Vaccine hesitancy would harm pandemic flu response

The rise of fake news and “vaccine fatigue” could seriously harm the response to a global flu pandemic on the scale of the 2009 swine flu outbreak, experts have warned.

Flu experts told a conference on pandemic preparedness at Chatham House in London that falling public trust in vaccines and short memories meant that the world would struggle to fight a deadly outbreak of flu.

Marc van Ranst, a virologist at Leuven University in Belgium and the man who led his country’s response to the 2009 swine flu outbreak, told the conference that anyone trying to fight a flu pandemic in the modern era would have to contend with rumours flying around on social media.

Dr van Ranst described the idea of fake news during a flu pandemic as scary.

“Social media wasn’t really around in 2009 and people had respect for authority. Now everyone has graduated from the university of Google and respect for knowledge has gone. Why do you need [knowledge] when you can get the information you want from typing keywords into Google?” he said.

Swine flu – or H1N1 – was first identified in Mexico in April 2009 before quickly spreading throughout the rest of the world and is estimated to have killed nearly 300,000 people.

Last week the World Health Organization identified “vaccine hesitancy” as one of its priorities for the year ahead, alongside tackling obesity and air pollution.  Reluctance or refusal to vaccinate is seen as one of the reasons for a 30 per cent increase in the number of cases of measles globally. "Anti vaxx" attitudes and social media bots spreading misinformation have encouraged vaccine scepticism, WHO warns.

Gulsah Gabriel, a virologist at Leibniz University in Germany, told the conference: “We are in the middle of an epidemic of vaccine fatigue. No one cares about influenza any more. People think it’s not dangerous.”

She said that influenza vaccination rates across Europe were poor, particularly among health workers.

A recent review of vaccination rates in Europe by the European Centre for Disease Prevention and Control found that just 30 per cent of health workers across the continent had the flu vaccination in the 2016-17 season, despite WHO recommendations that workers should receive the jab each autumn.

The highest rates were reported by Belgium and England where around 60 per cent of health workers received the vaccination.

The UK also has a better track record on ensuring that older people get the vaccination – Scotland, Northern Ireland and England were all close to the European Union’s vaccination target of 75 per cent or over.

Some speakers at the conference suggested that mandatory vaccination of health workers might the answer. Susanne Herold, professor of pulmonary infections at Giessen University in Germany told the conference of an intensive care nurse in her hospital who did not have the vaccination and who she believes picked up the infection from a patient in his care.

“We are at a point where we need to to discuss mandatory vaccination. This would cause a lot of debate but it’s worth thinking about,” she said.

Prof. Herold warned that European countries would find it harder to fight an outbreak of pandemic flu because there were more people at a high risk of developing complications from flu.

“We have a constantly ageing population. In industrialised countries more and more people are obese and have diabetes. We also have more people on immuno-suppressive therapies who cannot be vaccinated,” she said.

But the conference heard that the current flu vaccine is not a panacea – experts have to predict what strain of flu will be circulating the following year and do not always manage to get it right.

Dr Gabriel said: "What is predictable in influenza is that nothing is predictable. We might concentrate on one subtype [strain] of flu but then another subtype could surprise us and cause a large outbreak."

Scientists are working on a universal flu vaccine, although they are yet to agree on what it would look like. One that would protect against all strains of flu and would only be administered once is seen as the holy grail.

Florian Krammer, a virologist at Icahn School of Medicine at Mount Sinai University in New York, told the conference the research was promising but called for a reality check.

"The only problem is that this will take many years. We don't have enough production capacity at the moment, even for high income countries," he said.

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