Despite the fact that an effective measles vaccine has been circulating since the 1960s, there is currently a measles outbreak ravaging the Philippines. As of this writing, 261 people have died as a result of the epidemic this year alone, far surpassing the 202 deaths that occurred in the entirety of 2018. Most of the victims were children under the age of five, and around 2.6 million children remain at risk. This crisis was absolutely avoidable, but the island nation is still suffering from it.

Logically, the lower a community’s immunization coverage, the more likely it is that an outbreak will occur. According to the World Health Organization (WHO), immunization coverage for measles in the Philippines dropped from 80 percent in 2008 to below 70 percent in 2017, and it is almost certain that it has decreased further over the past year. While measles vaccines are provided by the government for free in state hospitals and health centers, some factors such as inadequate deliveries and rural inaccessibility have impeded full vaccination.

However, the strongest factor in diminished coverage has been vaccine hesitancy. In late 2017, The Philippine Department of Health (DOH) supported a school-based vaccination campaign to distribute the first licensed dengue vaccine, Dengvaxia. Early in the program, Sanofi Pasteur, the maker of the vaccine, released a statement saying that further studies on the vaccine showed that those who had not previously had dengue would be more vulnerable to a more severe form of the disease after receiving the vaccine. Sure enough, dozens of deaths of those who had participated in the program were then attributed to the vaccine. While some claims were disproved, dengue-related deaths did follow. The program was suspended, and blame-hopped between the DOH, various administrative officials, and Sanofi itself.

The scare broke public trust with the government and the safety of vaccines. While the consequences could be attributed to the fact that the vaccine was relatively new and still undergoing study when it was distributed, the damage was done. Public confidence is fragile, and this scandal ruined the already tenuous acceptance of vaccines.

We live in a world where the eradication of diseases is scientifically possible, but that goal is contingent on support and voluntary participation in immunization campaigns. While it is generally viewed that vaccines are beneficial, we are certainly not all medical experts. The fear of contracting a certain illness can sometimes compete with the fear that the vaccine we just took to protect us from a disease will harm us in another way.

The vaccine skepticism that results from this worry is not new. The U.S. is infamous for a growing anti-vaxx movement that spreads fake news and campaigns of misinformation about, namely, how vaccines are linked to autism. While the Philippines had a more tangible experience through Dengvaxia that tarnished the reputation of vaccines, all opposition is founded on the fear of the unknown.

Health systems around the globe are charged with the duty to be diligent and responsible for the essential task of administering vaccines. They must maintain confidence to ensure that the public buys into vaccine programs — the final step in fully preventing outbreaks. The Philippine government is living up to this commitment, as it recently launched a mass anti-measles campaign to address the current epidemic. Thanks to these efforts, 54 percent of children aged 6 months to 5 years are now vaccinated against measles, despite lingering effects from the Dengvaxia mess. There will always be an underlying doubt of vaccines when faced with cases that delegitimize them, but like a child summoning the courage to get his or her first shot, overcoming that fear will be best for us in the end.