Muslim anti-vaxers slow eradication of polio

There’s always been some religious opposition to vaccination.  When Jenner and others introduced smallpox vaccination, 18th-century churches often denounced it as a “delusion of satan” and a “violence to the law of nature”.  This opposition was, of course, based on Scripture—including the argument that Job had been inoculated by Satan!—and on the view that saving people from smallpox was “thwarting God’s will,” and showing more concern for this life than the afterlife.  (To be fair, some religious people, like the pro-science New England preacher Cotton Mather, did promote smallpox vaccination).

But opposition remains among the faithful, though thankfully it’s waned.  Several readers called my attention to a piece in Friday’s Business Insider reporting on Muslim opposition to polio “vaccination” (vaccine now administered orally rather than through shots) in Asia and Africa—two of the last redoubts of the polio virus.

The Gates Foundation, and the Bloomberg Philanthropies have been investing millions of dollars trying to eradicate polio from the world, as smallpox was eradicated*. (What a triumph for science against the forces of faith and woo!). Since 1998, the number of polio cases per year has dropped from 250,000 to fewer than 225.  Since there is no animal reservoir for the virus, complete eradication means the disease, a nasty crippler and killer, would never return. These foundations aim to completely rid the world of polio within six years.

Sadly, some Muslims, especially fundamentalist Muslims like the Taliban, are opposed to polio vaccination on religious grounds. A 2009 paper in Emerging Infectious Diseases notes that “Religious opposition by Muslim fundamentalists is a major factor in the failure of immunization programs against polio in Nigeria, Pakistan and Afghanistan.” Muslims have issued fatwas against the vaccine, considering it an attempt to sterilize Muslims (!), a western incursion into their religious dictates, and, of course, an attempt to overthrow the will of Allah.

This is serious business, for vaccinators have been attacked and killed. Business Insider reports, with regard to the vaccination program:

Radical islamic militants are preventing that from happening by attacking clinics, health workers, and police who travel with vaccinators to administer the vaccine to children.

Earlier this month in northern Nigeria, armed men linked to Islamist extremist group Boko Haram killed nine people at a clinic after a local cleric denounced polio vaccination campaigns and local radio programs saying the campaigns are part of a foreign plot to sterilize Muslims.

The province, Kona, is now the epicenter of polio infections in Africa as it has refused to participate in the vaccination campaign.

In Pakistan a total of 18 people have been killed in the last three months, including a police officer who was escorting a polio team in the tribal areas in the country’s northwest.

The cultural suspicions may be even messier in Pakistan where came to light that CIA hired a Pakistani doctor to give out hepatitis B vaccine in Abbottabad in March 2011 in an apparent effort to get DNA samples from Osama bin Laden’s hide-out.

“Boko Haram and the Taliban in Pakistan and Afghanistan share a common ideology and common strategy and … their targets are similar,” Shehu Sani, president of the Civil Rights Congress of Nigeria, told the Guardian. “Boko Haram have targeted police stations, politicians, religious clerics who speak out against them and people engaging in polio vaccination programmes.”

. . . The tactics have been effective as polio infections have doubled in Pakistan since 2009, new cases are on the rise in Afghanistan, and a polio virus traced to Pakistan was recently found in sewers in Cairo, Egypt (which hasn’t seen a case since 2004).

The best way to ensure the eradication of polio, as was done for the eradication of smallpox, is to vaccinate everyone and sequester every remaining case until no new ones appear.  Radical Muslims won’t let this happen, and that means the deaths of thousands of people, most of them children.  But there’s another way:

Pakistanis aren’t so optimistic about solving it through cultural outreach.

“There is only one lasting solution to this and that is to militarily defeat the Taliban once and for all,” according to an editorial in the Pakistan Express Tribune.

I’d prefer religious defeat (i.e., the disappearance of Islam), but that won’t happen anytime soon. In the meantime, it’s pretty clear that without religion, we’d have no polio. Religion not only poisons everything, but infects everything as well.

__________

*A really good book on the history of smallpox and its eradication, which I recently read, is Angel of Death: The Story of Smallpox, by Gareth Williams. (2010; Palgrave Macmillan, New York). Developing the vaccine was a convoluted story (it originated in many places, including ancient India and China, and Jenner was not the “inventor”), and getting rid of the disease is a monumental achievement of the human intellect, science, and the sweat and toil of dedicated field workers.

