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1、精选优质文档-倾情为你奉上VaccinationA jab in timeSome Western countries have lower vaccination rates than poor parts of Africa. Anti-vaxxers are not the main culprits Mar 26th 2016 | From the print edition ERADICATING a disease is the sort of aim that rich countries come up with, and poor ones struggle to reach
2、. But for some diseases, the pattern is reversed. These are the ailments for which vaccinations exist. Many poor countries run highly effective vaccination programmes. But as memories of the toll from infectious diseases fades across the rich world, in some places they are making a comeback.The Worl
3、d Health Organisation (WHO) reckons that vaccines save 2.5m lives a year. Smallpox was eradicated in 1980 with the help of a vaccine; polio should soon follow. In both cases, rich countries led the way. The new pattern looks very different.The trend is most evident for measles, which is highly conta
4、gious. At least 95% of people must be vaccinated to stop its spread (a threshold known as “herd immunity”). Although usually mild, it can lead to pneumonia and cause brain damage or blindness. The countries with the lowest vaccination rates are all very poor, but many developing countries run excell
5、ent programmes (see chart). Eritrea, Rwanda and Sri Lanka manage to vaccinate nearly everyone. By contrast several rich countries, including America, Britain, France and Italy, are below herd immunity. Last year Europe missed the deadline it had set itself in 2010 to eradicate measles, and had almos
6、t 4,000 cases. America was declared measles-free in 2000; in 2014 it had hundreds of cases across 27 states and last year saw its first death from the disease in more than a decade. The trends for other vaccine-preventable diseases, such as rubella, which can cause congenital disabilities if a pregn
7、ant woman catches it, are alarming, too.This sorry state of affairs is often blamed on hardline “anti-vaxxers”, parents who refuse all vaccines for their children. They are a motley lot. The Amish in America spurn modern medicine, along with almost everything else invented since the 17th century. So
8、me vegans object to the use of animal-derived products in vaccines manufacture. The Protestant Dutch Reformed Church thinks vaccines thwart divine will. Anthroposophy, founded in the 19th century by Rudolf Steiner, an Austrian mystic-cum-philosopher, preaches that diseases strengthen childrens physi
9、cal and mental development. In most countries such refuseniks are only 2-3% of parents. But because they tend to live in clusters, they can be the source of outbreaks. A bigger problem, though, is the growing number of parents who delay vaccination, or pick and choose jabs. Studies from America, Aus
10、tralia and Europe suggest that about a quarter of parents fall into this group, generally because they think that the standard vaccination schedule, which protects against around a dozen diseases, “overloads” childrens immune systems, or that particular vaccines are unsafe. Some believe vaccines int
11、erfere with “natural immunity”. Many were shaken by a claim, later debunked, that there was a link between autism and the MMR vaccine, which protects against measles, mumps and rubella.In America, some poor children miss out on vaccines despite a federal programme to provide the jabs free, since the
12、y have no regular relationship with a family doctor. Some outbreaks in eastern Europe have started in communities of Roma (gypsies). Members of this poor and ostracised minority are shunned by health workers and often go unvaccinated.Several governments are trying to raise vaccination rates by makin
13、g life harder for parents who do not vaccinate their children. A measles outbreak last year that started with an unvaccinated child visiting Disneyland and spread from there to seven states prompted California to make a full vaccination record a condition of entry to state schools. The previous year
14、, in a quarter of schools too few children had been vaccinated against measles to confer herd immunity. A dozen other states are considering similar bills. After a toddler died from measles last year, Germany recently started to oblige parents who do not wish their children to be vaccinated to discu
15、ss the decision with a doctor before they can enroll a child in nursery. Australias new “no jabs, no pay” law withdraws child benefits from parents who do not vaccinate, unless they have sound medical reasons.Persuasion, a fine artThere is, however, surprisingly little evidence that tough laws make
16、a big difference to vaccination rates. European countries that are similar in most respects (such as the Nordics) may have similar rates for jabs that are mandatory in one country but not in anotheror very different rates despite having the same rules. Rates in some American states where parents can easily opt out are as high as in West Virginia and Mississippi, which have long allowed only medical exemptions.And strict rules may even har
