Vaccines and Alternative Medicine

The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey  is the title of a study  just published by EBio Medine. A team of the London School of Hygiene & Tropical Medicine interviewed 65,819 respondents across 67 countries about their attitudes towards vaccines. The study is “the largest survey on confidence in immunization to date”.

Researchers submitted four statements to their sample, asking people to specify on a Likert scale their degree of agreement-disagreement. The four statements were,

1) "Vaccines are important for children to have."

2) "Overall I think vaccines are safe."

3) "Overall I think vaccines are effective."

4) "Vaccines are compatible with my religious beliefs."

The majority of interviewed people thought that vaccines are important for children but, rather contradictorily, they showed lower confidence in vaccine  effectiveness and, above all, in safety. Everywhere, education increased confidence in vaccine importance and effectiveness but not safety. Religion did not play a major role both in vaccine acceptance and hesitancy, with the exception of Mongolia where 50.5% of respondents said vaccines were not compatible with their religion (Buddhism), which is rather odd considering that other Buddhist countries were instead aligned with average results (around 8-10% people thinking that vaccines are hardly compatible with their religion).

Interestingly enough, European countries showed the lowest confidence in vaccine safety with France the least confident: 41% of respondents in France disagreed with the assertion that vaccines are safe (on average, 12% of respondents in other nations disagreed with this statement). Authors noted that "France recently has experienced 'anxiety' about suspected but unproven links between the hepatitis B vaccine and multiple sclerosis and, separately, the human papillomavirus vaccine and side effects like fatigue in girls". This element is certainly important, yet it hardly explains the findings.

In order to make more meaningful the survey, I would suggest to confront it with figures concerning prevalence of Complementary and Alternative Medicine (CAM).  Although in economic terms the largest CAM market is still the US, the market that is growing faster is the European market. Moreover, there is a significant difference between the US and the EU markets, while in the US the lion's share is largely taken by chiropractic, in the EU homeopathic and herbal remedies account for the largest part of the market. Homeopathy is particularly popular in France, where it is the leading alternative therapy. The costs for homeopathic products are partially covered by the French National Health System and the percentage of French population habitually or sporadically using homeopathy has grown from 16% (1982) to 62% (2004). This is mirrored by the attitude of health care professionals.  Homeopathy is taught in all major French medical schools and in schools of pharmacy, in dental schools, in veterinary medical schools, and schools of midwifery. According to a 2004 survey, 95% of GPs, dermatologists and pediatricians, consider homeopathy effective and are willing to prescribe it, or co-prescribe with conventional medicine. Another survey showed that 94.5% of French pharmacists advise pregnant women to prefer homeopathic products because "safer".

Concerns about safety of medical products are thus wider than vaccine hesitancy and vaccine hesitancy is probably only the peak of an iceberg. Further research is certainly required in order to understand better social, psychological, and economic dynamics that underlie this phenomenon. Yet an element is already self-evident: making appeal to scientific arguments to convince people to vaccinate themselves is a pure waste of time, if – at the same time -  the whole social fabric welcomes pseudo-scientific practices among recognized medical treatments.