By Sreya Salim:
“Vaccines cause autism.” “Immunization makes you infertile.” “Vaccination is a part of America’s conspiracy to reduce Muslim population“. “Immunization was made mandatory so that multinational companies can make more profit.”
Go to God’s own country and you can hear so much more. Northern Kerala, especially Malappuram district has become the epicentre of a strong anti-vaccination propaganda driven by orthodox religious groups and quacks. A large number of people in the region, most belonging to Malappuram district have been denying immunisation to their kids. The result has been the slow re-emergence of many diseases once eradicated or kept under control. The latest in the list is Diphtheria, which has already killed two children and many more.
Diphtheria is a vaccine-preventable disease that was brought under control in India by introducing DPT vaccine in the immunisation program in 1985. However, Kerala has been experiencing a relapse of for a few years now. In 2008 alone, more than 12 cases were reported from Malappuram (1). Recently, two children died of Diphtheria, and more than five have been infected; all of them residents of the same hostel. According to reports, a considerable number of people are at risk.
Even individuals who have received vaccination bear the risk of harbouring bacteria in their body without showing any symptoms (carrier state). Thus, there is a high risk that a major epidemic may break out in this area. Moreover, medicine for Diphtheria is hard to procure as most of the pharmaceutical companies no longer produce this. One doesn’t have to look far for the reasons behind this sorry state of affairs. Any health worker in Malappuram and Calicut would say that the problem is not lack of availability of vaccines or doctors but that a large number of people here reject immunisation.
By the latest official count, out of 3,55,279 children below the age of five, 4,729 had not taken any kind of vaccination. If children between five and ten years of age are counted, the statistics get even scarier. One out of three children growing up here is vulnerable to a large number of diseases ranging from tuberculosis, whooping cough, polio to measles. It may seem like an irony that this is happening in a state where there is a large number of health centres, doctors and, a high literacy rate. The children, here, are being kept away from immunisation by their parents and guardians based on false beliefs.
The belief that immunisation causes health problems has become the major reason for the rejection of immunisation. The growing number of quacks and self-proclaimed doctors in the state has not helped matters either. Most of the people in Mallapuram have no access to accurate information about vaccination. A large number of people believe in the tall claims made by pseudo-doctors. Posts claiming that vaccines against already eradicated diseases are a part of the Government’s policy to help multinational companies, and that immunisation causes sterility have been making rounds on social media for a few years now. Some eminent newspapers even published news about vaccinations crippling children even though doctors and scientific journals emphasize that the risks of immunization are negligible, and that the problems are being exaggerated. Since, most people lack scientific knowledge about these topics, they often fall prey to sugar coated lies. The number of times these messages have been circulated on social media stand testimony to this.
Moreover, a few locally powerful religious groups have been urging its followers to forego immunisation. Similar opposition was also meted out against the rubella vaccination initiative, which aimed at protecting all teenage girls from rubella. Almost all health initiatives including iron and folic acid supplementation and vaccination against elephantiasis were looked upon with suspicion.
The cause of the problem seems to be that people are losing faith in the health initiatives of the Government. Moreover, many are falling prey to the selfish motives behind propaganda. Lack of widespread awareness programs in the state has made the problem worse. Many private hospitals promote ‘glamour vaccines’ that are costly and not needed in Indian health scenario. These include vaccines for rare diseases that children have little chance of contracting. Another contributory problem has been the lack of vaccines in many hospitals. Due to the closure of Pasteur Institute in Koonor and Central Research Institute in Kasauli, vaccine scarcity can turn into a disaster.
Even though the Government sprung into action after the Diphtheria deaths, health workers are finding it difficult to battle the stubborn mindsets of people. Recommendations have been put forth to make immunization mandatory for school admissions, insurance schemes, etc. and to incorporate Diphtheria vaccine along with tetanus vaccine. Task forces have been set up to vaccinate all the children at risk.
However, none of this is possible unless the orthodox mindset of people is given up. The problem here is not the lack of facilities, but the lack of awareness and the spread of false knowledge. Hence, the first step should be the creation of a health force that will be able to operate at the grass root level with full cooperation from the people. Other steps like availability of all vaccines should also be taken.
Though the adage, prevention is better than cure, is one of the first things medical students learn, this is not upheld in real life. It seems that we have to wait until the problem becomes complicated and serious to start looking for a solution. Proper vaccination coverage is the first step towards the dream of ‘health for all’ which is the third Sustainable Development Goal. Vaccines prevent diseases, cut health care costs and ensure the well-being of the entire nation. As William Foege said, they are the tugboats of preventive health. We should never let false knowledge and ignorance sink them.
(1): T, Dr. Jayakirshna. Diphtheria Thirichuvarunnu. Mathrubhumi Arogya Masika- September 2008 edition.