The prevalence of medical misinformation on the Internet and social media today has created an increasing fear of immunisation amongst Malaysians. According to the Health Ministry, there is a growing number of parents refusing to vaccinate their children in the past few years. The influence of social media and the Internet was one of the top reasons cited for vaccine refusals among Malaysian parents, based on data from 2016.

This report is disconcerting as children who are unvaccinated or under-vaccinated are at serious risk of potentially fatal diseases. Beyond that, they can also destroy the collective herd immunity enjoyed in the country, while contributing to an increase in the re-emergence of vaccine-preventable diseases in Malaysia.

In an article by AJ Pharma Holding Managing Director, Dr Tabassum Khan, here are five myths surrounding vaccine refusal and what we can do to change some of the commonly held misconceptions.

Myth #1 Vaccines cause autism

It has been 20 years since the infamous article by former British doctor, Andrew Wakefield, falsely linking the MMR (measles, mumps and rubella) vaccine to autism, was published in the medical journal, The Lancet. The paper was eventually discredited and retracted from the journal due to serious procedural errors, undisclosed financial conflicts of interest and ethical violations, and Wakefield ultimately lost his medical licence. However, the myth that vaccine causes autism continues to persist.

Numerous consecutive studies were conducted to examine this link but were found to provide no evidence to support the notion that the MMR vaccine causes autism. For example, a meta-analysis involving nearly 1.3 million children, published in the journal Vaccine, has demonstrated that there is no causal link between vaccines and autism .

Myth #2 Multiple vaccines overload the immune system

Another strongly held myth is that multiple vaccinations can overload a baby’s immune system. According to the World Health Organization, scientific evidence shows that giving several vaccines at the same time has no negative effect on a child’s immune system.

A child is exposed to several hundred foreign substances that can trigger an immune response every day. In fact, they are exposed to many foreign antigens, or substances not found naturally in the body, through simple acts such as eating, drinking and playing.

In comparison, vaccines contain a much smaller number of antigens, and thus a child’s immune system will not be overwhelmed even when multiple vaccines are given at the same time or within a short period.

Myth #3 Vaccine components are toxic

Many anti-vaccine lobby is to have expressed concerns over the use of chemicals such as mercury, aluminium and formaldehyde in vaccines. Although it is true that these chemicals are toxic to the human body at certain levels, only trace amounts are present in the final vaccines. The vaccine industry is highly regulated globally, and all products undergo rigorous testing prior to approval by the drug administration and medical regulatory authorities around the world.

Furthermore, this fear regarding the chemical components of vaccine is unwarranted as people actually ingest more mercury from food on a daily basis, while aluminium is also present in the air as well as in food and water. Our body also produces formaldehyde as part of a normal physiological function, as it is one of the basic building blocks of protein required by the body.

Thus, it is important to note that vaccines do not contain ingredients that will harm the body. Each ingredient used in a vaccine plays a necessary role towards maintaining the stability, safety and effectiveness of the final product.

Myth #4 Naturally acquired immunity is better

Some parents prefer that their children acquire natural immunity – by catching a natural infection and subsequently developing a primary immune response – as it results in stronger immunity towards the disease than vaccination, which is induced by deliberate exposure to deactivated disease-causing microorganisms.

Although it is true that natural immunity lasts longer in some cases compared to vaccine-induced immunity, the dangers of this approach far outweigh the benefits. The risk factors associated with acquiring some of these diseases are tremendous and can include paralysis, permanent brain damage, liver failure, deafness, blindness, and death in extreme cases.

For example, wild measles infection causes death in two out of every 1,000 reported measles cases. However, the MMR vaccine may result in a severe allergic reaction only for one in every one million vaccinated individuals.

Myth #5 Better hygiene and sanitation reduces disease

Although better sanitation, nutrition, clean water, and healthier living conditions have helped in the overall reduction in diseases, many infections can still spread no matter how clean and hygienic we are. Thus, vaccines are still necessary to stop these infectious diseases.

When several developed countries such as Great Britain, Sweden and Japan cut back on the use of the pertussis (whooping cough) vaccine over 20 years ago due to a decrease in the prevalence of the disease, they saw a significant drop in their immunisation levels, leading to a dramatic increase in pertussis incidences in all three countries .

It is important to note that while better hygiene and sanitation has contributed to halting the spread of certain diseases, the best approach is to ensure full herd immunity within communities which can only be achieved by ensuring consistently high levels of vaccination within all members of the community.

Spreading Accuracy, Collectively

The multitude of vaccine myths present in society and the availability of anti-vaccine online platforms have led to an ongoing fear and rejection of immunisation amongst a subset of parents. Left unaddressed, this could lead to far worse consequences than what is already seen today.

It is important that everyone from Government to healthcare workers, to pharmaceutical companies and the general public works together to address and alleviate fears expressed by this subset of individuals and the anti-vaccine groups to ensure the ongoing protection of communities. Clear and accurate messaging is key to ensuring there are no misconceptions and people are guided by information and not emotion when it comes to immunisation.