(First published in Danish
at Raeson.dk 25th August 2021 - https://www.raeson.dk/2021/professor-morten-sodemann-vaccineskepsis-blandt-minoriteter-er-velkendt-og-velundersoegt-men-der-er-brug-for-en-dybere-indsigt-i-dens-kontekst/)
You cannot fix a
problem you do not understand. There is a need for much better knowledge about
the skepticism of minorities and about how this skepticism is nurtured, reinforced,
and spread. And we need to acknowledge that we, the majorities of the high-income
countries, ourselves have a share in the blame for skepticism about medicines
and vaccines. If we are not prepared to realize that, then we will never create
the basis for inclusion and equality in health.
In an interview on 18
August in the Danish newspaper Politiken, it was mentioned that vaccine
skepticism in ethnic minority communities could have other causes than those we
are used to hearing in Denmark, and an example of vaccine skepticism was
mentioned based on the CIA using a vaccination campaign in Pakistan to capture
and kill Osama Bin Laden. Many believed that the example was precisely an
expression of misinformation, but it is in fact correct
and well documented that the Americans, to identify where Osama Bin Laden
was in a suburb of Islamabad, first carried out a false study of children's antibodies
against hepatitis (hepatitis) through blood tests in order to compare the children's DNA with Bin
Laden's DNA. Next, a fake polio vaccination campaign was organized in the area
where it was now known that Bin Laden's children lived, and through that, his housing
complex was found. This led to skepticism towards foreign
health campaigns in Pakistan and in a number of countries on the African
continent.
One has also seen a correlation between the frequency of drone flights
and adherence to vaccination campaigns: As US drone flights over Pakistan
slowed, vaccination adherence increased again. In many countries, vaccination
workers have been hunted wildly after the process in Nigeria, DR Congo, and
Pakistan, just as vaccine skepticism has been widespread on social media in South Africa even
before COVID-19. The problem has been hailed as one of the world's 10 biggest
health problems by the World
Health Organization (WHO). At a recent public meeting in suburban area of
Odense, Vollsmose with a high proportion of ethnic minorities, it was pointed
out that many refugees come from countries where you cannot trust either the
authorities, the government or the press, while social media is perceived as
"our own media", because it is the media that politicians close each
time there are demonstrations. Social media therefore becomes the least
unreliable source of information.
A recurring problem in
Africa
The political
undertones of the vaccination debate are not new - celebrities, religious
leaders, presidents, and political leaders have for centuries helped to keep the skeptical
flame burning . For example, Ghandi believed that vaccines were a "fatal
misconception not even found among the savages." Certain
denominations, such as the American Apostolic Churches, have been active
opponents of vaccines in several African countries, and the churches
have had direct responsibility for measles epidemics in a number of African
countries. In Nigeria, religious leaders in three states decided in 2003 to
boycott a global polio eradication program with vaccination. The rumor was that
the vaccines infected Africans with Western diseases like HIV and cancer and
that they were meant to make girls infertile. Childhood vaccinations were accused
in Cameroon of making girls in certain ethnic minority groups sterile. Due
to political touch anxiety, the misinformation could spread and was the direct
cause was the direct
cause of a fivefold increase in the number of polio cases in Nigeria in 3
years.
India (like several
other countries) has a dark history when it comes to forced sterilization
among the poor and less privileged, and the link between vaccination and
sterilization in countries with ethnic conflicts is obvious (see, among others,
Deepa Dhanraj's documentary, ‘Something like a war’). There are over
36 documented links between infertility and vaccination, mass treatments of
children, condom campaigns with defect condoms, poisoned milk powder or drug
trials – the first dating back to 1920 and up to today. For example one of the
current vaccine manufacturers had to pay
large compensations in Nigeria after a failed, unethical medical trial with
medical treatment of meningitis, where the participants were not told that they
were involved in a trial.
In Mozambique, a
cholera vaccination program ran into problems because a previous government
program to desinfect water wells with chlorine was blamed
for making girls infertile, and it led to all sorts of misinformation about
other vaccination campaigns being brought into the rumor mill - because parts
of the population in advance was anger at the government.
During the Ebola
epidemic, more than 250,000 blood samples were taken, which, often without
acceptance, were exported to the major
vaccine companies in the high-income countries, which further contributed
to skepticism about the rich countries' real intentions when "offering
help" in health programs such as vaccinations and testing.
Effort requires
insight
Most people in
low-income countries would like to be vaccinated, but due to the many political
links that have always existed between vaccines and politics, the majority of
respondents in a CDC survey - 15,000 people in 15 African countries - would
like evidence that the vaccines are safe and that there are no hidden agendas
with the vaccines. The study also showed that there was a lack of respect among
health authorities around the world for this understandable skepticism (and
their own role in it), and that one had neglected, globally, to explain why
vaccines may make sense both for oneself and for society at the same time.
Authorities should refrain from basing campaigns on prejudices and
preconceptions and instead become more aware of the needs of specific target
groups and then organize a wide range of tailored information and vaccination
campaigns.
Public health research
has identified rumors and misinformation as significant barriers to
vaccination, but they have primarily been perceived as communication errors
that need to be corrected by providing more accurate information about
vaccines. But rumors are more than just stories that are not true. The
widespread rumor of sterility after vaccination is a way of formulating
understandings about reproductive organs, collective survival, feelings of
social exclusion and can be an expression of powerlessness towards the global
power structures.
Vaccine skepticism
among minorities is well known and well researched, but a deeper insight is
needed into its context, group thinking, historical conditions, political and
socio-cultural contexts, political disgrace, and media coverage.
You cannot fix a
problem you do not understand. There is a need for much better knowledge about
the skepticism of minorities and about how this skepticism is nurtured, reinforced,
and spread. And we need to acknowledge that we, the majorities of the
high-income countries, ourselves have a share in the blame for skepticism about
medicines and vaccines. If we are not prepared to realize that, then we will
never create the basis for inclusion and equality in health. The
good bad news is that today we are as skeptical of science as humans were
in the Middle Ages.
The example of the
CIA's unscrupulous use of false, well-documented vaccination campaigns shows
that truths and lies are opportunistically woven into each other. When Western
powers can invent one vaccine, they can invent anything with their vaccines.
Correct news turns into fake news in a particular social context. There are organized
Russian network trolls that drive vaccine skepticism, for example towards
the Pfizer vaccine, to promote the Sputnik vaccine. There is no quick fix -
just hard work.
The concerns that
refugees may have about the side effects of medical treatment and vaccines are
often quite basic and are based on experience and knowledge from the home
country. A targeted effort based on dialogue is needed to create the knowledge
that enables the individual to decide about e.g., vaccination or treatment of
diabetes. It is a sound investment that will ensure a stronger inclusion of
ethnic minorities in prevention and treatment.
The vaccine skepticism
of ethnic minorities is not just a vaccine skepticism but a skepticism towards
the authorities who most often want to hurt them and who therefore fail their
part of the welfare contract. Because as several expressed it at a recent
public meeting in the district Vollsmose in Odense: ‘Why are you so
preoccupied with vaccinating us now - where was your care for us before
COVID-19?
