The World Health Organization says the refusal to get vaccinated threatens to disrupt progress made against deadly diseases.

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A measles outbreak in the Portland, Oregon area is being linked to unvaccinated people. Getty Images

You might expect the deadly Ebola virus to make the World Health Organization’s list of “Ten Threats to Global Health in 2019.”

But “vaccine hesitancy”? That one’s raising a few eyebrows.

On its website, officials at the World Health Organization (WHO) define vaccine hesitancy as “the reluctance or refusal to vaccinate despite the availability of vaccines.”

The agency says the phenomenon threatens to reverse the progress we’ve made in tackling vaccine-preventable diseases.

“I was impressed, somewhat surprised, but also gratified that vaccine hesitancy made the top ten list from the WHO,” Dr. William Schaffner, a professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine in Tennessee, told Healthline.

“It means that this is an issue that’s embedded now around the world,” he added. “We knew it was not just located here in the United States.”

The WHO announcement comes during a week in which a measles outbreak in the western United States has brought the anti-vaccination campaign into the spotlight once again.

Health officials in Clark County, Washington, have declared a public health emergency because of a “hot spot” of measles in the nearby Portland, Oregon, area.

Health officials said at least 20 of the people who contracted the disease were not vaccinated.

Schaffner says part of the problem is that vaccines have been so successful in stamping out diseases. The means people don’t see anyone suffering from these diseases and therefore don’t see the need for a vaccine.

“Before we had vaccines in the U.S., 400 to 500 people a year died due to measles and its complications,” Schaffner explained. “The current generation of parents has no personal experience. The grandmother of a newborn may not have seen measles either and has only a vague notion of what diphtheria is.”

“The more successful we are with the vaccines,” Schaffner added, “the more vaccine hesitancy we create because the diseases are eliminated.”

Attorney, activist, and environmentalist Robert F. Kennedy, Jr. is the chairman of Children’s Health Defense, formerly known as the World Mercury Project. His group is known for its anti-vaccine positions.

He has a different take on how “vaccine hesitancy” made it onto the WHO list of top ten global health threats and he doesn’t mince words.

“I’m not surprised because the WHO has devolved from a sterling public health agency to a subsidiary of the pharmaceutical industry” Kennedy told Healthline.

“We’re seeing more and more orchestrated efforts by the industry to not only co-opt health officials but to control international health policies,” he added.

Kennedy says the agency ignores research, such as a 2017 study by Scandinavian scientists that he says shows the sometimes deadly risks associated with vaccines.

He also accuses the WHO of pushing vaccines that haven’t been properly vetted using its own gold standard safety testing methods.

“Parents have an obligation to be skeptical. They have an obligation to protect their children” Kennedy said.

Supporters of vaccines see the criticism of the WHO announcement in a different light.

“It doesn’t matter what we try and defend with. Those who are advocating against vaccines will always come up with some reason it’s not a good thing,” Cynthia Leifer, PhD, an associate professor of microbiology and immunology at Cornell University in New York, told Healthline.

Leifer says she also doesn’t buy the argument that listing vaccine hesitancy as a health threat is about Big Pharma making money.

“Vaccines are not a particularly large money maker for pharmaceutical companies. They give them away for pennies on the dollar to other countries,” Leifer noted.

Why does she think vaccine hesitancy made the list?

“The fewer children that are getting vaccines, the more likely it is that diseases we haven’t seen in years will spread” Leifer said. “There’s a critical threshold of individuals that need to be vaccinated to keep these diseases under control. Once we drop below that critical threshold, there’s going to be a rapid spread of these diseases we really haven’t seen in the U.S.”

” I think we’re teetering on the edge of that” she added. “There’s also a big anti-vax group in Europe and they’ve had some disease resurgence, too.”

She says people who aren’t vaccinated can be the “back door” for those illnesses.

“I always say measles, even polio, is still endemic in a few countries and is just a plane ride away. In our global society, all you need is somebody traveling somewhere to pick something up and bring it back” Leifer said.

“If we take the brakes off of the pressure, we’re going to end up with children that are blind and sterile or possibly even dying from these diseases that are completely preventable” she added.

“My hope would be that this will make people pay attention if the World Health Organization is saying this is really, really important” Leifer said. “I hope people will think twice about delaying vaccines or choosing not to immunize their children.”