经济学人:疫苗 及时一针(下)

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　　Members of this poor and ostracised minority are shunned¹ by health workers and often go unvaccinated. 这些贫穷、被放逐的少数民族得不到医务人员的关注，他们通常没有接种疫苗。

　　Several governments are trying to raise vaccination⁵ rates by making life harder for parents who do not vaccinate⁴ their children.  几个国家试图通过干预那些不让孩子接种疫苗的家庭的生活，从而提高疫苗接种率。

　　A measles⁶ outbreak last year that started with an unvaccinated child visiting Disneyland and spread from there to seven states prompted California to make a full vaccination record a condition of entry to state schools.  去年美国麻疹疫情爆发正是由于一名未接种疫苗的儿童在迪士尼乐园游玩，造成麻疹疫情迅速传播至七个州。此次疫情爆发，促使加利福利亚州制定了详尽的疫苗接种记录，这一完善的记录成为进入公立学校的条件。

　　The previous year, in a quarter of schools too few children had been vaccinated³ against measles to confer herd⁷ immunity⁸.  前年，四分之一的学校中，极少数孩子注射麻疹疫苗以达到群体免疫。

　　A dozen other states are considering similar bills.  其它的十二个州正在考虑与之类似的法案。

　　After a toddler died from measles last year, Germany recently started to oblige parents who do not wish their children to be vaccinated to discuss the decision with a doctor before they can enroll⁹ a child in nursery.  去年，一名幼儿死于麻疹后，德国开始对进入托儿所设立门槛，除非那些不愿让孩子接种疫苗的父母可以跟医生就接种疫苗展开商讨。

　　Australia’s new “no jabs, no pay” law withdraws child benefits from parents who do not vaccinate, unless they have sound medical reasons. 澳大利亚出台新法案“没有接种，就没有补助”同时取消没有接种疫苗的儿童津贴，除非父母可以提供一些合理的拒绝接种的医疗理由。

　　There is, however, surprisingly little evidence that tough laws make a big difference to vaccination rates.  然而，出人意料的是鲜有证据表明严格的法律能对疫苗接种率起到很大的作用。

　　European countries that are similar in most respects (such as the Nordics) may have similar rates for jabs that are mandatory¹⁰ in one country but not in another—or very different rates despite having the same rules.  那些在某些方面具有相同特性（如具有北欧日耳曼民族外貌特征）的欧洲国家，尽管一国规定强制接种另一国不强制，但两国却有相接近的疫苗接种率；然而有相同的接种规定的国家却有不同的疫苗接种率。

　　Rates in some American states where parents can easily opt¹¹ out are as high as in West Virginia and Mississippi, which have long allowed only medical exemptions¹³. 在美国，西弗吉尼亚州和密西西比州一直以来仅允许提供合理医学证明的人拒绝接种，而其它一些相对容易逃脱接种的州的疫苗接种率却同前两个州一样高。

　　And strict rules may even harden anti-vaccination attitudes.  严格的规定甚至会使得反疫苗接种的态度变得强硬。

　　Australia had previously¹⁴ made exemption¹² conditional¹⁵ on speaking to a doctor or nurse about the benefits of vaccines¹⁷.  澳大利亚先前对谈及疫苗好处的医生或护士有豁免条件。

　　The new rules mean fewer chances to change parents'minds.  新规定意味着改变父母想法的可能性更小。

　　Research suggests that making it harder to avoid the most important vaccines may make it more likely that people who strongly oppose vaccination in general shun² optional ones, says Cornelia Betsch of the University of Erfurt. 埃尔福特大学的科妮莉亚说，研究表明对接种最为重要的疫苗实行更严格的要求，会使得那些通常拒绝接种的人们更容易的放弃可自由选择接种的疫苗。

　　More important, say public-health experts, is to boost confidence in the safety of vaccines and trust in the authorities that recommend them—both badly damaged in many European countries by pastpublic-health mis-steps, such as a scandal with contaminated blood supply in France from the late 1990s.  公共卫生专家说道，更重要的是要增强人们对疫苗安全的信心和对官方机构的信任，而这两“信”曾在许多欧洲国家由于过去公共卫生的过失政策被严重破坏过，例如20世纪90年代末法国的血液供给被污染的丑闻。

　　The best way to handle a vaccine¹⁶ scare is to express empathy and promptly¹⁸ share the results from investigations¹⁹ of alleged²⁰ adverse²¹ reactions, says Heidi Larson of the London School of Hygiene²² and Tropical Medicine.  伦敦卫生和热带医学学院海蒂?拉森说道，处理疫苗恐慌最好的方法是表达同情，并立即分享来自机构的所谓不良反应的消息。

