Translator: Cynthia Evenden Reviewer: Tanya Cushman
Good afternoon, all.
It's great to be here.
Each year, here in the Netherlands,
600 women are diagnosed with cervical cancer
and 200 of them die of this disease.
These are women who are often in the prime of their lives.
They have careers, they have family and they have children who rely on them.
And this is despite the fact that the Netherlands
probably has the most efficient cervical cancer screening program.
Worldwide,
cervical cancer is the second cause of death among women.
The good news
is that we can now prevent this terrible disease with a vaccine.
What's even better is that we will be able
to eliminate this lady-killer from the face of the earth,
provided that we reach high enough vaccination coverages.
Vaccination coverage is the proportion of a population that is being vaccinated.
Cervical cancer is caused by the HPV virus
and it's sexually transmitted.
And for that reason,
an elimination program based on vaccination would be most efficient
if we vaccinate persons before they become sexually active,
and in the Netherlands, that's before the age of 14.
My name is Henry de Vries.
I'm a dermatologist,
and I'm also a member of the Health Council committee
that will advise the Minister of Health
on the future of the cervical cancer vaccination program.
And I hate to say that this future looks rather bleak.
Last year, a mere 45% of the girls in the Netherlands
were vaccinated against cervical cancer.
If you compare that with the year that we started this program -
that was in 2009 -
it was already low, only 60%.
And that's way, way too low to achieve this goal in the long term
to completely eliminate this terrible disease.
So why is it so important to reach high vaccination coverage?
Well, that's because you can induce group protection.
And through group protection,
you halt an infection from further spreading through society.
And the good thing about group protection is that you do not need to vaccinate all.
If the far majority of a population is vaccinated,
those who are left unvaccinated are also protected.
And there are always individuals that you cannot vaccinate,
either because they're too young,
or they're too sick,
or they have allergies
against any of the components of which the vaccine is made of,
or simply because in some people
the vaccination unfortunately doesn't work.
Not only the cervical cancer vaccination program
is affected by declining vaccination coverage;
you see the same thing with measles vaccination.
Can you imagine
that in the European Community in the first half of this year
more than 40,000 cases of measles were registered?
And don't think that measles
is just a harmless and innocent children's disease.
It is a killer as well.
Thirty-seven people died,
and a multifold of this number
will be affected for the rest of their life
by the complications of measles.
So vaccination coverage is not about dry statistics,
but it's about solidarity with the weakest individuals in society.
It's about taking care of your family, your friends, and your relatives.
So what is causing this declining vaccination coverage
we see all over the world?
I think a lot has to do with groups that are active on social media platforms
and that are called "anti-vaxxers."
They deny the effectivity of vaccination,
and they sow seeds of fear and doubt
about the safety and side effects of vaccination.
And one of the sources that they base their conspiracy theories on
is a paper published by Dr. Wakefield and co-authors in 1998
in the authoritative journal The Lancet.
And in this journal, he and his colleagues claimed
that there was an association between measles vaccination
and the onset of autoimmune diseases and autism among young children.
Well, you can imagine, that that led to a lot of turmoil in the medical world.
This was never claimed before.
And a lot of groups tried to reproduce his findings,
but they couldn't, time and time again.
And this led to the suspicion of the British General Medical Council,
and they conducted and inquiry into the study,
and the end result
was that Dr. Wakefield was found guilty not only of falsifying data
but also financial fraud
and conducting unethical experiments with very, very young children.
It took many years to unmask Dr. Wakefield and his co-authors.
And in the meanwhile, so much unrest was achieved in British society
that the vaccination coverage for measles declined,
outbreaks occurred,
and many unnecessary deaths and disease happened.
What happened to Dr. Wakefield?
Humph!
He moved to the United States
where he became the martyr of the anti-vaxxer community.
And up until today,
he still claims falsified claims
that measles vaccination is the cause of autism in children.
So, why do they try to make you believe these false accusations?
Well, one of the things that the anti-vaxxers often use
is that they state
that where there is an association, there also must be a causation.
