Oksana has never vaccinated her 4-year-old son, convinced that such preventative measures against potentially lethal diseases do more harm than good.
"There is a lot of data that children who were vaccinated actually contracted diseases," explains the 30-year-old mother from Kyiv, without providing specifics. "There's also been lots of information about vaccinated children dying," Oksana adds, declining to divulge her surname out of fear that her comments could trigger negative reactions among her friends.
Such notions, shared by a minority of parents in Ukraine, may be putting the Eastern European country of 45 million on the brink of a major health crisis, experts warn.
"Ukraine is on the verge of a measles epidemic," says Yevhen Komarovsky, a leading pediatrician in the Ukrainian capital in discussing the respiratory disease that can spread very easily through contact with infected mucus and saliva.
"If we take into consideration the [low] level of vaccination, then the mortality rates are practically miraculous," Komarovsky notes. "We are still very lucky." However, he warns that "in 2018, unfortunately, the situation should get worse."
According to 2016 data from the World Health Organization (WHO), Ukraine ranks last in terms of measles-vaccination coverage in Europe.
The WHO also warns that it takes only a small percentage of unvaccinated kids to create the breeding grounds for measles outbreaks.
Health Crisis Looming
The numbers suggest the country is well on its way to a health crisis.
Cases of measles are 20 times higher in 2017 compared to the previous year, according to data from Ukraine's Health Ministry. Two children died in Ukraine in 2017 from the disease, which the UN Children's Fund (UNICEF) says is one of the biggest killers of children in the world.
Some experts suggest the media shares some blame for the situation, for allegedly fanning the flames of fear in Ukraine. In particular, media outlets are accused of blurring the facts on a measles-vaccination campaign in the east of the country in 2008 that was linked to one death at the time, although health officials have rejected any connection.
In the past, Ukraine suffered shortages of vaccines amid delivery disruptions in part exacerbated by the conflict in eastern Ukraine, where more than 10,300 have died in fighting between government forces and Russia-backed separatists since 2014.
But Ukraine has turned the corner, explains Fyodir Lapiy, Kyiv's chief immunologist. "We currently have over 600,000 doses of vaccine. This is enough to give to all the children who have scheduled vaccinations and for those who missed their target date," Lapiy explains, adding that a fresh batch of vaccines for measles, mumps, and rubella -- often included in one injection -- are scheduled for delivery in 2018.
The vaccine, purchased by the Ukrainian government, is free to children, Lapiy stresses.
Tumbling Vaccination Rate
Tetyana, a mother of two toddler girls, says she decided to have them vaccinated, unlike some of her fellow mothers in Kyiv. "I have friends who don't vaccinate their children. They say that vaccinations will kill the best defense against diseases, their [children's] immunity systems," explains Tetyana, who declined to give her last name.
Giovanna Barberis, UNICEF's representative in Ukraine, has written that "myths about vaccinations being potentially harmful," has in large part "meant that Ukraine's coverage against measles dramatically dropped from 97 percent in 2007 to 42 percent in 2016."
Officially, Ukraine says the rate of those who refused measles vaccinations in 2017 was only 7.4 percent.
Numbers from WHO say that less than 50 percent of 1-year-olds were vaccinated against measles in 2016.
That puts Ukraine dead last in Europe.
And the actual numbers could be worse, because there are suspicions that the number of children vaccinated against measles may be higher "on paper" than in reality.
"Among the so-called vaccinated are, in fact, many unvaccinated children; that is, those who are vaccinated only on paper, because their parents have purchased [fake] certificates of vaccination [from doctors]," Lapiy explains.
By law, parents are supposed to provide a certificate of immunization before their children start school.
2008 Death Blamed
The data suggests that vaccinations began to dip in 2008, around the time of a widely reported incident in the eastern Ukrainian city of Kramatorsk.
Anton Tyshchenko, a 17-year-old, died from a measles vaccine in May that year. The serum was developed in India and apparently wasn't tested in Ukraine, according to the findings of two investigative commissions. They also found the boy did not actually need a vaccination at all because he had already been immunized twice.
Some in Ukraine linked his death to the serum, although government officials as well as WHO and UNICEF insisted there was nothing wrong with the vaccine.
Despite such denials, the incident seems to have ignited an antivaccination fervor in Ukraine.
At the time, Vyacheslav Kostylev, head of the League of Civil Rights Protection, a nongovernmental organization, said the number of people asking for legal help on how to refuse vaccinating their children was growing.
Now, Ukraine seems to be paying the price for parents' decision to opt out of vaccines.
In the first 10 months of 2017, 2,381 cases of measles were recorded in Ukraine, according to data from the Health Ministry.
That compares to only 102 cases in 2016 and 105 in 2015.
Two children also died of complications from the disease in the Odesa region in 2017, according to the ministry.
Modern medicine's ability to bring diseases like measles to heel means parents are underestimating the threat, Komarovksy says. "People are no longer afraid of measles, they are now afraid of the vaccinations."
A survey by UNICEF in 2012 showed that as many as a third of Ukrainian parents were against vaccinations.
According to a statement from WHO, "where immunization rates fall below 95 percent, the number of susceptible individuals grows each year and this increases the risk of a large outbreak with possible tragic consequences."
As the numbers rise, Ukraine's vaccine vacillators may have a change of mind, as Oksana appears to have done. She now says that she and her husband will probably vaccinate their children against measles, considering the number of cases rises in Kyiv.
The couple will, however, proceed cautiously. "We will buy a Belgian-[produced vaccine] and have it done in a private clinic," Oksana says. "We don't trust the doctors at the ordinary [state-run] polyclinics."
