The many shades of vaccine hesitancy
On a trip to the UK earlier this year, US Presidential candidate Chris Christie outlined his position on vaccination. “Mary Pat [Christie’ s wife] and I have had our children vaccinated and we think that it’s an important part of being sure we protect their health and the public health”, explained the twoterm Governor of New Jersey. But he went on to say that “parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide...not every vaccine is created equal, and not every disease type is as great a public-health threat as others”. Meanwhile, Christie’s rival for the Republican nomination, Rick Perry, has publicly regretted ordering that girls in Texas, where he serves as Governor, should receive the HPV vaccine. Other presidential candidates off ered more enthusiastic backing. “I have no reservations about whether or not it is a good idea and desirable for all children to be vaccinated”, affirmed Bobby Jindal. “I think it is irresponsible for leaders to undermine the public’s confi dence in vaccinations that have been tested and proven to protect public health”. The Governor of Louisiana was probably taking aim at his rivals, but leaders who express hardened opposition to immunisation campaigns are not to be found in the USA. In 2003, a senior Muslim cleric in Nigeria, Datti Ahmed, described polio vaccines as “corrupted and tainted by evildoers from America and their western allies”. He alleged the vaccines had been deliberately contaminated with antifertility drugs. Several northern Nigerian states boycotted the polio programme—Kano state did so for 11 months. More than a dozen countries were aff ected by the subsequent polio outbreak, costing the eradication campaign millions of US dollars. “And this was just a politically driven rumour, there was never an adverse event or episode”, explains Heidi Larson (London School of Hygiene and Tropical Medicine, UK). Similar rumours have beset anti-polio eff orts in Pakistan, exacerbated by the fake campaign run by the US Central Intelligence Agency as part of its eff orts to track down Osama Bin Laden. The mistrust is likely to have played a part in the Taliban’s 2012 refusal to permit campaigners to enter North Waziristan, leaving 250 000 children unvaccinated (the region has since been recovered by the Pakistani army).