26 Comments

  1. Posted March 4, 2013 at 6:41 am | Permalink

    Agreed entirely. On another note, the appalling use of polio vaccination as a cover for US intelligence gathering didn’t help: http://www.nytimes.com/2012/07/10/health/cia-vaccine-ruse-in-pakistan-may-have-harmed-polio-fight.html?pagewanted=all&_r=0

    • Posted March 4, 2013 at 9:27 am | Permalink

      “It was a setback, no doubt,” conceded Dr. Elias Durry, the World Health Organization’s polio coordinator for Pakistan. “But unless it spreads or is a very longtime affair, the program is not going to be seriously affected.”

      This is a quote from the same article which makes it clear that vaccination teams have had to confront Muslim resistance long before the CIA made this stupid decision.

  2. Tulse
    Posted March 4, 2013 at 6:49 am | Permalink

    I’m not clear as to whether the opposition is really religious, or just cultural suspicion. The objections don’t seem to be primarily theological, but instead the belief that these vaccinations are part of a Western plot. (And, unfortunately, the CIA piggy-backing on these for its own ends has not helped in this matter.)

    So this may be “clash of cultures” paranoia, but it doesn’t seem really to be founded in anything particular about Islam.

    • michaelbusch
      Posted March 4, 2013 at 12:43 pm | Permalink

      When fatwas are being issued, people are using their religious authority to impede vaccination and eradication.

      This is not particular to Islam, as explained above, but religion is still being used as a way to justify prolonging suffering.

      • Paulo Jabardo
        Posted March 4, 2013 at 5:27 pm | Permalink

        The weird thing is that vaccination was not opposed by at least one relevant crazy fundie: bin Laden. The CIA really fscked up and should bear a portion of the responsibility for this disaster. What used to be mere absurd conspiracy theories – mass sterilization of Muslims or whatever – just gained “respectability”, at least among millions of poor and ignorant Muslims still undecided on the issue of vaccination.

  3. Linda Grilli Calhoun
    Posted March 4, 2013 at 6:54 am | Permalink

    “…without religion, we’d have no polio.”

    Wouldn’t that make a great bumper sticker?

    L

  4. Jonathan Wallace
    Posted March 4, 2013 at 6:59 am | Permalink

    It’s odd that Steve Jobs was regarded as having almost saintly status in some quarters for having produced some (admittedly cool) electronic gizmos whilst Bill Gates is often reviled as the head of microsoft. Full credit to BG though for his efforts to spend his personal fortune for the good of mankind and particularly for his efforts in helping to eradicate diseases such as polio.

  5. Posted March 4, 2013 at 7:02 am | Permalink

    Agreed, religious conspiracy theories are an annoying and deadly obstacle to Polio eradication. Agreed also with Paul, the appalling and unethical decision to hijack a public health program for intelligence gathering was a disaster.

    But eradicating Polio is much harder than eradicating smallpox, even without religious nonsense interfering. Almost every smallpox victim had characteristic symptoms, meaning that a vaccination team could be sent out immediately to stop the virus spreading. In contrast, many Polio carriers don’t show any symptoms, thus for every clinical Polio case there are maybe hundreds of carriers.

    Not saying this to support the anti-vaccers of course, just pointing out that it’s an enormous challenge to finally get rid of the disease – which we hopefully will, if reason prevails.

  6. threecheersforreason
    Posted March 4, 2013 at 7:26 am | Permalink

    unfortunately, the eradication of polio is not quite as straightforward as it sounds. the economic decision to base the campaign on the use of an attenuated live virus vaccine that is orally administered virtually guarantees that human reservoirs of virus will continue to be an issue. killed virus vaccine, which both avoids that problem and is more effective, requires administration by injection and presents storage difficulties. immune compromised individuals treated with live virus vaccine can asymptomatically shed virus for the rest of their lives; that problem is part of the complicated background to the current problems in nigeria.

    • Posted March 4, 2013 at 12:00 pm | Permalink

      I was under the impression that killed virus does not provide as long-lasting an immunity as the live virus vaccine, which is why the live vaccine was used in the first place.

      In the West, where we no longer have wild polio cases, we vaccinate first with the killed vaccine and then with the live vaccine after we’ve ensured that the child can defeat the live virus before he begins to excrete it. This is indeed because of cases of vaccine-related polio.

      In places where polio still exists in the wild, the stronger vaccine must be used.

      • Posted March 4, 2013 at 1:45 pm | Permalink

        I was a bit confused about the effectiveness of live vs. killed virus vaccine, too, and was under the impression that the injection with killed vaccine may be “weaker”. But it seems that is not the case, at least at an individual level the safe injection with the killed vaccine protects as well as the oral live vaccine, according to information of. e.g., the CDC.

        It seems oral vaccine has two main advantages that may outweigh the small risk of vaccine-related polio:
        1. because the live vaccine virus is transmitted, immunity spreads to persons other than the immunised child – a huge benefit in remote places that are rarely visited by health teams.

