To be or not to be vaccinated

Okot Nyormoi

 

Vaccination has become a question of to be or not to be. Parents worry about it, not just because of the prick their babies must endure but because without vaccination certificates, their children may not attend school. Adults are also not free of vaccination requirements because vaccines such as yellow fever and cholera may be required for international travel.

A form of vaccination was practiced in African long before an English doctor, Edward Jenner, modernized it in 1796 when he developed the smallpox vaccine. Since then, scientists have developed many vaccines with spectacular protection against polio, measles, tuberculosis, diphtheria, cervical cancer, Ebola, etc. Given such incredible success in preventive medicine, one would expect the world to be happy with vaccination. On the contrary, many people are still struggling with the question, ‘To be or not to be vaccinated’.

It is true and people know it. Anything can go wrong during the process of vaccine development. From conceptualization, testing, manufacture, efficacy and safety, the process requires rigorous appraisal. People have a legitimate right to ask questions, to ensure that the primary goal of protecting people from preventable diseases through vaccination is achieved without jeopardy.

While most people readily accept vaccination, a minority of people reject the concept and practice of immunization all together because it is against their religious or personal belief of not introducing foreign substances into the human body. Others find vaccines prepared in tissues of aborted human fetuses morally unacceptable because they believe it encourages the practice of abortion which they do not approve of.

Although some people may be exempted from vaccination for personal or religious reasons, it raises the risk of preventable infection. Such exemptions have resulted in resurgence of measles, mumps and pertussis (whooping cough) in the USA, polio in Asia, the Middle East and Africa when these diseases were already virtually eradicated. To minimize the risk of such resurgence, some countries do not grant vaccination exemption. Such measures can be effective only if all countries abide by the same rules.

There are also concerns about technical problems associated with vaccines. These include issues of efficacy, safety and costs involved. In this regard, concerns about transparency, misinformation and misunderstanding are critical. While genuine concerns about the danger of attenuated vaccines led to development of safer vaccines, there are also conspiracy theory spin-doctors who take advantage of uninformed people to gain notoriety for personal and financial gains.

The most celebrated case involved Dr. Andrew Wakefield who published a paper in 1998, claiming that the MMR vaccine causes autism in children. However, after more than ten years of extensive and careful studies, the claim could not be confirmed, and the controversial paper was not only retracted but the author was also stripped of his medical practice. Despite the thorough debunking of Dr. Wakefield’s allegation, the enormous damage it has done on immunization is still reverberating around the world today.

Of course, formerly colonized and formerly enslaved people have a legitimate mistrust of Euro America-led vaccination programs. The ugly history of racist abuse of science in the name of science is there in the record book.

Even after ethical guidelines for human experimentation were created (Nuremburg Code 1948, Declaration of Helsinki 1964, Belmont Report 1979), some unscrupulous individuals or institutions, driven by the pursuit of fame and fortune, still conduct unethical experiments. Often when their evil deeds are discovered, they use every trick to hide them. The infamous 1932-1972 Tuskegee study in which the US government deliberately infected black men with syphilis in alleged scientific study, is a dark chapter which reminds black people to watch their backs.

In view of these horrific experiences, it does not take much for vaccine conspiracy theories to spread among black people. For example, HIV was rumored to have been invented in the USA for the extermination of black people using polio and smallpox vaccination. Despite the lack of evidence, such rumors continue to circulate among black people and on the internet.

In 1994, a Pro-Life organization, reportedly initiated another rumor that WHO and UNICEF were conducting a sterilization program in Mexico, Tanzania, Nicaragua and the Philippines under the guise of tetanus vaccination. In 2003, religious and political leaders in northern Nigeria alleged that the polio vaccine was a Western plot to sterilize their women to reduce the Muslim population. In 2014, Kenyan Catholic Bishops alleged that the tetanus-diphtheria vaccine was laced with contraceptive to sterilize women of child-bearing age. The vaccine-sterilization rumor apparently originated from a phase 1 clinical trial in India to evaluate a contraceptive vaccine.

These claims were apparently based on misunderstanding and misinterpretation of the clinical trial. Also, the conspiracy theorists were probably just projecting the clinical trial onto a totally different vaccination program. To date, there is no evidence to support the scientific basis nor the alleged evil intent of the vaccination campaigns.

While Africans have a right to question vaccination campaigns, they must base it on a clear understanding of the science of vaccination and do it without jeopardizing the lives of people who would otherwise be protected from preventable diseases. Nevertheless, to allay the fear of alleged Western plot to exterminate black people through vaccination programs, black people must learn to recognize facts from rumors and to build their own capacity to monitor the quality of foreign manufactured vaccines or even better, manufacture their own vaccines. Today in Africa we have the capacity and the facility to do this.