Friday, February 11, 2005

More on vaccines

In my post yesterday about MMR vaccine and autism, I forgot to mention another especially bad consequence of anti-vaccine movements: the resurgence of polio in Nigeria and now around the world.

The WHO had a goal to eradicate polio by 2005. Just a couple years ago it was down to Nigeria, Niger, Pakistan, India, Afghanistan, and Egypt. But rumors spread in northern Nigeria that the vaccine was actually a plot by Western powers to sterilize Muslim men, and some local officials capitalized on Muslim resistance to the vaccine in the north as a way to build their own power at the expense of the central government, by blocking the World Health Organization from carrying out vaccination drives in their provinces.

After this resistance to the polio vaccine, polio has spread beyond Nigeria to neighboring countries in Africa that had previously been declared polio-free. And now, pilgrims have brought polio to Mecca during the pilgrimage season:
Polio apparently reached Mecca, Islam's holy city, just before last month's annual pilgrimage by two million Muslims, and World Health Organization officials now fear that it could be spreading around the world, carried by returning pilgrims. In crowded nations with spotty vaccination coverage, like Bangladesh and Indonesia, "there could be substantial consequences," Dr. Bruce Aylward, coordinator of the W.H.O.'s Global Polio Eradication Initiative in Geneva, said in an interview. ...

Spotting new outbreaks in far-flung countries will still take weeks, experts said. Paralysis affects only about 1 in 200 carriers of the virus, symptoms can take up to 35 days to emerge, pilgrims traveling by bus or boat can take weeks to get home, and epidemiological reporting in poor countries is often slipshod. ...

The virus lives in the intestine and spreads through fecal-oral contact, so anything from changing a diaper to sharing a food dish or swimming in contaminated water can transmit it. Polio vaccination was not required for hajj pilgrims because it was a rapidly diminishing threat until this year. Even if it was required, thousands of pilgrims arrive illegally, and many legal visitors carry forged immunization records, said the government spokesman, Nail al-Jubeir of the Saudi Embassy in Washington.
It's hard to blame anyone for this because the responsibility is so diffuse; but I really just wish people would stop inventing absurd fears about vaccines. Polio could have joined smallpox on the list of eradicated diseases, but for baseless fears about safe and effective vaccines.

N.B. I do realize that resistance to polio vaccination in Nigeria occurs in a different sociocultural context than Western anti-vaccine movements, so perhaps it's not accurate to group them together as "anti-vaccine movements" (as if they were a unified intellectual phenomenon) even if they are both, literally speaking, anti-vaccine movements. The point is, though, that vaccines prevent really bad diseases, and stopping vaccination really does lead to a resurgence of those diseases.

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