The measles have also been on the decline for many years, but with more people being critical towards vaccination, outbreaks still happen, such as in Samoa. In late 2019 and early 2020, 5,707 people in Samoa were infected with measles, 83 people died, and 72 of them were children under 5, according to a study in the medical journal the Lancet.
“When this happens, and when children die, there is always a big uproar. Why did it happen? Because the child wasn't vaccinated,” Lars says. “The discussion is the same as having a fire department: As long as there're no fires, you're arguing about the need for a fire department.”
Vaccines have also contributed to the long life expectancy that we are enjoying now. “The mortality in under five-year-old children was very high before vaccinations started, like for example polio, diphtheria and tetanus,” Lars says. As an example, one hundred years ago, children under 5 represented over 25 per cent of all deaths. Today, the number has gone down to under 1 per cent, according to the Australian Institute of Health and Welfare.
Making decisions based on evidence
A focus of Lars’ work is to advise people in regard to vaccinations when they travel to tropical countries. “There're a lot of myths and misinformation about vaccines,” he says.
When people are looking for information in terms of vaccines, it’s important not to take sides. “First of all you need to explain. I always tell people, ‘look, I'm here to give you the best evidence I have’, Lars says. “'I'm going to tell you what are the pros and the cons, but in the end, it’s your decision.’”
Lars states that he can’t make a decision for the people who come to him. Instead, he says, “it is about empowering the client to understand the issue, and then he or she makes the decision. Very often people come to me, and they have no concerns with vaccines. They say, ‘yes, I want that vaccine’,” Lars says. “If people are hesitant, I don’t try to convince them. I just give them evidence which is out there.”
Difficult decisions about rare diseases
Lars says that sometimes people have to make difficult decisions, especially when it comes to rare diseases like rabies. Rabies is mostly transmitted by infected dogs in travellers, for example in Africa or South East Asia. “If you get bitten by a rabid dog, and if you didn't get a vaccine and you don't see a doctor, then you're going to die,” Lars says.
The power of vaccines
In the end, if we get vaccinated or not, depends on us: we need to find reliable information so we can make informed decisions that are based on facts and not emotions. “Vaccines are one of the most powerful public health interventions we have, and vaccines have saved millions of lives in the past decades,” Lars says. “Let’s keep it this way.”