Promote vaccination, particularly the childhood immunisation programme and the HPV vaccine for both girls and boys

“Misinformation about vaccines is as contagious and dangerous as the diseases it helps to spread.” Dr Tedros Adhanom, Director-General of the World Health Organisation, September 2019

Global life expectancy gains resulting from universal immunisation programmes represent one of the greatest achievements of humanity. The irony is that this success can lead to complacency as we forget the morbidity and mortality caused by diseases such as smallpox and polio in the past.

In recent years in Ireland we have had to face new challenges to vaccination confidence. Much work has gone into restoring that confidence but undoubtedly this work is not over.

HPV Vaccine Uptake Under Threat

Chronic infection with Human Papilloma Virus (HPV) infection causes cervical cancer, along with other cancers of the vulva, vagina, penis, anus, and oropharynx. A school-based programme of HPV vaccination for teenage girls began in Ireland in 2010. It was initially well received with an 87% uptake in the 2014-15 academic year. However, following a coordinated anti-vaccination campaign this plummeted to an estimated 50% in 2016-17.

Anti-vaccine campaigners managed to utilise both traditional media and social media to spread misinformation about the HPV vaccine with devastating effect.

The response to the drop in HPV vaccination uptake required a co-ordinated effort from a wide range of stakeholders. This included the formation of an HPV Vaccination Alliance (www.

hpvalliance.ie), led by the Irish Cancer Society, to promote the vaccine and regain parental trust.

The role of patient advocates in the Alliance was vital in connecting with the public.

I would particularly like to remember the contribution of one such advocate, Laura Brennan, who sadly passed away at the age of 26 in March this year as a result of cervical cancer.

Her legacy will be the lives saved through her inspirational efforts to encourage girls to get vaccinated. Her work and the work of everyone involved in the HPV Vaccination Alliance has seen uptake rates dramatically improve to over 70%. In addition, from this academic year, boys in secondary school are now able to avail of HPV vaccination which will further reduce HPV related cancer deaths in years to come.

The Vaccine Alliance

Regrettably, Ireland has experienced a drop in the uptake of many of our other routine childhood vaccinations over the past five years. This has been associated with recent national outbreaks of vaccine preventable diseases such as measles and pertussis and has highlighted the need for on-going vigilance regarding our childhood immunisation programmes.

In September this year I launched the Vaccine Alliance which includes members from a wide range of health and civil society organisations. The alliance will look to replicate and build on the good work done by the HPV Vaccination Alliance.

Their vison is to ensure all children in Ireland are protected from vaccine preventable diseases and I will support them in whatever way I can to achieve this goal.

Social Media

Although the absolute effect on vaccine uptake is difficult to measure, I have no doubt that social media has played a role in under- mining confidence in vaccination. The dynamic nature of social media presents a new challenge for maintaining confidence in immunisation programmes worldwide.

Misinformation on social media has the potential to spread and amplify in manner not seen before. However, it also provides an opportunity to disseminate information regarding the benefits of vaccines to a wide audience especially younger generations who are less inclined to use traditional media.

It has been heartening to see that social media companies have begun to recognise the important role they can play in preventing the spread of vaccine misinformation on their platforms.

Information about vaccines on social media can be misleading. I welcome efforts to direct parents to trusted sources of information with the appropriate scientific advice which can enable them to make the right choice to vaccinate their children.

From an Irish perspective, I look forward to engaging with social media companies in the coming weeks and months to discuss what further measures can be put in place to combat vaccine misinformation.

The Role of the European Union

Cooperation between member states plays an important role in protecting the health of all Europeans as infectious diseases do not respect national boundaries. We have seen evidence of this with the rise in outbreaks of measles across Europe in over the past couple of years.

Within the European Union I would like to especially commend the ongoing collaborative research on Vaccine Hesitancy.

“The State of Vaccine Confidence in the EU 2018” report highlights the need to maintain high levels of confidence in vaccination programmes to achieve herd immunity but also underlines the complexities involved, including both individual and environment factors that can influence confidence.

At an international level I think it is important to recognise the role that transnational agencies play in protecting us all. The work of the GAVI Alliance has seen huge strides being made in countries that would otherwise not be able to financially support and organise national immunisation programmes.

Similarly, the work of the WHO and of representative member states in reacting to Public Health Emergencies of Inter- national Concern and preparing for future pandemics is vital and I hope this work continues and strengthens into the future.

Vaccinations save lives

Vaccinations have saved millions of lives since they were first introduced towards the end of the 18th century, and we continue to improve and strengthen our vaccination programmes with the introduction of more vaccines, like those against HPV and rotavirus, as they become available. It would be a travesty to see this progress stall or regress, however there are worrying signs both in Ireland and in Europe.

I therefore call on all member states to redouble their efforts in maintaining robust childhood immunisation programmes to protect the futures of all children in Europe.