A baby gets vaccine against measles in Thanh Hóa Province. — VNS/Photo Thanh Hải

Mai Khuyên

The recent emergence of an “anti-vaccine” trend in Việt Nam has sparked a debate, with many parents, officials and other stakeholders weighing in either side, mostly favouring vaccinations as a life-saver.

Votaries for vaccines argue very passionately that there is strong evidence of the method saving millions of lives on its way to becoming an indispensable part of public healthcare.

They say that 200 years after the discovery of vaccine by the English physician Edward Jenner, immunisation has been credited with saving approximately nine million lives a year worldwide.

In all, vaccines are said to have brought seven major human diseases under some degree of control - smallpox, diphtheria, tetanus, yellow fever, whooping cough, polio, and measles.

Despite this “strong evidence,” vaccine controversies have continued to surface time and again over at least 80 years.

The argument in favour also states that recommended vaccines are safe and effective, that unsubstantiated scare-mongering has actually resulted in outbreaks and deaths from vaccine-preventable diseases.

The recent anti-vaccine trend in Việt Nam, not surprisingly, has quickly “caught on” because of social media. Thousands of members of a social media group, mostly parents, have been debating whether or not to get their infants vaccinated. 

Many members of this group have highlighted cases where children have suffered abnormalities and complications after getting vaccinated, with some proving fatal.

Experts and pediatricians have strongly condemned the trend saying it is groundless and likely to harm children far more than any real or imagined negative effects of vaccines.

While it is easy to stay on the side of the experts, the latest trend cannot be dismissed out of hand, and the debate that it has generated needs to be welcomed as an opportunity to take a fresh look at the issue, to go beyond binary perspectives and see where it gets us.

In Việt Nam, it was in the 1980s that the country first embarked on a national campaign called expanded vaccination programme. It was initiated by the Ministry of Health with support from the World Health Organisation and the United Nations Children’s Fund.

The programme aimed to provide free vaccination services for children under a year old, protecting them from the six most common and deadly diseases. It is said that this programme helped the country succeed in eliminating polio and neonatal tetanus.

There was no discernible anti-vaccine trend 30 years ago. People trusted at the programme, possibly because dissemination work by the healthcare sector and local authorities. There was also no scepticism about the quality of the vaccines used.

What has changed in the last 20 years is that there is greater fear today. The important thing is not to dismiss this fear as irrational and based on fake conspiracies. The fear has to be looked at seriously, because there is evidence of the dangers of vaccine that cannot be overlooked.

There have been several cases of children dying suddenly after being vaccinated. The healthcare system that administers the vaccines is not perfect, and questions have been raised about the quality of vaccines, inadequate preservation and weak supervision of many unqualified health workers.

Against this, it is said that many parents have turned against vaccines because they trust something they have read on the Internet or other media about links between autism in children and the vaccines they are given.

This argument posits that parents see autism as a risk not worth taking; that it is a condition worse than measles or polio; that people think autism is a fate worse than death from some other disease.

Are these misperceptions caused by inadequate or wrong information?

Personally, I can vouch for the fact that my children’s doctors never fully explained the side-effects that a vaccine can have. One of my children had a pretty strong immune response to a vaccination, with symptoms indicating some developmental regression. This was scary as a parent.

I had no idea how serious this reaction would become, whether this was permanent. Fortunately, the reaction subsided after a few weeks, but the experience stayed, and I remained sceptical of vaccination benefits for years.

Such scepticism should be seen as normal, but also as something medical professionals should address seriously, because they cannot but look at this issue from the perspective of parents.

While scepticism, fear and superstition might indeed be factors behind the new anti-vaccine trend, they might not be the only ones.

The fundamental questions that the trend raises cannot be ignored, if only on the basis that constant questioning of accepted “truths” is the basis on which scientific advances, including those in the medical field, have taken place.

Some of these fundamental questions have to do with the veracity of claims made by pharmaceutical firms, doctors, government agencies and even international bodies like the World Heath Organisation. None of them have a perfect record in truth-telling, so it should be okay to ask if vaccinations are as effective immunisers as they are made out to be, given some incriminating evidence against them.

The other question is a corollary to the first one. If they are not as effective, are some of the side-effects being downplayed?  

What are the lessons that stakeholders have drawn from previous vaccine failures that are said to have provided insufficient protection, and in some cases, caused outbreaks instead of preventing them?

There have also been reports about toxins and antibiotics in vaccines. What are the steps being taken to address this problem, even if it has been overstated?

All the benefits that vaccines have delivered do not delegitimise these questions, and it is up to the primary stakeholders to address them in public interest, and to win public confidence. — VNS