Association found between rise of European populism and vaccine hesitancy

Reviewed by Kate Anderton, B.Sc. (Editor)Mar 2 2019

There is a significant association between the rise of populism across Europe and the level of mistrust around vaccines, according to a study by Queen Mary University of London.

Lead author Dr Jonathan Kennedy from Queen Mary University of London said: "It seems likely that scientific populism is driven by similar feelings to political populism, for example, a profound distrust of elites and experts by disenfranchised and marginalised parts of the population.

"Even where programmes objectively improve the health of targeted populations, they can be viewed with suspicion by communities that do not trust elites and experts. In the case of vaccine hesitancy, distrust is focused on public health experts and pharmaceutical companies that advocate vaccines."

The study, published in the European Journal of Public Health, looked at national-level data from 14 European countries. This data included the percentage of people in a country who voted for populist parties in the 2014 European Parliament elections, and the percentage of people in a country who believe that vaccines are not important, safe and/or effective, according to data from the 2015 Vaccine Confidence Project.

The analysis found a highly significant positive association between the percentage of people in a country who voted for populist parties and the percentage who believe that vaccines are not important and not effective.

Professor Sophie Harman, an expert on global health politics from Queen Mary's School of Politics and International Relations, who was not involved in the research, commented: "Like restrictions on reproductive rights, anti-vaccination rhetoric has long been the canary in the coal mine for populism."

In the research article, Dr Kennedy writes that modern vaccine hesitancy is usually traced to Andrew Wakefield's now discredited 1998 Lancet article, which claimed a link between the measles, mumps and rubella (MMR) vaccine and autism.

MMR vaccination rates in the UK fell from 92 per cent in 1995 to a low of 79 per cent in 2003, well below the 95 per cent rate needed to achieve herd immunity. Confirmed cases of measles in England and Wales rose from 56 in 1998 to 1370 in 2008.

Wakefield was struck off the UK medical register and the Lancet study retracted. Nevertheless, his ideas remain influential and are cited as a reason why measles cases have increased in Europe over the past few years.

There is additional anecdotal evidence suggesting a connection between the rise of populist politicians and political movements in Western Europe and increasing levels of vaccine hesitancy, Kennedy writes.

The most prominent example is Italy. The Five Star Movement (5SM) have raised concerns about vaccine safety and the link between MMR and autism. It is argued that these concerns caused MMR vaccination coverage to fall from 90 per cent in 2013 to 85 per cent in 2016, and resulted in an increase in measles cases from 840 in 2016 to 5000 in 2017.

Despite this, the upper house of the Italian Parliament--bolstered by newly elected representatives from 5SM and League--recently passed a law to repeal legislation that makes vaccines compulsory for children enrolling in state schools.

In France, the right-wing Front National have also raised concerns about vaccine safety and laws that make childhood vaccinations mandatory.

And in Greece, the left-wing SYRIZA government proposed that parents should be able to opt out of vaccinating their children.

While UKIP has not expressed similar concerns, a poll conducted by Mori showed UKIP voters were almost five times more likely than the general population to believe that MMR was unsafe.

Further afield in the US, Donald Trump has met well-known anti-vaccination campaigners, including Wakefield, and expressed sympathy with their ideas. For example, in 2014 he tweeted: 'Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn't feel good and changes--AUTISM. Many such cases!'

Dr Kennedy adds: "Vaccine hesitancy will be difficult to resolve unless its underlying causes of populism--an iniquitous economic system and unrepresentative political system--are addressed."