　　British authorities'dismissive response to the MMR scare failed to reassure²³ worried parents. 英方对麻风腮三联疫苗恐慌轻视的处理方式没能使得忧虑的父母安心下来。

　　One promising²⁴ new approach is to keep track of the vaccine myths circulating in cyberspace²⁵ and rebut²⁶ each one as it appears.  一个有希望的新方法是及时了解在网络上散布疫苗谬论的动态，每当一个谣言出现时就反驳它。

　　This requires tracking information from search engines and following anti-vaccination websites and parents'forums.  这要求追踪搜索引擎、反疫苗网站和父母论坛的信息。

　　On one such forum²⁷, worriers say they have scoured²⁸ government and vaccine-manufacturer websites but feel overwhelmed by information that they regard as inconclusive or contradictory²⁹.  在这样一个论坛上，忧虑者说他们搜遍了政府网站和疫苗制造商的网站，但对他们毫无定论和相互矛盾的信息感到不知所措。

　　One mother seeks advice on how to get around California’s “fascist” new rule.  一位母亲寻求如何避开加利福利亚“法西斯”般的规定的建议，

　　Another casts doubt on a study on severe allergic³⁰ reactions to vaccines: 33 cases from 25m jabs, she says, seems “fishily low”. 另一位母亲则对2500万疫苗接种只有33例剧烈过敏反应的研究生疑，说比例太低难以置信。

　　Some countries are starting information campaigns that treat such concerns with respect.  部分国家正开始以尊重对待忧虑的信息活动。

　　A parents'organisation in Bulgaria launched one recently, under the auspices³¹ of the ministry³² of health and the national association of paediatricians.  保加利亚的一个父母组织在卫生部和国家协会的儿科专家支持下发起了该活动。

　　Its website is jargon-free and easier to navigate³³ than unwieldy official hubs.  该网站语言通俗，避免了专业术语，比不实用的官方活动更易操作。

　　France is launching a national dialogue on vaccines this spring, with a website where citizens can swap³⁴ gripes, worries and advice. 法国在今春发起了疫苗国际对话活动，市民可在网络上发布怨言、忧虑和建议。

　　Although vaccine-hesitant parents often search for answers on the internet, their most trusted sources are doctors and nurses.  尽管在是否接种疫苗上犹豫不决的父母经常在网络上寻求答案，但是他们最信任的还是医生和护士。

　　The WHO recently developed guidelines to help health workers figure out, through a questionnaire, which type of worrier a parent is—and how to alleviate³⁵ specific concerns.  最近，世界卫生组织通过问卷，在帮助卫生工作者弄清楚父母属于哪种类型担忧和如何减轻特定的忧虑上制定了指导方针。

　　But recent research from several European countries shows that many doctors and nurses are also hesitant about vaccines, for much the same reasons as their patients.  但是，来自几个欧洲国家的近来研究表明许多医生和护士对接种疫苗也持迟疑态度，原因与父母一样。

　　In a survey conducted in 2014, 16-43% of French family doctors said they never or only sometimes recommended some of the standard vaccines. 在一个2014年进行的调查中，16%-43%的法国家庭医生说道他们从未或偶尔会推荐标准疫苗中的一些。

　　An additional problem is that many adults were not immunised as children and have not caught up since.  此外，许多成年人和小孩一样并没有免疫力，且从未引起重视。

　　In the 1970s and 1980s, when the measles vaccine was new, many children did not receive it, or got just one shot, which is now known not to be reliable in conferring immunity.  在20世纪70/80年代，当麻疹疫苗刚问世时，许多小孩并未接种或只是接种一次，更因不可信任而寻求免除接种疫苗。

　　Some countries offer free catch-up jabs to some adults when outbreaks flare³⁶ up—usually parents with small children and health workers in affected³⁷ areas. 当疾病爆发时，部分国家向一些成年人提供免费的强化疫苗，因为带小孩的父母和在受感染的地区的卫生工作者都是成年人。

　　But such efforts have, on the whole, been too little, too late.  但是总的来说，这些努力都太微不足道。

　　The return of easily preventable diseases that had all but disappeared is a shame.  那些差点就消失的可预防疾病的卷土重来本就是一种耻辱。

　　A bigger shame would be for governments to continue blaming it all on ignorant  parents. 而对政府来说，更耻辱的是他们还继续将责任推至那些无知的父母身上。

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