And I'd like to illustrate that in an imaginary study
that you want to conduct to find a cause
of a very mysterious skin disease that happens every summer
and which causes red and painful and burning skin.
And one of the things that you also record in your study
is ice cream consumption.
And you come to the surprising finding
that on days when a lot of ice cream was eaten,
those individuals also developed sunburn.
Millions and millions of children are vaccinated each year.
And yes, some of them, unfortunately, develop autism.
But it doesn't mean that the two events are related
and causally associated with one another.
Although the anti-vaxxers are a relatively small group,
they are very efficient in targeting parents
who have legitimate questions and doubts about vaccinating their children.
And we should stop further damage to our vaccination programs.
And I'd like you to consider five action points
that we need to do better research on.
The first is mandatory vaccination.
There are very legitimate reasons
not to allow unvaccinated children to enter day care centers.
It's not because they made the decision, but it is the parents.
The simple reason is that these children
form a threat to the youngest, not-yet-vaccinated children
who are also in these day care centers.
Personally, I do not think that's the way to go.
Often, coercive measures will lead to increased resistance.
And for sure,
they will fuel the conspiracy theories of the anti-vaxxers.
The second thing we can do better
is inform the general public about the importance of vaccination.
Right now, with our one-sided websites,
our paper flyers full of facts,
they don't have the desired effect any longer.
In this time and age, with social media platforms
on which emotion and personal beliefs from many
prevail over facts and evidence,
we are no party any longer.
We should seriously sit together
with social scientists, with anthropologists,
with communication experts
and find new and smarter ways how to well-inform the general public.
Thirdly, we need to keep on unmasking conspiracy theories.
Not so much in an effort to convince anti-vaxxers -
they are not to be convinced;
they don't want to be convinced for various reasons -
but to reach out to parents who are vaccine-hesitant
and who are ill-informed by these groups.
Maybe we should take an example of companies
that have come under attack by campaigns of misinformation
and as an effect,
now monitor social media platforms 24 hours a day, 7 days a week, year long,
and whenever any false accusations that could affect their interest pops up,
they respond to it immediately.
Fourthly, we should reform our vaccination programs altogether.
And maybe we should look better
at countries where they do achieve high vaccination coverage.
For example, Australia.
In Australia, over 80% of the girls are vaccinated against cervical cancer,
and that is achieved by school-based programs
in which school nurses play a central role.
They know their students.
And the parents of these students, they know the nurses.
And whenever they are in doubt or have questions
about whether to vaccinate or not,
they know exactly where to go to and address their questions.
How different is this from the situation in the Netherlands?
We vaccinate via mass vaccination campaigns.
And we summon adolescents by the thousands
to anonymous recreational centers,
and they stand in lines,
and these kinds of scenes of mass hysteria occur frequently.
We seriously should start listening to the parents and to their children.
What do they think
that is a child-friendly and safe environment to be vaccinated?
And to address their questions.
What do they think of waiting times?
What do they think of opening hours?
We don't know because we haven't researched it.
The last thing I'd like you to take home is the formation of alliances.
Let's take an example of Ireland,
where they have formed what is called the HPV Alliances,
where healthcare workers, together with teachers, scientists and patients -
and they are backed by the Minister for Health -
stand against conspiracy theories which involve vaccination campaigns.
And they stand for saving lives via vaccination.
To conclude, conspiracy theories are as old as the first newspaper,
and they are here to stay.
But in this time and age, with social media platforms,
they have much more effect and threat to society.
And we should prevent further damage to our vaccination programs.
We should take action now.
And we shouldn't despair, I think.
Parents all want their children to grow up and become happy and healthy adults.
And altruism and empathy needed for vaccination solidarity
are all human traits.
If we do not take action now, deadly outbreaks will reemerge,
and that, for sure,
will convince a lot of parents to have their children vaccinated.
But as healthcare providers,
we will have failed
and we will be held accountable
for all the unnecessary losses that have occurred.
So let's seriously start doing some research,
and with that evidence,
reform our vaccination programs now.
Thank you so much for your attention.
(Applause)