The government and other institutions continue with the authoritarian patronage mentality, not feeling it necessary to inform and educate people first so as to enable them to make informed choices. There is an assumption that the powers-that-be always know better, reflecting contempt for the illiterate or less-educated masses — just as government hospital doctors do not bother to explain to patients the nature of their problem, often not even providing the name of the disease they are affected by.
The government has either not kept up with developments surrounding the polio vaccine, or it has chosen not to divulge inconvenient information to the public. Should it not have told us that the oral polio vaccine itself, for example, has also become a carrier of polio? Should we not have been told which vaccine is being used in Pakistan? Is it the newer, ‘inactivated’ risk-free vaccine, which the US and other industrialised countries started using after abandoning the previous one? Or is it based on the original vaccine made from a live poliovirus which carries the risk of transmitting polio — but is still used in Third World countries because it is much cheaper, even though there continue to be outbreaks?
It was the late Dr Maurice Hilleman, developer of Merck’s vaccine programme, who discovered that the new virus had come about via the polio vaccine he had developed. Given that this vaccine is now the leading cause of polio paralysis, it makes one wonder about the real reason this campaign is being thrust on us, complete with threats of not allowing Pakistanis to travel abroad — or even blockade us — if we fail to carry out the programme.
This is certainly a matter for the professionals, and yet, the medical community continues to be inexplicably quiet on the issue. The electronic media needs to look beyond the senseless killings into the vaccine itself.
A dangerously erroneous impression that prevails is that the oral vaccine alone prevents polio, mainly because the government disseminates little of relevance and would be caught out in its neglect of health infrastructure if it preceded polio campaigns with an information blitz about how polio is caused.
It is important to drive home the message clearly and unambiguously that polio arises from unhygienic conditions. There is only one cause to polio and that is infection through the poliovirus, which infects humans and humans alone. It is extremely contagious and spreads easily from person to person. Specifically, it mostly spreads through contact with the faeces of the infected person, which can be through unwashed hands or inadequately cleaned utensils or clothing or other surfaces touched.
To a lesser extent, it can also spread through infected saliva or respiratory secretions. It is not restricted to any season and in Pakistan’s warm climate and widespread unsanitary conditions, thrives more easily. Infected persons can, therefore, also infect outsiders as they come into contact with them, who otherwise practise very hygienic habits.
It is important to be aware that the live poliovirus enters the intestinal tract and mucus in the nose and throat of infected persons for one to two weeks, or in the faeces for up to two months, according to the Global Vaccine Institute. This makes the rest of the household extremely susceptible, children and adults alike.
If Pakistan really wants to be polio-free, it is more important for governments to spend much, much more on clean water supply and household sanitation, specifically on toilets that are easy to maintain — at least two in every home; one for the men, and the other for women and children. In the bargain, this would help eradicate a whole lot of other water-borne diseases that also affect us.
Without cleanliness, the oral polio vaccine can do very little good. In fact, in a previous round, 78 per cent of Pakistani children, who contracted polio, turned out to be the very ones who had been vaccinated earlier. The Centres for Disease Control (CDC) confirms that it is possible for children to develop polio from the vaccine itself. According to the World Health Organisation (WHO), despite the large percentage of prescribed vaccinations carried out, Pakistan had the highest number of polio cases in a decade.
What is worse, the virus in the vaccine can mutate into deadlier versions. Seemingly, the wild virus is being replaced by the vaccine-derived one, which causes paralysis. Earlier this year, an international meeting was organised by WHO in collaboration with the US Centres for Disease Control and Prevention (CDCP) and the Japanese ministry of health on this matter. Why haven’t we heard the outcome of this?
Meanwhile, those who want to be kept informed and updated for their own protection could sign up with the free online advocacy portal of the National Vaccine Information Centre (NVIC), USA, the world’s leading source on vaccines and infectious diseases. The founder of the NVIC had long ago said that “with mounting evidence that cross-species transfer of viruses can occur, the United States should no longer be using animal tissues to produce vaccines”. Incidentally, NVIC has throughout advocated for informed consent to vaccination, something that our own government or international backers seem to feel differently about.
The fact remains that vaccines don’t work for everyone invariably; they may work for some, but also fail others disastrously. And yet, the authorities were ready to penalise parents in some way or the other if they refused to let their children be vaccinated. Now, they can divert attention and blame it on the Taliban instead. Vaccines by the millions make a lot of money for pharmaceutical companies producing them, but polio is too high an individual or national price to pay for profits.
Published in The Express Tribune, January 24th, 2013.
COMMENTS (24)
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The chemicals that Ms Aban Marker's family business has regularly dumped in the water are one of the causes of water pollution. However, Ms. Sadeque has cleverly decided to overlook that fact because Ms. Marker is her longtime friend as well as employer.
Saleh Sayeed
Keep the good work going on Najma Siddiqui for sharing such an informative article regarding Polio Vaccines. I do not why people have reacted so harshly to ET for publishing this article. What happened to freedom of expression? Vaccines is not religious issues! Its just that if you feels that its good for your health, you can have one. If the other one believes its going to bring harm than its his choice not to get vaccinated. What is the problem with this?
