Despite the rising number of measles cases and an official push to boost immunisations, Alexandre Cerqueira and his partner Nhep Srey Mom are determined not to vaccinate their two young children against the disease.
Mr Cerqueira lives in the country of Louis Pasteur, the French biologist who discovered the principles of vaccination in the 19th century. But he nevertheless doubts the efficacy of the vaccine, worries about the presence of tiny amounts of aluminium, and is concerned about what he sees as potential side-effects such as autism.
Scientific research overwhelmingly supports the need for vaccinations. But Mr Cerqueira believes that the profit potential of vaccines for big pharma drives the industry, thinks that statistics can be manipulated by interested parties such as politicians, and is sceptical of the role of so-called medical experts in the debate.
“I don’t like to hear these described as conspiracy theories, because it denigrates ordinary people’s ability to do their own research and analysis,” said Mr Cerqueira, 36. “It’s not because you’re in an important position that you’re necessarily right.”
The latest figures from the World Health Organisation show a sixfold increase in measles outbreaks last year in France. With nearly 3,000 people in France contracting measles last year and three dying, the authorities there have taken a tough new approach to compulsory vaccinations, threatening to bar children who have not been vaccinated from attending school.
This has further angered anti-vaxxers such as Mr Cerqueira, who will have to prove that their children have been inoculated before they can attend school.
“We’ll be obliged to vaccinate our children, against our will, in order for them to go to school,” he said. “It’s very difficult to find yourself in this situation.”
The trend in France is part of global phenomenon. The WHO has warned that efforts to halt the spread of measles worldwide are slipping, with reports suggesting that the number of cases globally was up about 50 per cent last year.
In the Philippines for instance, authorities have warned that there have been 5,600 cases of the disease and 87 deaths so far this year, more than double the 2,500 cases seen in a normal year. They too blame parents’ reluctance to vaccinate their children because of Dengvaxia, a now-discontinued dengue vaccine from Sanofi that caused some children who were given it to become ill.
“This is an absolutely avoidable outbreak,” said Gundo Weiler, a WHO representative in Manila.
The increased scepticism chimes with the growth of a populist narrative about vaccination, centred on distrust of experts, scientists and elites.
President Donald Trump has previously linked MMR (measles, mumps and rubella) vaccinations to autism, even though the research that initially suggested this link has been widely discredited.
In Italy, the ruling anti-establishment government has removed the legal obligation to vaccinate children. In France, far-right leader Marine Le Pen has endorsed people’s right to say “no” to the country’s new mandatory vaccinations.
“The wave of populism is contributing to a drop in vaccination rates,” said Nicolas Bouzou, economist at Asterès. “Populists have constructed a narrative of collusion between big pharma, government and statistics.”
While overall more children in Europe are being vaccinated against measles than ever before, according to the WHO, there are still large pockets where rates of vaccination are low, leaving people susceptible to infection.
The WHO recommends that at least 95 per cent of every population needs to be immune, either through doses of vaccination or prior exposure to the virus, in order to ensure protection for everyone.
In France in 2017, only 80 per cent of the population had both doses of the measles vaccine. In some areas this figure is as low as 65 per cent. With an epidemic in the ski resort of Val Thorens now affecting 24 people, France’s minister of health Agnès Buzyn said last week that those affected were “young people, unvaccinated, born after the 1980s, so who have not been in contact with the virus before.”
“There is a big vaccine hesitancy environment in France, on all vaccinations, not just measles,” said Evelyne Caulin, an associate director in medical affairs at pharma company MSD.
Flagging vaccination levels in countries like France stem from “lack of sufficient awareness of the benefits of vaccines, issues related to supply and access to them, and a climate of mistrust of vaccines,” said Dr Siddhartha Datta, manager of the vaccine-preventable diseases and immunisation programme at the WHO.
Last year France increased the number of compulsory vaccines for children from three to 11, and now includes MMR in the mandatory shots.
This supports work being done at a European level, notably a European vaccine action plan whose priorities include providing MMR and polio vaccines to refugees, asylum-seekers and migrants to the region.
There are early signs that France’s new mandatory immunisation programme has had a positive impact. In January, 155 cases of measles were declared, compared with 404 in January 2018, according to the French health authorities. Still Mr Cerqueira remains reluctant. He continues to do his own research.
“We’re told by experts that we are not smart enough to understand, that we do not see all the issues,” he said. “But there are some things that government would like us not to see, would like us not to know.”