        2. the oral vaccine is cheaper – if we can’t afford to vaccinate all children with killed vaccine, it’s better to at least offer the oral vaccine than leave them unprotected.

        But in the long run, oral vaccine needs to be phased pout and replaced by the injection, because of the reasons mentioned by threecheersforreason.

      • 3cheersforreason
        Posted March 4, 2013 at 3:07 pm | Permalink

        from an expert:

        http://www.virology.ws/2013/01/08/who-will-switch-to-inactivated-poliovaccine/

        “A known side effect of the Sabin poliovirus vaccines, which are taken orally and replicate in the intestine, is vaccine-associated poliomyelitis. During the years that the Sabin poliovirus vaccines (also called oral poliovirus vaccine, or OPV) were used in the US, cases of poliomyelitis caused by vaccine-derived polioviruses (VDPV) occurred at a rate of about 1 per 1.4 million vaccine doses, or 7-8 per year. Once the disease was eradicated from the US in 1979, the only cases of polio were caused by VDPVs. For this reason the US switched to the Salk inactivated poliovirus vaccine (IPV) in 2000.”

        there’s more at the link.

  7. Griff
    Posted March 4, 2013 at 8:03 am | Permalink

    Looks like an interesting book. Sadly no Kindle edition.

  8. Posted March 4, 2013 at 8:08 am | Permalink

    Sadly, some Muslims, especially fundamentalist Muslims like the Taliban, are opposed to polio vaccination on religious grounds.

    The obvious inference, is that Allah is the polio virus.

  9. bleikind
    Posted March 4, 2013 at 8:50 am | Permalink

    Opposition to polio vaccination by some Islamic leaders pre-dates the US use of the polio vaccination program in Pakistan.

    Islamic radicals were campaigning against polio vaccination in Nigeria before the recent problems in Pakistan.

  10. Eli Siegel
    Posted March 4, 2013 at 9:26 am | Permalink

    The CIA made a terrible mistake using a vaccination program to try to determine if Osama was in Abbottabad. THe CIA has agreed not use journalists, clergy, or the Peace Core as cover. Medical personnel should also be included.

  11. Posted March 4, 2013 at 12:16 pm | Permalink

    The best way to ensure the eradication of polio, as was done for the eradication of smallpox, is to vaccinate everyone and sequester every remaining case until no new ones appear.

    Smallpox is transmitted from human to human. Poliovirus lives in the wild and can be contracted by drinking water contaminated with feces from infected humans. WHO reports that it can take up to 180 days for the infectiousness of the virus to decrease by 90% in certain conditions. Plus, its habitat, water, can move.

    Smallpox was eradicated in the developing world not by vaccinating everyone, but by swooping in on cases and vaccinating in a ring around them. It was not necessary to vaccinate everyone, just to contain the outbreak and prevent its spreading to other unvaccinated people.

    Polio eradication will require that a much larger population of people be vaccinated, conceivably all people who are not unable to tolerate the vaccine.

  12. Hempenstein
    Posted March 4, 2013 at 7:35 pm | Permalink

    As far as Nigeria goes, I can offer some optimism. By great serendipity I had the good fortune to meet the Governor of Osun state (one of the 60 states in Nigeria) Thursday before last. The governor, Rauf Aregbesola, is a mechanical engineer, and after speaking at Harvard, and before speaking at the National Press Club in DC, he stopped in Braddock PA, outside Pittsburgh, to see a demonstation of how the ceramic water filters for the third world are produced in the basement of the Carnegie Library there.

    In the election that brought him to office, he was declared the loser, but he petitioned the courts with evidence of massive voter fraud, and was installed in office a couple years ago. By all accounts (Google him!) he is immensely popular for taking technology to the people, which was what brought him to Braddock.

    Now maybe Osun state is comparable to Massachusetts and other states are comparable to Mississippi, but the fact that someone like Aregbesola, who seems by all accounts, and seemed to me in person completely devoid of the usual bluster of politicans, and could have an election overturned without apparent bloodshed to boot, gave me a lot of hope for the direction of Africa.

  13. johndhynes
    Posted March 5, 2013 at 2:20 am | Permalink

    Cotton Mathers was pro-science? The witch trial preacher who believed in spectral evidence?

  14. lutesuite
    Posted March 5, 2013 at 11:03 am | Permalink

    Uncommon Descent has responded to this post:

    http://www.uncommondescent.com/intelligent-design/religion-as-an-obstacle-to-vaccination-new-atheists-continue-to-propagate-a-myth/

    As usual, the fatuity of their argument requires little further comment (although the blatant antisemitism of Comment #2 by Robert Byers should be noted). However, what I find puzzling is why they see fit to address this at all? ID, its proponents repeately insist, is not a religious idea, but a scientific hypothesis supported by abundant empirical evidence. Religion, the claim goes, has nothing to do with it. So, if that’s the case, why do they feel compelled to respond to an article that criticizes religion, but which makes no reference to ID?

