James Mather, Infectious Diseases Analyst, GlobalData
GlobalData’s primary and secondary research into vaccine hesitancy suggests that it is caused primarily by the availability of misinformation propagated through the internet, as well as via non-scientific press articles and other media outlets. In the case of MMR specifically, the link between MMR vaccines and development disorders such as Autism Spectrum Disorder (ASD) stems from now retracted fraudulent research by Andrew Wakefield and colleagues, originally published in The Lancet. Their study only had a small cohort of participants but was still published and heavily cited before its retraction, which generated public mistrust in MMR vaccines. As part of their retraction, it was stated that the data did not show a causal link between MMR vaccines and ASD. Excluding this study, the vast majority of vaccine R&D has shown that in most situations the benefits of vaccines highly outweigh their risks, both for individuals and for public health.
MMR vaccines are live-attenuated vaccines, which often carry increased risks compared to other types of vaccines since they contain pathogens capable of replicating, but these risks are not significant compared to the protection they provide for the majority of patients; however, patients with compromised immune systems are unable to receive these vaccines. Other risks associated with vaccines generally include localised inflammation at the injection site and other systemic effects, usually mild fever, drowsiness, or vomiting. These small risks are significantly outweighed by the protection offered to the individual and communities if enough of the population are immunised to allow herd immunity to prevent disease outbreaks.
Big Pharma have spent millions of dollars on combating the stigma that was generated surrounding links between vaccines and developmental disorders. Over the last decade, immunisation rates, particularly for MMR vaccines, have improved, however, in the last couple of years major outbreaks of measles have struck developed countries due to inadequate MMR immunisation coverage amongst their populations.
Merck, Sanofi, and GSK are the major players in childhood immunisations across the globe marketing DTaP, MMR, rotavirus, and influenza vaccines in many different markets. These three companies currently dominate the pediatric vaccines market, and therefore increasing immunisation rates by working with national and international initiatives and investing in future R&D efforts is essential to their short- and long-term revenue streams.
Although improvement is still possible, due to the efficacy and safety provided by the currently available range of vaccines, R&D into childhood vaccines in North America and Europe is fairly subdued. There is currently significantly more clinical development activity from native biotechnology and pharmaceutical companies in markets such as India, where Big Pharma does not dominate the vaccines market. Therefore, opportunity for newcomers to the childhood vaccines space should aim to target emerging markets across APAC, Asia, South America, and Africa in order to receive adequate return from the expensive process of developing vaccines.
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