Making vaccination a condition for entering school could keep the anti-vaccines effect at bay, according to the director of the Italian national health observatory.

Walter Ricciardi was recently in Malta to meet public health officials and provide training for medical leaders.

At the moment, it is mandatory for children in Malta to be vaccinated against diphtheria, tetanus and polio by particular ages as stipulated by the national schedule. Vaccination against measles and mumps is not yet mandatory, while rubella is mandatory only for girls by the age of 13.

Superintendent of Public Health Charmaine Gauci urges all people born after 1970 to get vaccinated with MMR.

The real anti-vaxxers are no more than three per cent of the population but they are particularly aggressive and noisy

In comments to the Times of Malta, Prof. Ricciardi, who is also the president-elect of the World Federation of Public Health Associations, called for clear and simple messages to be conveyed to the public, in particular about the safety of vaccines and the dangers of some diseases such as measles.

The dangers, he said, were largely underestimated. And parents were hesitant because they overrated the risk of side effects.

According to Unicef, just 10 countries were responsible for three-quarters of the global surge in measles cases last year, when 98 countries reported more cases of measles than in 2017.

In Malta, in 2018 there were five imported cases and one case of local transmission. However, since there was no sustained transmission, Malta has maintained the status of ‘elimination’ of measles.

Measles cases primarily occur in unvaccinated populations and large outbreaks with fatalities are occurring in many European countries that had previously eliminated or interrupted endemic transmission. 

Read: Global measles cases up 300% year-on-year: WHO

With vaccine hesitancy being identified as a global health threat, does Prof. Ricciardi think the so-called anti-vaxxer effect has gotten out of hand? Is it too late?

“Absolutely not,” he replied.

“We can manage this via legislation, as we did in Italy. France and now Germany, Ireland, the Netherlands and possibly the UK are introducing mandatory vaccination for access to kindergarten and primary schools. The real anti-vaxxers are no more than three per cent of the population but they are particularly aggressive and noisy.”

Prof. Ricciardi – who is also director of the WHO collaborating centre for Health Leadership and Governance at the Institute of Public Health, Catholic University of the Sacred Heart in Rome – referred to Malta’s public health community as “fantastic”.

Asked about the Mediterranean region and any reluctance to vaccinate against diseases such as measles, he noted that Italy and France had the highest percentage of sceptics.

However, he reiterated that this could be managed through education, information and legislation.

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