  15. Alfonso
    Posted March 16, 2013 at 6:04 pm | Permalink

    1885 smallpox epidemic in Montreal. Michael Bliss points out (twice) that the pope had called vaccination a gift from God in the early decades of the 19th century, long before the Montreal epidemic, and shortly after the value of smallpox vaccination had been shown. Bliss also writes that during the Montreal epidemic, the hierarchies of the both the Protestant and the Catholic Church repeatedly advised their followers to be vaccinated. He concludes that French Canadians were slow to be vaccinated because of the power of prejudice, fear, and distrust between French and English Canadians.

  16. Alfonso
    Posted March 16, 2013 at 6:05 pm | Permalink

    http://bedejournal.blogspot.com/2009/03/pope-leo-xii-and-vaccination-ban.html

    A Catholic historian Donald Keefe came across the story when it was repeated by Prof. Daniel Maguire of Marquette University. Keefe tried to trace the source of the quote from Leo XII, tracing it from footnote to footnote, from book to book and found it had emanated from a Dr. Pierre Simon in Le Contredes naissances with no authority given at all. It is probable however, that the myth is much older and dates from the 19th century as it can be found in G. S. Godkin’s ‘Life of Victor Emmanuel II’ from 1880.In conclusion, Leo XII’s alleged ban of vaccination is a whiggish myth which has been repeated and promulgated slavishly ever since, despite having absolutely no basis in fact whatsoever. No doubt in cyberspace it will continue to take on a new lease of life amongst those who will swallow any myth as long as it is anti-catholic or anti-religious.

  17. Alfonso
    Posted March 16, 2013 at 6:08 pm | Permalink

    The Influence of Korean Catholic Church on the Introduction of Smallpox Vaccination by Cheong Yak-yong : A Hypothesis.
    If he did, it was also done in the context of Western culture imported by Korean Catholic Church. Considering the above facts we can suggest the higher possibility of the introduction of smallpox vaccination through Catholic groups with Cheong Yak-yong. Of course other routes could have been available, but its possibility seems to be comparatively low.

    http://www.koreamed.org/SearchBasic.php?DT=1&RID=78501

  18. Alfonso
    Posted March 16, 2013 at 6:17 pm | Permalink

    Finally anti-Catholic myths begin to unravel. Of course it is wrong to say that Pope Leo XII condemned the vaccine. But the reality is more fascinating. Both the Catholic clergy as many monarchs as Carlos IV of Spain actively promoted the vaccination (and before the cinchona bark for malaria), while Cromwell was left to die by not testing the bark Jesuit …
    In response to a Large Outbreak of smallpox in the Spanish colonies, King Charles IV Francisco Xavier de Balmis Appointed to lead an expedition That Would Jenner’s vaccine to introduce These colonies. In 1798, King Charles IV statements the civilian population that should be vaccined. A year later, a copy of Edward Jenner’s book was sent to King Charles IV by an Italian physician, weitere historical attracting attention to the prevention of smallpox. All These events culminate in the Issuance of a royal edict Announcing the Widespread Availability of the smallpox vaccine in Spain in 1800. THIS Vaccination Campaigns Be Supervised by the Catholic Clergy and immunization registries That be kept by priests. I advise you to read this wonderful article:
    The Spanish Royal Philanthropic Expedition to Bring Smallpox Vaccination to the New World and Asia in the 19th Century

    http://cid.oxfordjournals.org/content/41/9/1285.full

    http://www.catholicsocialscientists.org/CSSR/Archival/2005/Tarrago_181-196.pdf

    According to Rafael E. Tarragó “The Catholic Clergy Gave Their support to the Vaccination
    campaign. In New Spain the expedition and feted in was wellcomed cities like Guadalajara and Oaxaca by their bishops. The bishop of
    Oaxaca Encouraged the clergy to support the Vaccination Campaign
    Preaching That Should none of them feel no obligation to do so, thinking
    I Had the care of souls and not That of teddies; Such a view Would show
    His ignorance, a lack of charity, and a failure to understand that he who
    Is able to save a fellow human being and do not does so commits a
    crime.The bishop of Puebla wrote a pastoral letter encouraging historical
    flock to get Vaccinate, himself and I assisted in the formation of a
    Vaccination board. …
    French historian studies of Bercé about pope Leo XII, apparently already in a paper of 1983 mentioned the French clergy as a great booster of the vaccine in nineteenth-century France.


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