Alarming rise in measles cases: 'Anti-vaccination sentiment threatens public health'

Aslı AĞIRDİL - 12punto.com.tr

The rise in measles cases worldwide is causing concern. According to the World Health Organization's European Region Measles Report, Turkey has become the third country with the highest number of cases, following Russia and Tajikistan. Speaking to 12punto, Istanbul Medical Chamber Board Member Dr. Saffet Ercan pointed to anti-vaccination sentiment as the reason for the rise in measles cases.

According to a UNICEF report, in the Europe and Central Asia region, from January 2023 to December 5, compared to the previous year, 30,601 measles cases were reported, marking a 3266 percent increase. In 2022, this number was only 909.

Speaking to 12Punto, Dr. Saffet Ercan, a member of the Board of Directors of the Istanbul Medical Chamber,stated that the reasons for the increase in cases are the migration phenomenon experienced in recent years, the increase in the unregistered population, and problems specifically related to vaccination as the primary causes. 

REPORTS OF DEATHS HAVE EMERGED

Emphasizing that measles cases have shown a particular increase this year, Ercan noted that there have also been reports of deaths. Ercan stated the following; 

“Measles is a highly contagious type of disease. It is a disease we see especially in children. It presents with fever and rash, and then continues. Fortunately, there has been a vaccine for it that has been administered for the last 50 years. While tens of thousands of cases were seen before the vaccine, there were even years after the vaccine when no cases were seen at all, but it continues to appear from time to time. In 2023, we were observing an increase in cases in Turkey as well. In the statements we made at the beginning of the year, reports of deaths had also arrived. The last time there was an increase in Turkey was 5-6 years ago, in 2018 or 2017. Before that, there was a notable increase in 2011. The year 2023 has also gone down in history as a year in which measles cases showed an increase.”

MISINFORMATION REGARDING VACCINES

Recalling the anti-vaccination sentiment that began during the pandemic, Ercan continued: 

"Both the problems experienced due to the change in the specific schedule for measles and the widespread misinformation regarding vaccines during the COVID vaccination period caused issues. A distrust of COVID vaccines was created in the public eye. Naturally, this affected all vaccines. Consequently, we began to encounter families who did not want to have their children vaccinated. However, this threatens not only the health of the children but the health of the entire society. People have prejudices in their minds that vaccines are harmful and ineffective. Some of these can be dispelled through conversation, but some are very rigid."

'PUBLIC SANCTIONS ARE NECESSARY'

"We are experiencing the consequences of a ruling made by the Constitutional Court (AYM) in 2017. A family had applied to the court, claiming that it was their own discretion since they did not want to vaccinate their children. The court process lasted for years, and ultimately the Constitutional Court ruled that getting vaccinated is an individual choice. As a result, there are no sanctions other than trying to persuade and talk to them. We know that countries in Europe implement measures regarding vaccines. In some countries, they do not even accept children who are not fully vaccinated into public schools, or families are fined if their children's vaccinations are incomplete. However, in our case, it is a situation left entirely to the efforts of healthcare workers and the sensitivity of families."

Expressing that efforts should be made to encourage vaccination, Ercan said the following:

"After our warnings, the ministry carried out some work on television in the form of public service announcements regarding vaccines, but the problem has evolved into something that cannot be solved by this alone. Certain sanctions could be brought to the agenda to encourage people to get vaccinated. Because for measles not to be seen in a society, the vaccination rate needs to rise above 90 percent, but when some families do not have it done, we cannot reach this rate, and all children are then faced with the risk of measles. Therefore, this is not a subject that can be brushed off as individual freedom. Because it is something that affects other children as well. Therefore, it is an issue where public sanctions must be introduced."

IRREGULAR MIGRATION AND INEQUALITY IN REGIONAL VACCINATIONS 

"There is no problem regarding the cost of the vaccine because everyone who comes to Family Health Centers is vaccinated. However, we have had a problem for years: there is an injustice and inequality in regional vaccinations. This is especially experienced in the Eastern and Southeastern Anatolia regions. Although it has decreased in recent years, the inequality still persists. On top of this, it must be said that the phenomenon of migration in recent years, the difficulties experienced regarding the registration of incoming refugees, and the increase in the unregistered population are causing problems specifically regarding vaccines. Therefore, in order to keep immunization rates high, the entire population must be registered, and the inequality in access to vaccines must be eliminated."

"The efficacy of measles vaccines is 95 percent. Because it provides 95 percent protection, it cannot protect the remaining 5 percent of the population. This 5 percent accumulates, and measles cases increase during certain periods. Therefore, due to the cumulative effect of the vaccine, it is an expected situation for measles cases to increase every 3 to 5 years. However, there are far more measles cases this year. We cannot attribute this situation solely to the result of the cumulative effect. Because we can say that the biggest reason is the problems experienced in vaccination."