-Analysis-

BUCHAREST — Olivia Steer is young and beautiful, and she frequently graces the front pages of Romanian magazines to promote a healthy diet and lifestyle. But Steer is also famous for something else: She is the face of the country's growing anti-vaccination campaign.

"Vaccines have mercury and aluminum, a mixture that can cause autism," she wrote on her Facebook page, which has drawn tens of thousands of followers.

Steer highlights the stories of parents from all across Romania who claim their children suffered grave illnesses after being vaccinated. Her daily battle against vaccines has given rise to a large and coordinated anti-vaccination movement in this eastern European nation.

According to UNICEF, Romania has the highest infant mortality rate in the European Union with 11 deaths for every 1,000 births. The main causes of death are infectious diseases like tuberculosis and rubella, which are easily preventable through the use of vaccines. Even though three people die from tuberculosis every day in Romania — the highest rate in the EU — vaccination coverage is steadily decreasing.

Misinformation regarding vaccines is widespread, especially in rural areas.

Steer may be the pioneer of Romania's anti-vaccination movement but she's joined by other celebrities and prominent members of the country's scientific community. The Christian-Orthodox pro-life nonprofit Pro Vita recently embraced her cause, saying it was "ready to defend the rights of parents to make decisions regarding the health of their children, including rejecting vaccination."

The Romanian Orthodox Church has somewhat distanced itself from these campaigns and encouraged vaccinations with the caveat that they "respect the freedom of the patient."

Opposition to the anti-vaccination movement in the public realm is meek even as a rapidly worsening measles epidemic spreads across the country. From 2016 through January 2017 there were 2,165 reported cases of measles resulting in 13 deaths, at least three of whom were children less than a year old. In 2015, there were only 15 cases and no deaths. Earlier this year, more than 30 children were treated for rubella, some with grave complications, at just one hospital that provides this service in the western city of Timisoara.

As the anti-vaccination campaign gathers pace, the response from national institutions has been weak and ineffective. Misinformation regarding vaccines is widespread, especially in rural areas. The Romanian government has failed to conduct a coherent campaign that promotes the benefits of vaccination. It has also failed to warn parents of the risks their children face if they aren't vaccinated.

Bucharest baby — Photo: J Stimp

There's also a shortage of vaccines. The government has pledged to purchase more vaccines in March, when it will be able to spend the funds included in the recently approved budget.

The health ministry issued new guidelines on vaccinations, requiring children to be vaccinated against measles at 11 months instead of the previous 13. The Hepatitis B vaccine, which is usually administered within 24 hours of birth, is now mandatory after two months — but stocks have been exhausted and it is no longer available on the Romanian market. Desperate parents who flock to emergency wards with their children are told that new supplies will arrive "sooner or later."

The administration of current Prime Minister Sorin Grindeanu, elected last December, is still reeling from mass protests against corruption that led to the resignation of the justice minister in early February. The government blames the lack of vaccines on the technocratic administration that preceded it, accusing it of delays in the supply process and of choosing suppliers unable to provide the vaccines in the agreed-upon time.

The health ministry is now planning a legislative measure that would hold parents legally responsible for not vaccinating their children.

As the outbreaks of infectious diseases continues unabated in Romania, the country faces a public health disaster. The only vaccine producer in the country, the Cantacuzino Institute, is on the verge of bankruptcy and the health ministry has asked other EU countries to supply vaccines from their reserves. About 180,000 children were scheduled to receive vaccinations against pneumococcus this year, but the government lacked the funds to purchase necessary vaccines.

The vaccination rate plummeted by 20% in recent years, a testament to the efforts of Steer and others in the anti-vaccination movement. In an attempt to reverse this trend, the health ministry is now planning a legislative measure that would hold parents legally responsible for not vaccinating their children. A determined anti-vaccination movement, combined with a structural inability to maintain vaccine stockpiles, have led Romania into a deepening crisis.