy and what it means for global health efforts. Read about how it has put aid workers at risk in Pakistan, how people are avoiding vaccination requirements in Nigeria, and understand the drivers and potential solutions to the issue globally.