@ najma sadeque
can you start this practice from your family members children?
@Falcon: see reply of Faraz Kakar - medical doctor in the field of Public Health
@Falcon: http://tribune.com.pk/story/498539/towards-polio-eradication/
Ridiculous and Poor!
"There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life (WHO, Poliomyelitis, Prevention, http://www.who.int/mediacentre/factsheets/fs114/en/)."
Other commenters have already said much of what needed to be said in response to this ridiculous piece. However, I cannot strongly enough express my shock and disgust at reading this stubbornly ignorant and misleading OpEd.
The Express Tribune's "mission is to defend the liberal values and egalitarian traditions we believe in, and which deserve to be upheld in writing that is both informative and insightful" (http://tribune.com.pk/about) yet the editors saw fit to publish this abhorrent tripe, a piece which is neither informative nor insightful.
Whatever the writer's agenda, it is extremely distressing to see such baseless, biased rumor-mongering given credence in this highly influential forum. The bounds of responsible journalism have been grossly transgressed here, especially in light of the tragic recent measles outbreak in Pakistan.
As a result of the Global Polio Eradication Initiative "More than 10 million people are today walking, who would otherwise have been paralysed" (WHO, Poliomyelitis, Progress, http://www.who.int/mediacentre/factsheets/fs114/en/).
Despite such overwhelming success in nearly every part of the world "Endemic transmission is continuing in Nigeria, Pakistan and Afghanistan. Failure to stop polio in these last remaining areas could result in as many as 200 000 new cases every year, within 10 years, all over the world" (WHO, Poliomyelitis, Progress, http://www.who.int/mediacentre/factsheets/fs114/en/).
This, and worse, is the legacy we risk bestowing on the world's population if we do not actively combat campaigns of disinformation and hopelessly misinformed viewpoints.
The rest of the world used the same vaccine to stop polio, why should Pakistan be different? And to use NVIC as a source on vaccine efficacy is like citing the KKK for an article on race relations. The children of Pakistan (and the readers of this fine newspaper) deserve better.
Subhanallah.
Now after months looking for the truth regarding vaccines and especially polio vaccines, the ET finally did a great job in publishing whats true.
I can not do more, but agree with that author of this article.
One can do easily a search on dangers of vaccination and their ingredients and the harmless polio virus to find out what the lady really had to say now.
And Bravo and may Allah protect the lady for having the guts to speak up for the correct view on this issues in public.
Bravo ET team.
This article is not just poorly researched but highly dangerous to the entire polio eradication effort
The key question is ..why is ET providing this platform for this travesty.
We were so used to fooling everyone in the world that we have started fooling ourselves now. We think we are the smartest humans on this earth. The death wish possessing all of us comes in many shapes. Who needs enemies with this capacity to self destruct. May Allah save our children. Amen!
Not a single reference cited by the writer in support of her argument, according to the sourced website 1 in every 2.7 million carry a risk of paralysis, that the writer chose to not mention!
"Although OPV is safe and effective, in extremely rare cases (approx. 1 in every 2.7 million first doses of the vaccine) the live attenuated vaccine virus in OPV can cause paralysis. In some cases it is believed that this vaccine-associated paralytic polio (VAPP) may be triggered by immune deficiency.
The extremely low risk of VAPP is well known and accepted by most public health programmes in the world because without OPV, hundreds of thousands of children would be crippled every year.
A second disadvantage is that very rarely the virus in the vaccine may genetically change and start to circulate among a population. These viruses are known as circulating vaccine-derived polioviruses (cVDPV)."
Extremely poor selection of a totally misleading article by ET which will definitely go a long way in ensuring that polio eradication becomes a more controversial subject in Pakistan. How can we ignore the fact that the same vaccine (OPV) was used in China and India to eradicate polio who are our next door neighbours. Rather than questioning the efficacy of the government to conduct a full fledged campaign that covers each and every child in a single round just like China that achieved polio free status only in 4 rounds, here we have a non technical person questioning the polio vaccine. I recommend that such articles should only be printed after proper background check by the editors of the paper. Pathetic selection by ET.
The Taliban may have hijacked the polio eradication campaign for all the wrong reasons, but that still does not make the programme a desirable one.
you mean stop it? what India achieved (by eradicating polio) is a fake story? Mullahs will thank you, madam.
What a pathetic article aimed at questioning the use of the Polio Vaccine!
As for the "National Vaccine Information Centre (NVIC)", a quick search on Wikipedia reveals that this is not a federal or government health organisation at all, but instead a private group whose sole function appears to be "almost entirely of opposing federal efforts aimed at vaccinating children." (I guess the author thinks the measles vaccine should also be stopped in Pakistan)!
As for the "cleanliness" issue, the Author must be inferring that Pakistan is somehow far dirtier than all of the rest of the world including Africa, South America, Asia and even INDIA where polio has been fought to near or total extinction!
