The recent outbreak of measles in Italy is another confirmation of how damaging the anti-scientific stance of protest parties can be. A misleading campaign with the motto “vaccinate less, vaccinate better” by the Five Star Movement convinced a worrying number of Italian parents not to follow the doctors’ advice.

Campaign poster of the Italian Five Start Movement that says “Vaccines, the whole truth”. The party, and especially its leader, Beppe Grillo, have campaigned on an anti-vaccination agenda.

 

On 17 April, the Centers for Disease Control and Prevention (CDC), the leading national public health organisation of the United States, warned American citizens of yet another country that poses serious health risks to travellers, advising them to get vaccinated before travelling there. The fact that this country is Italy may come as something of a surprise, especially as it boasts one of the most developed, comprehensive and accessible health systems in Europe. Italy is also the healthiest country in the world, according to the Bloomberg Global Health Index.

An unprecedented outbreak of measles has spread over Italy. Figures are shocking; according to the Italian Institute for Public Health (Istituto Superiore di Sanità – ISS), 2,719 cases were reported since the beginning of 2017, spread all over the peninsula.

What is significant, however, is another figure: 89% of those cases were people who had not been vaccinated. Thus, what concerns the most, is not only the number of people infected by the virus, but rather the fact that this could have easily been avoided. The common MMR vaccination (Italian MPR) against measles, mumps, and rubella, introduced in 1971, is 97% effective. Yet, the number of people getting vaccinated has steadily decreased, from 88 per cent in 2013 to 86 per cent in 2014 and 85.3 percent in 2015 (data from the New York Times). But why is this so?

A general fear over vaccines has spread in the last three decades, fuelled by a study published in 1988 linking the MMR vaccination with autism in children. The totally misguided claim of the study was completely discredited in scientific circles, and its proponent, Dr Andrew Wakefield, has been struck off as a doctor in the UK. Since then, numerous medical studies have proved the effectiveness of the vaccination which, according to the CDC, has led to more than 99 % reduction in measles cases compared with the pre-vaccine era.

Why then, does the number of vaccinations decrease yearly, even 30 years after the infamous study? Why, notwithstanding medical research and scientific facts supporting vaccines, is there still widespread skepticism surrounding their effectiveness and alleged negative health effects?

The real cause of the problem can be found elsewhere: not in the realm of medicine, but in that of politics. The leader of the Italian populist party Five Star Movement (M5S), Beppe Grillo, has played an influential role in fostering the misguided and unproven claims that reproduce old fears about the risks of vaccinations. Indeed, Grillo’s anti-vaccinations stance has always been clear: from a TV show in 1998, in which the politician aka comedian questioned the effectiveness of vaccinations, to the current official website of the political movement, which argues for ‘vaccinate less, vaccinate better’,

On his party website, he blames pharmaceutical companies for putting pressure on doctors to prescribe more vaccines for their own profit; doctors, in turn, for falling into this trap; the scientific world for having ‘abandoned a medical approach based on evidence’; and finally, politicians for representing the interests of powerful groups, rather than citizens. In this fashion, Grillo’s party portrays itself as the people’s saviour and the enlightened party capable of restoring ‘accuracy’ to our scientific knowledge. The web page dedicated to the topic of vaccinations ends with a video of an ‘expert’ who explains why vaccinating less is better.

It is somewhat ironic to read all this on the official web page of the Five Star Movement, and one cannot but wonder whether this is all just a satirical joke or a test of the Italian people’s knowledge. Unfortunately, it is neither. Rather, it is clear evidence of a blatant attempt to exploit people’s fears and ignorance. The effectiveness of vaccinations is not an opinion, but an objective fact. Most of us do not remember a time when measles killed people. Yet, there is  increasing public support for the Five Star movement’s no-vaccinations proposals and of cases of parents choosing not to vaccinate their kids.

The populist party is promising Italians truth, while actually distorting it. But people are trusting these ‘truths’, as opposed to the opinions of experts, identified as part of an elite conspiracy against ‘the average people’. In our post-truth times, it is apparently possible to dismiss not only media news, but even scientific evidence, and exploit it for political (populist) ends.

 

“The populist party is promising Italians truth,
while actually distorting it.”

 

Responses to this have been bitter and the majority of Italian experts and doctors have campaigned and actively encouraged people to learn the truth and vaccinate their children. The media have been broadcasting numerous stories about cases of unvaccinated children who face serious health risks. Finally, on 19th May, the parliament approved a law which makes vaccination compulsory for admission into nursery and primary schools; enforces fines of up to € 7,500, as well as the removal of paternal responsibility for parents who do not vaccinate their children.

It is the response to this strong decision that brings to light yet another important factor. The element of compulsion introduced by the law created widespread discontent. One can read article titles such as ‘Was it right for Italy to make vaccinations compulsory?’, ‘I want to be free to decide whether I want to vaccinate my child’, as well as an incredible number of hateful comments towards the doctors and experts who openly campaigned for the passing of this decree.

In a time when individual freedom is given the utmost priority and importance in our society, when democracy and the will of the majority must win over everything else, a strong negative reaction to this law is hardly surprising. However, when it comes to prioritising individual choices that affect others (you not vaccinating your child means mine might contract the virus too), the right of a citizen to autonomously decide was put aside by the Italian parliament. Rightly so.

The debate surrounding vaccinations is polarising Italian society, more so than anyone could have imagined. As a result, society is not only being split between vax and no-vax people (for and against measles vaccination), between more traditional political groups and populist parties, but also between knowledgeable people, experts and doctors, and charlatans, between culture and ignorance. The issue is yet another evidence of the huge divides that exists in contemporary societies.

The post-truth and ‘fake news’ era in which we are living, combined with the wave of populism that the Western world is experiencing, the lack of faith in the authorities, and, last but not least, the individual determination of wanting to make life choices in complete freedom in a democratic context, is an explosive recipe.

In the context of healthcare, as the issue around vaccinations in Italy shows, it seems that the very foundations of our contemporary society, which developed to its current stage thanks to the strong scientific and cultural foundations reached throughout years of struggle and research, are  under threat. Italy seems to have halted this by taking away the freedom of choice over whether to use vaccinations from its citizens. Paradoxically, one may claim, Italy is trying to preserve the very foundations of a modern and developed society based on scientific knowledge through a measure that comes across as not-so-democratic.

Less freedom of choice, and less democracy for more truth and better choices in society, all for the benefit of its people. More of this to come in Europe?

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