Falsehoods spread by ‘anti-vax’ movement in part to blame for backsliding in progress against potentially deadly illness, experts say

Anti-vaccine scepticism, conflict and poor access fuelled a 50% increase in measles cases last year, according to the World Health Organization.

The UN health agency said the resurgence was happening at a global level, including in wealthy nations where vaccination coverage has historically been high.

“Our data is showing that there is a substantial increase in measles cases. We’re seeing this in all regions,” said Katherine O’Brien, WHO’s director of immunisation and vaccines. “We’re having outbreaks that are protracted, that are sizeable and that are growing,. This is not an isolated problem.”

The figures are a worrying sign of the vast reach of vaccine-scepticism, said Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. “It’s very serious. Historically measles outbreaks go up and down but this is a pretty dramatic increase.”

On Wednesday, Darla Shine, wife of the White House communications director, Bill Shine, went on an extraordinary anti-vaccine tirade while spreading conspiracy theories about an outbreak of measles in the Pacific north-west. In a series of tweets, she lashed out against a CNN report detailing the outbreak, in which 50 unvaccinated people contracted measles in Washington state and Oregon.

“Here we go LOL #measlesoutbreak on #CNN #Fake #Hysteria,” Shine tweeted. “The entire Baby Boom population alive today had the #Measles as kids. Bring back our #ChildhoodDiseases they keep you healthy & fight cancer.”

She went on to claim:

Darla Shine (@DarlaShine) I had the #Measles #Mumps #ChickenPox as a child and so did every kid I knew - Sadly my kids had #MMR so they will never have the life long natural immunity I have.



Come breathe on me!

Measles is often the first vaccine-preventable disease to emerge when vaccine coverage drops, O’Brien said, adding that the public health community had been in denial about the dangers of vaccine scepticism. “It hasn’t been taken seriously enough for too long,” said Larson.

“Measles is a canary in the mine … you need to look at what other vaccines are not being given,” she added.

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Mistrust of vaccines has been fuelled by social media, populist leaders and suspicion of experts. In France, Marine Le Pen, who leads the far-right National Rally, has opposed an expansion of the list of mandatory vaccinations, while in Italy, members of the Five Star Movement have previously suggested vaccines were unsafe.

In the US, Donald Trump has also expressed scepticism over vaccines, having invited Andrew Wakefield – the discredited gastroenterologist who has claimed the MMR vaccine was linked to autism – to his inaugural ball.

In poorer countries and marginalised communities, misinformation is often further complicated by conflict and a lack of access to healthcare.

The highly contagious disease can cause severe diarrhoea, pneumonia and vision loss. It can be fatal in some cases and remains an important cause of death among young children, according to the WHO. The disease can be easily prevented with two doses of a safe and efficient vaccine that has been in use since the 1960s, the UN agency says.

In 2017, measles caused an estimated 136,000 deaths around the world, according to the WHO’s preliminary figures.

The Philippines is among the countries struggling to contain a measles crisis, with at least 70 deaths, mainly of children, in the past month. The spike in cases follows a scandal around a dengue vaccination. Dengvaxia, which was given to school children across the country, was accused of putting children at risk of contracting a more serious form of the disease. Links were made to the deaths of several children, though nothing was ever proved.

Countries have until April to report measles cases registered in 2018 to the WHO. But the agency said the data it had received so far showed that about 229,000 cases had already been reported, compared with 170,000 for 2017.

Less than 10% of actual measles cases are reported, according to O’Brien, who said the true number of infections was in the millions. “So when we see the reported cases increasing by 50%, we know that we’re heading in the wrong direction,” she said.

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Up until 2016 the number of measles cases had been steadily declining but since 2017 the number had soared, according to Katrina Kretsinger, who leads WHO’s expanded immunisation programme.

“There are a number of outbreaks … which are driving some of these increases,” she told reporters, pointing to significant outbreaks in Ukraine, Madagascar, the Democratic Republic of the Congo, Chad and Sierra Leone.

In Madagascar alone, from October 2018 to 12 February 2019 a total of 66,278 cases and 922 deaths had been reported, the WHO said.

“We’re backsliding on the progress that has been made,” O’Brien said. “And we’re not backsliding because we don’t have the tools to prevent this. We do have the tools to prevent measles. We’re backsliding because of the failure to vaccinate.”

Facebook has said it is “exploring additional measures” to address anti-vaccination posts, after concerns were raised when the subject appeared in groups and pages across the social network. The company admitted that the task was challenging, as it tried to strike a balance between freedom to express opinion and the safety of its users, but said it was committed to tackling the problem.

“We actively work across multiple fronts to prevent false and misleading content from getting broad distribution on Facebook. Anti-vax content is eligible for fact-checking, and we’re working on even more ways to efficiently detect and address it,” a spokeswoman for Facebook said.

• This article was amended on 18 February 2019. An earlier version said that WHO preliminary figures showed “measles caused approximately 136,000 deaths around the world” in 2018. The word “approximately” has been changed to “an estimated”, and the year changed to 2017.