As for PROFITS, would the author kindly provide credible references that support her view that the polio vaccine makes fat profits for the pharmaceutical companies! NOT!
How did you come up with "Given that this vaccine is now the leading cause of polio paralysis" - there is no scientific proof to back this claim. This is fear mongering. As if we don't have a problem with mullahs spreading impotency theories, we now have anti-vaccine propaganda trying to blame OPV as being the biggest cause of wild polio spread as well. Unbelievable.
Vaccine transmitted polio is supposed to be a 1 in a million case (1 in 750,000 to be exact) - more so in adults than kids and is a risk worth taking. OPV is a great cure and vaccines work through herd immunity so things like 'so many vaccines given, yet cases occurring' are a sign of utter illiteracy.
The oped cites NVIC and GVI. NVIC is no world leader, it is an anti-vaccine propaganda outlet.
Shameful to see such an anti-scientific load of bull, unfactual propaganda published on the pages of an International Herald Tribune partner. You don't see Jenny McCarthy anti-vaccine opeds on the pages of NYT.
As they say little knowledge is a dangerous thing. This is a very misleading Op Ed not fit for ET. Polio vaccination is essential and most kids in the world including the US where there is no Polio get it. Vaccination against such diseases is mandatory and a lifetime record is kept. Without the vaccination a kid cannot go to school for instance. The live virus vaccine has been used to eradicate Polio from the West now the threat is gone so they use the modified vaccine. When Pakistan reaches at that stage they would not need the live virus vaccine. The fiction that vaccine causes disease is the biggest lie and disservice to kids. As far as having two clean bathrooms for the family and all hygienic conditions is like telling poor people if you don't have bread to eat why don't you eat cake? Let us not give more excuses to our naive people and mandate the vaccination as it affects the whole society. Yes the govt should force people to be vaccinated so they do not become a carrier and spread the disease among other children in their class. The fact is Polio vaccination is needed up to 10 times in one's life not just once or twice and then complaint that it did not protect.
'' The small risk of circulating vaccine-derived poliovirus (cVDPVs) pales in significance to the tremendous public health benefits associated with oral polio vaccine (OPV). Every year, hundreds of thousands of cases due to wild polio virus are prevented. Well over eight million cases have been averted since large-scale administration of OPV began 20 years ago.'' (WHO 2012)
The attempt to prove Oral Polio Vaccine (OPV) as a source of infection rather than prevention of polio transmission by cherry picking some references while ignoring others is a disappointing attempt by the esteemed author to sensationalise the issue. It helps in no way in finding solution to the challenges encountered in eradicating this crippling diseases from our country. Instead it serves as a great source of demoralisation for thousands of polio workers across the country who are giving their lives to save our children from paralysis. The fact that she does not include opinion of WHO, CDC and other actors of Polio Eradication programme shows her bias. To think that polio can be eradicated from Pakistan by targeting the unhygienic conditions alone is as unrealistic as anything. Furthermore, the logistic and financial burden associated with the introduction of inactivated polio vaccine (IPV) are grossly underestimated.
A disappointing attempt to undermine selfless efforts and sacrifices. And a perfect source for conspiracy theories.
Another misinformation propaganda and it is tragic that ET has become a platform.
While the authors view on cleanliness is laudable, it is not going to abrogate the spread of polio. Similarly, unsanitary conditions are not the incendiary milieu for the spread of polio. If so, every slum in the world, from Mumbai to Nairobi will be full of polio infected individuals.
Polio is an infectious disease and not contagious and the author should know the differences between these two terms before using them interchangeably. All polio vaccines are "live attenuated" Salk vaccine and not " inactivated vaccine" and inactivated vaccines are no longer used because the immunity of the inactivated vaccine does not last long. All Salk vaccine types can become "inactivated" vaccine if improperly stored during field usage and this has been the problem.
Virus production requires live animal( human) cells, and the chances of zoonotic viral transmission of unknown origin from animal cells are YET to be proven. However, the chances of contaminated viral transmission from human cell culture is very high, despite precautions. Again, there is no evidences hither to that it has happened and all modern live vaccines are produced in human cell derivatives and are thoroughly monitored and efficacy tested before field release.
The reversal of vaccine strain to virulent ( infectious) phenotype is a scientific concern of academic importance and despite billion usages of various vaccines, the reversal is yet to be proven, including in the Merck study. Scientific studies specifically designed to address the "reversal" phenotype failed to produce any evidence on this matter.
Misquoting CDC information, and NVIC do not give credibility to the theme of the article. Then again, it is PAK so everything is others fault.
An informative article. I would like to see a medical doctor's view on the effectiveness of polio vaccinations (as practiced in Pakistan) as well.
Can't believe ET published this.
Only polio-free countries use IPV as the vaccine of choice. As IPV does not stop transmission of the virus, OPV is used wherever a polio outbreak needs to be contained, even in countries which rely exclusively on IPV for their routine immunization programme e.g. Netherlands in 1992. IPV is not recommended for routine use in polio-endemic countries or in developing countries at risk of poliovirus importations. In these countries, OPV are used.