22 June 2019 | New Scientist | 23
conducted as recently as the
20th century in the US, this fear
hits close to home – perhaps one
reason why African Americans
register lower uptake of certain
vaccines.
Jegede’s study describes how
vaccine boycotts can be avoided
through engagement with
community leaders, local public
awareness campaigns and locally
based ethics committees to help
ensure that interventions take
into account cultural norms and
sensibilities. A meta-study of
14 vaccination interventions in
developing countries conducted
in 2011 by Angela Oyo-Ita at the
University of Calabar Teaching
Hospital in Nigeria and her
colleagues supports the idea that
such initiatives can boost uptake.
In the US, the College of
Physicians of Philadelphia also
emphasises the importance of
communication and respect
for diverse social and cultural
perspectives in building trust
around vaccines.
Appropriate action needs to
be taken to maximise vaccine
take up. But that involves engaging
with the roots of mistrust – and
understanding that the practice
of science itself may carry
some blame. Collectively and
pejoratively labelling those
opposing vaccination as “anti-
vaxxers” won’t solve anything. ❚
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Views
JOS
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Comment
Don’t dismiss ‘anti-vax’
To win over opponents of vaccination, we must understand the of ten
complex roots of their mistrust, says Furaha Asani
M
EASLES is making a
shocking return to the
US. At the heart of this
return is a growing reluctance by
some groups in society, fanned by
social media, to have their children
vaccinated, citing mistrust of
government, big pharma and
scientists in pushing inoculation.
It is easy to dismiss “anti-
vaxxers” as just misinformed and
misguided. But vaccine mistrust
isn’t monolithic. To fully and
respectfully engage with people,
the reasoning behind different
communities’ doubts must be
unpacked with nuance.
An instructive perspective
comes from elsewhere in the
world. While the World Health
Organization reports that vaccine
uptake is increasing globally,
60 per cent of children who didn’t
receive routine immunisations in
2017 came from just 10 countries
in Asia and Africa. A deep-rooted
mistrust of Western health
interventions is one cause.
Take the malaria vaccine RTS,S,
which GlaxoSmithKline rolled out
as part of a pilot study in Malawi
earlier this year, with Ghana and
Kenya set to follow. RTS,S is up to
40 per cent effective at preventing
malaria in young children. Not
great, but this is the first proven
vaccine against a disease that kills
1200 people a day worldwide, most
of them children in Africa. Yet the
trial has provoked a backlash, with
concerns ranging from Africans
being used as guinea pigs in an
unethical trial to it being a plot
to sterilise local populations.
Social anthropologist Ayodele
Samuel Jegede of Ibadan
University in Nigeria studied the
roots of a polio vaccine boycott
in northern Nigeria in the early
2000s. He showed how it was
influenced by the Trovan case, in
which the drugs company Pfizer
was accused of unethically
trialling an antibiotic against
meningococcal meningitis in
the region in the 1990s. Pfizer
denies the claims, and settled a
case brought by the Kano state
government out of court for
$75 million in 2009.
The theme that vaccines are
a ploy for sterilisation has been
seen in Cameroon, Tanzania,
Pakistan, Afghanistan and India.
It has its roots in fear of eugenics.
With eugenicist programmes
Culture columnist
Chelsea Whyte feels
the fear as horror stalks
TV screens p32
Furaha Asani is at the
University of Leicester,
UK. Follow her on Twitter
@DrFuraha_Asani