[Vaccine refusal and implications for public health in 2012]

Public opposition to vaccination is growing in all western countries, resulting in poor vaccine coverage and failure, as exemplified by measles in Europe. Opposition to vaccination ranges from radical refusal to hesitation, negligence or omission. The fear of adverse effects is now stronger than the fear of infectious diseases. The benefits of vaccination for vanishing infectious diseases can be hard to perceive. Safety alerts, false messages spread by the media and internet, and mistrust of experts also play a part. Studies consistently show that parents of children who are inadequately vaccinated or not vaccinated at all suffer from a lack of reliable information. More information on vaccines is needed, especially on the risk-benefit ratio. Doctors and other healthcare professionals need better training in vaccines, infectious diseases and epidemiology; and college students must receive better scientific education if they are to understand public health messages. Free, compulsory or recommended vaccination, and changes in vaccine schedules, cannot alone overcome vaccine refusal. In France, better coordination is needed among the institutions responsible for vaccination. The growing influence of the media and internet calls for international reflection on how to limit the spread of false information on vaccines.