Declining childhood vaccination coverage in Estonia is becoming an increasing cause for concern. In 2010, 97 percent of 2-year-old children were vaccinated against diphtheria, tetanus, pertussis, polio and hepatitis B. By 2024, that figure had fallen to 83 percent. Preliminary data suggest it declined even further last year. In some counties, only slightly more than half of children have been vaccinated.

The situation is highly reminiscent of the final years of the Soviet era when vaccination became deeply unpopular and ultimately resulted in diphtheria outbreaks with high mortality rates. Even then, vaccination rates did not collapse overnight but deteriorated gradually, step by step. At the time, public doubts persisted despite the fact that just a few decades earlier, vaccination had eliminated polio and diphtheria.

Estonia was not spared either. Fewer than 100 cases of diphtheria were recorded, four of them fatal. The most regrettable aspect is that this occurred at a time when a vaccine that could completely prevent both illness and death was already available to everyone.

The outbreak was brought under control through the rapid and widespread vaccination of the population. After the first death, there were no longer any people refusing vaccination. In retrospect, it is difficult to determine how much of the opposition at the time stemmed from distrust of vaccines and how much from resentment toward those in power.

Today, we are seeing a similar trend. Childhood vaccination coverage is declining every year and in some places is approaching a critical threshold. Once an outbreak occurs, stopping it requires considerable effort and casualties cannot be entirely avoided.

A recent outbreak of meningococcal disease in southern England provides an example. Public health officials responded quickly, distributing more than 10,000 doses of antibiotics and vaccinating around 2,000 close contacts. Nevertheless, two young people lost their lives as a result of the outbreak. This was not due to delays in medical care. Rather, with most vaccine-preventable diseases, illness progresses rapidly and the pathogen can cause irreversible damage in a short period of time.

Another case occurred much closer to home. Latvia recently recorded 49 cases of measles, while more than 1,000 people who had been in contact with infected individuals were placed under observation. The disease was brought into the country by an unvaccinated child and most of those who became ill were also unvaccinated. With high vaccination coverage, measles could disappear from the world entirely, since the virus has no natural reservoir host and the vaccine is highly effective against it.

There are three main reasons people refuse vaccines: fear of side effects, belief in widely circulated false claims and a lack of trust in experts and the state. All three factors have intensified in recent years.

Vaccine skepticism in the United States and the coronavirus pandemic greatly amplified concerns about vaccine side effects around the world. This happened despite the fact that most childhood vaccines have been in use for more than half a century and numerous international studies have repeatedly demonstrated that they do not cause serious side effects. In the past, vaccines were suspected of causing certain syndromes, but improved diagnostic methods later revealed that these conditions were more likely the result of congenital or genetic defects.

At the same time, people do not fear severe infectious diseases themselves to the same extent or overestimate medicine's ability to treat them when necessary. By the time symptoms appear, irreversible damage may already have occurred.

Today, all kinds of controversial information spreads and gains traction on social media at remarkable speed. Misinformation is also skillfully packaged between statements that are factually correct. For example, it is entirely true that recovering from an illness can confer immunity. What is usually left unsaid, however, is that we have no reliable way of knowing in advance whose infection will be mild and who will suffer severe consequences.

It is possible that future advances will make personalized vaccination strategies feasible, but current scientific knowledge does not allow for that.

Developments in global politics also contribute to anxiety and resentment. Wars and armed conflicts, drones flying near us, rising prices and higher taxes create a sense among ordinary people that they no longer have control over their lives. Against whom, if not the state, are they likely to direct their dissatisfaction and distrust? Ignoring vaccination recommendations from officials and experts can therefore seem like one way of expressing that frustration.

There are also people who now ridicule the measures taken during the coronavirus pandemic and take pride in having ignored them. It is true that, in extremely rare cases, COVID-19 vaccines were associated with serious side effects. However one chooses to evaluate them in retrospect, the ultimate conclusion remains the same: the vaccines worked and saved millions of lives around the world.

Preventing disease is always more effective than treating it. Every parent who has not yet vaccinated their children should honestly ask themselves why they have not done so. Do they have sufficient evidence that vaccines do not work or that they pose serious dangers? Is it reasonable to rely on the hope that a dangerous disease will never reach their child or that if it does, the illness will be mild?

Belief in good luck and chance should be left in the past because modern medicine offers better alternatives. Vaccines help prevent serious illness and death and are, overall, safer than the diseases they protect against. Parents with questions or concerns can seek answers from their family doctor or family nurse, or from a school physician or school nurse.

--

Follow ERR News on Facebook and X and never miss an update!