Strategies being devised to make vaccinations mandatory

Updated May 05, 2019

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Resistance against polio vaccinations has mounted over the years, with dozens of polio workers and law enforcement officials being killed and the programme unable to bring refusals to an end. ─ File photo
Resistance against polio vaccinations has mounted over the years, with dozens of polio workers and law enforcement officials being killed and the programme unable to bring refusals to an end. ─ File photo

On Thursday, the Senate Standing Committee on National Health Services (NHS) called the Prime Minister’s Focal Person on Polio, Babar Bin Atta, for a detailed briefing on the sharp rise in polio vaccination refusals after the disinformation campaign in Peshawar.

The committee has sought the briefing as part of its effort to play a greater role in eradicating polio in the country. During it’s session earlier this week, Senator Ayesha Raza Farooq – the focal person on polio under the PML-N, noted that 10 polio cases have already been reported in country halfway through the year.

It should be mandatory to vaccinate children at birth, she suggested, adding that a “polio card should be required for school admissions so people ensure their children are vaccinated”.

Senator Farooq added that she had moved The Compulsory Vaccination and Protection of Health Workers Bill 2019, which she had initiated in 2015 and had been passed unanimously in the Senate but lapsed in the National Assembly.

The committee agreed that school admissions should be linked to completing necessary vaccinations, and the aforementioned bill will be approved at its next meeting after incorporating amendments from members or the government. Special Assistant to the Prime Minister on NHS Dr Zafar Mirza also endorsed the bill, agreeing that stringent measures are needed to make vaccinations mandatory.

Committee chair Senator Mian Ateeq Shaikh decided to call Mr Atta to the next meeting as well, for a detailed presentation on the polio situation as well as to devise a line of action to eradicate polio for good.

Students from a school in Masokhel were brought to the Hayatabad Medical Complex in Peshawar last month complaining of an adverse reaction to the polio vaccine. It was later revealed that the children were part of a staged effort against the vaccination campaign and were all safe. Suspects have been arrested for their alleged involvement.

Mr Atta told Dawn that he believed this was a huge opportunity, and he would love to brief the parliamentary committee on the polio issue.

“I shall seek the help of the chairman and the members of the standing committee to play their role to address the issue of community resistance. We were on the verge of eradicating polio in 2017, but we missed the boat because of our own mistakes. It was unfortunate that the interval between two polio campaigns was increased from four to eight weeks,” he said.

He added that having worked on the polio programme for eight years, he would be able to give the senators a detailed briefing.

He said that an Independent Monitoring Board (IMB) report on the October 2017-18 performance had noted “severe community resistance against vaccination and it suggested taking steps to convince people that vaccination is in their favour.”

“Unfortunately, the community does not trust the vaccination and believes that it is a conspiracy to reduce the country’s population by making them impotent,” he added.

Resistance against polio vaccinations has mounted over the years, with dozens of polio workers and law enforcement officials being killed and the programme unable to bring refusals to an end.

One of the major obstacles was that, although there has been some confusion regarding polio and other vaccines in Pakistan for years, the assassination of Osama bin Laden on May 2, 2011, in Abbottabad had revealed that a Pakistani physician, Shakil Afridi, helped the Central Intelligence Agency run a fake hepatitis vaccination programme in order to trace bin Laden’s whereabouts.

In June 2012, the Taliban banned polio vaccinations in the former Federally Administered Tribal Areas. People also began to refuse vaccinations by claiming they were haram.

In 2015, the government tested all the vaccines used in polio campaigns to prove that they were not, in fact, haram. They also prepared responses to frequently asked questions in order to answer to religious elements against the vaccine.

Three vaccines – Mono OPV 1 batch no. 132719 manufactured by Novartis, Polio Sabin batch no. AOP4A393AA manufactured by GSK and Polio Sabin batch no. AOPVB996BA manufactured by GSK – were sent to the National Control Laboratory for Biologicals in Chak Shahzad, which is run by the Drug Regulatory Authority of Pakistan.

The samples were tested using a sensitive method that could detect human hormones in minute quantities. An OPV dose is two drops, and tests found that none of the six possible hormones were detected in this quantity, even at concentrations as low as 0.0005 milligrams.

The results proved that the samples had passed the viral activity test and the sterility test, did not have any detectable levels of human hormones and were halal.

Despite these efforts, community resistance against the vaccine has remained strong.

Mr Atta said that the next strategy in this regard will involve the media, religious circles and influential figures.

“As far as social media is concerned, we have written letters to Facebook and spoken to the Pakistan Telecommunication Authority to stop the campaign against vaccines, as social media is being used for anti-vaccination propaganda,” he said.

Pakistan is one of the last two countries –the other is Afghanistan – where the poliovirus continues to circulate and cases are being reported.

A total of 10 cases have been reported in the country so far this year, including three from Lahore, one from Karachi, two from Bannu, one from Hangu, one from Waziristan, one from Bajaur and one from the Khyber tribal district.

Published in Dawn, May 5th, 2019