The decision to remove the antivax signage in south Auckland is welcome, but it all points to a substantially bigger problem: trust in official advice, writes Dr Nikki Turner, director of the Immunisation Advisory Centre at the University of Auckland

There has been an outpouring of frustration around the country, generated by the installation of a large anti-vaccination billboard by State Highway One in Otahuhu, Auckland.

This billboard is about deliberately provoking to get a response – it creates fear and generates attention. It was gratifying to see a rapid and sizeable public response pointing out how inappropriate it was. As a result the billboard company themselves decided yesterday to take it down.

So the big question is why do individuals feel the need to attack national public health programmes? There are a range of possible motivations. There are some who find it gratifying to get media attention at any cost. It is a connected world and attention-seeking comes in many forms. Get the pitch right and it gets amplified very loudly.

There are others who make an industry out of creating alternatives to the established health services. Then there are those who make a successful and lucrative business by exploiting families with tragic stories, as we see with US litigation cases against health authorities. And there are always those who genuinely believe the government has just got their scientific medical advice wrong, either because of ignorance about the health advisers or from some form of corruption in the advice.

However, there is a broader issue. Immunisation programmes and other established public health programmes (such as fluoridation) now appear to be pawns in an unrelated, but problematic international issue – that of “trust”. There seems to now be quite a deep malaise over the concept that governments care for their population as evidenced internationally by the Trump-style US and in much of the Brexit rhetoric.

To some extent, I get this: It is a complex world, things go wrong at times, people can behave badly, we want more personal control over our destiny. However, this cannot then simply add up to somewhat simplistic responses of throwing away all our trust in authorities. Why would I assume my knowledge and a few hours on Google will give me a better answer than the advice from our Ministry of Health? Do I then feel more in control of my destiny? Seems like a bit of a con job really.

I fear this translates into creating a lot of unrealistic pressure on the individual. Parents of young children can feel they themselves have to carry the full responsibility for health decisions for their children, with a baseline starting point of suspicion that the advice of established authorities cannot be trusted.

This particular billboard is attacking a well established public health programme that is recommended by the NZ government with good quality standards, a proven safety track record and very clear outcomes, ie fewer sick children. Childhood immunisation programmes are delivered by every country in the world, supported by the World Health Organisation. This is not about a vaccination debate.

This is a debate around trust, and in this case lack of trust in the health advice given by our government for our children.

Dr Nikki Turner is director of the Immunisation Advisory Centre at the University of Auckland and a member of the World Health Organisation Strategic Advisory Group of Experts on Immunisations