Europe’s new threat to public health: Politicians

LONDON — In those balmy days before the coronavirus upended our lives, wacky conspiracy theories about the dangerous side effects of vaccines seemed to be an eccentricity that Europe could just about afford.   

A global survey carried out by the Wellcome Trust in 2019 showed shockingly low vaccine confidence on the Continent, with particularly alarming results in France: Less than half the population agreed with the statement that “vaccines are safe.”  

But if vaccine hesitancy caused some degree of concern back then, policymakers could comfort themselves with the notion that infectious diseases posed a limited threat to public health in Europe.    

Take the measles, for example. Rumors of a link between the MMR vaccine and autism — an idea put forward in the 1990s by the scientist Andrew Wakefield, whose research has since been debunked — led to falling vaccine coverage and a 20-fold increase in measles cases in Europe between 2016 and 2019. And still, Europe, thanks to its relatively well-sourced health systems, managed to avoid widespread deaths.  

At the time, I remember wondering whether the only thing capable of improving attitudes to vaccines was an infectious disease outbreak so deadly it would jolt people out of their complacency. I couldn’t have imagined how quickly this hypothesis would be put to the test.   

Fast-forward 18 months, and the coronavirus pandemic has raised the stakes of vaccine confidence to unprecedented levels. Many people who would have once prevaricated are now willing to run over proverbial burning coals to get the jab because they have experienced the impact of this plague firsthand and realize that vaccines provide the only route out of the purgatory of the last year.   

But for others, the specificities of COVID-19 vaccines, most notably the speed at which they were developed and approved, have piqued their “spider sense” that the state and pharmaceutical companies are hiding evidence of dangerous side effects. Such worries, if understandable, are unjustified. All vaccines — including the AstraZeneca vaccine — have gone through stringent testing.   

It’s fair to presume that the countries that suspended use of the AstraZeneca vaccine earlier this week after reports it caused blood clots believe they are being risk-averse. They feel a need to show they are willing to take every step necessary to ensure vaccines are safe. And in principle, it is right to be cautious — especially given the fragility of vaccine confidence in Europe.  

However, any response must be proportional to the risk. As David Spiegelhalter, professor of the public understanding of risk at Cambridge University, has clearly shown, the purported link between the AstraZeneca vaccine and blood clotting appears to be spurious: Out of 5 million people vaccinated, 30 “thromboembolic events” were reported, which is fewer than one would expect to see in an aging population in normal times. On Thursday, the European Medicines Agency reiterated that the vaccine is safe and effective — and that its benefits far outweigh the possible risks.

The countries that suspended the AstraZeneca jab in an effort to reassure their population have underestimated the possible unintended consequences of their actions.   

The fact that Wakefield’s pseudo-science about MMR vaccine and autism remains so influential today shows just how dangerous and long-lasting misinformation about vaccines can be.  

It’s fair to say the general public doesn’t have Spiegelhalter’s ability to understand risk. Recent research has demonstrated that people with low numeracy skills are more likely to believe misinformation about coronavirus. That’s why it is crucial that policymakers communicate a clear and consistent message that vaccines are safe and effective.

Unfortunately, governments’ decision to suspend the AstraZeneca vaccine have muddied the waters. Their mixed messages will inevitably undermine trust in a jab that is supposed to be a “workhorse” of immunization programs because it is relatively cheap, as well as easy to store and transport.  

As a result, it’s now very likely that an increasing number of people will refuse to take the AstraZeneca vaccine and hold out instead for other, supposedly superior vaccines.   

We saw a precursor of this kind of public backlash a few weeks ago when the German and French regulatory agencies didn’t allow elderly people to have the AstraZeneca vaccine, leading to a huge pileup of unused vaccines that could have saved many lives. European public health actors were already openly talking about the need for a “collective rehabilitation” of the vaccine’s image after this episode.    

From a public health perspective, it is an absolute disaster to have millions of scarce vaccines sitting on shelves in warehouses, particularly when it looks as though Europe could be heading into a third wave of coronavirus. More people will get ill, and more people will die. Lockdowns will begin sooner, be stricter and last longer.   

This will undoubtedly have political implications, too. Despite presiding over a year of chaos, Boris Johnson’s popularity has surged on the back of Britain’s speedy vaccine rollout. By contrast, Germany’s ruling Christian Democrats’ disastrous showing in last week’s state elections appears to be a rebuke for the painfully slow progress of the country’s vaccine program.   

Europe’s governments may think they are playing it safe by halting AstraZeneca jabs. In reality, they are doing untold damage not only to the current vaccine rollout — but to vaccine acceptance for decades to come.