PAKISTAN’S latest anti-polio vaccination campaign met a new challenge when reports of an ‘adverse reaction’ to the vaccine by schoolchildren in Peshawar led to a health emergency situation. The panic culminated with more than 25,000 children being rushed to different hospitals with claims of nausea and diarrhoea following the administration of polio drops.
Doctors treating the children concluded that the symptoms were not linked to the polio vaccination and probably a psychological reaction to the manufactured hysteria over safety fears about the vaccine.
The provincial government also indicated that the same batch of polio vaccines administered in other parts of the province did not produce any of the side effects claimed by the schoolchildren. The provincial minister of health, Hasham Inamullah Khan, referred to the panic as ‘manufactured’ by the Taliban-led anti-vaccination movement. The panic also led some sections of the enraged crowd to set ablaze a basic health unit in Moshakhel, near Peshawar. The incident had an immediate ripple effect. As the news spread, parents in Islamabad also refused vaccination. In Balochistan, one woman vaccinator was murdered while doing her work. Another policeman escorting the polio vaccination team was also gunned down in cold blood.
The use of social media has acted as a potent weapon.
As a result of the security fears, the campaign did not seem to have gone as planned, despite government claims of it running its full course. This time around, the vaccination campaign was meant to reach 39.4 million children under the age of five across the country. Of these, 19.7m were in Punjab, 9m in Sindh; 6.8m in Khyber Pakhtunkhwa (including tribal districts); 2.49m in Balochistan; 0.36m in Islamabad; 0.7m in Azad Kashmir; and 0.24m in Gilgit-Baltistan. However, the campaign failed to reach 1.5m targeted children. One media report suggested 700,000 parents in Peshawar refused vaccination which was the highest vaccine refusal rate in recent history.
The malicious propaganda regarding the safety of the vaccine is a relatively new tactic unleashed by anti-vaccine elements in Pakistan. While in the past, extremists relied on physical attacks on vaccination teams as a way to create fear and halt the drives, now another weapon has been added to their gradually expanding armoury: the misinformation campaign around the safety of the vaccines, and the enlistment of parents in the resistance.
Social media has acted as a potent weapon in this disinformation war. One local TV channel also showed clips of children at a hospital caught being instructed by a man to fake illness. Another video shows the same man propagating fake news of the death of children due to anti-polio vaccines. Another individual presumably active in the vaccine resistance lobby posted anti-polio messages, amplifying the schoolchildren video.
The new information war against polio vaccination was also mainstreamed by an influential right leaning commentator and analyst on a primetime TV show. He cast doubt on the science of anti-polio vaccination and enlisted a prominent US anti-vaxxer on the show. This alliance between the local vaccine resistance lobby and the global anti-vaccine sentiments is a new threat in the war on polio eradication.
Before 2012, when the Pakistani Taliban began their anti-vaccination campaign, Pakistan was inching closer to the goal of eradicating polio. Today, Pakistan, Afghanistan and Nigeria remain the only countries where polio still persists. The Taliban banned vaccination drives in the areas then controlled by them in 2011 and 2012. The perceived involvement of the vaccination campaign in the hunt for Osama Bin Laden also contributed to the anti-vaccine sentiments. In time, the anti-polio vaccine lobby adopted violence as its chief strategy, which has seen dozens of vaccinators, including those protecting them, killed.
The polio eradication programme is in uncharted territory. In the changed circumstances, the government will have to redouble its efforts and push through new strategies. The newly energised vaccine resistance movement following its social media campaign ‘success’ calls for a more robust and coordinated response from the government and the immunisation programme.
To counter the continuing negative propaganda would require a massive public health campaign. Already, Pakistan’s immunisation coverage is the lowest in South Asia. Within the country, the immunisation coverage has also varied with the conservative areas of Balochistan and KP remaining under covered. To eradicate the scourge of polio, a coordinated and comprehensive thinking is required from all stakeholders.
The writer is the author of Patient Pakistan: Reforming and Fixing Healthcare for All in the 21st Century.
Published in Dawn, May 15th, 2019