There’s a delightful meme going around Facebook right now, featured above, that portrays five African women, fists raised, all wearing aprons proclaiming “Kick out polio!” Accompanying the meme is a message from the American Academy of Pediatrics celebrating that yesterday marked one full year since the last case of polio was recorded on the continent of Africa and praising African leadership in executing successful vaccination campaigns against this dread disease, in particular recent declarations in support of eradication from the African Union Heads of State Summit and the Organization of Islamic Cooperation Foreign. I don’t know if these women are nurses, doctors, or aid workers, but it’s a great picture showing determination to eliminate polio, an achievable goal.
Unfortunately, it’s not all African leadership. At the same time there were news stories celebrating this important landmark in the effort to eradicate polio from Africa (and eventually the world), there were other stories that were not so heart warming because, after briefly mentioning this achievement, the report switches gears and interviews Dr. Wahome Ngare, who invokes the specter of eugenics before launching into a rant about vaccines:
But last week, a polio vaccination campaign in Kenya faced an unlikely opponent: The country’s Conference of Catholic Bishops declared a boycott of the World Health Organization’s vaccination campaign, saying they needed to “test” whether ingredients contain a derivative of estrogen. Dr. Wahome Ngare of the Kenyan Catholic Doctor’s Association alleged that the presence of the female hormone could sterilize children.
Ngare is a practicing gynecologist with no infectious disease experience.
He raises the specter of eugenics — sterilizing segments of human populations. He put forth other objections as well: “There are all sorts of stories out there,” he told me. “Vaccines can cause autism. Vaccines have been used for spread of HIV. There are some cancer-causing viruses that you’d find in vaccines. So there are lot of stories. Some of them we don’t know whether they’re true or not true.”
Here’s the audio:
Oh, no. Not again.
Unfortunately, yes, it’s happening again. You might remember that last fall, the same clueless cast of characters used essentially the same fear mongering rumor to stoke fear, uncertainty, and doubt about the tetanus vaccine right in the middle of a vaccination campaign in young women to prevent neonatal tetanus in their babies after they were born. In that case, the general class of misinformation was the same, namely that somehow vaccines would sterilize their women or children. Last time around, the Kenyan bishops, aided and abetted by the Kenyan Catholic Doctors, claimed that the campaign to vaccinate young women against tetanus was in actuality a “mass sterilization exercise using a proven fertility regulating vaccine.” In fact, proving that once a crank latches onto an idea he never lets go of it and, in the antivaccine crank world, if your only tool is a hammer every vaccine turns into a nail. Nagare is the same doctor who was spreading the misinformation that the tetanus vaccine was a plot to sterilize young Kenyan women in the prime of their fertility; his lack of imagination has apparently led him to say the same thing about the polio vaccine, except that this time it’s sterilizing the children.
As I detailed at the time, it was a conspiracy theory that conflated an old attempt to develop an immunocontraceptive; i.e., a vaccine that would serve as a contraceptive. In the case of the tetanus vaccine, Ngare claimed that it contained beta-HCG, sometimes called the “pregnancy hormone” because of its critical role in maintaining the pregnant state. That made it a promising target for immunocontraceptives, and decades ago vaccines were tested that targeted hCG, the intent being to result in the inability to maintain a pregnancy. It takes little more than a quick trip to Wikipedia (among other sources) to learn that as far back as the 1970s, hCG was conjugated to a protein known as the tetanus toxoid in order to make a vaccine against hCG. The reason was that hCG itself did not provoke enough of an immune response. It’s not necessary to know all the details and history. However, from the 1970s on, there have been clinical trials of such vaccine contraceptives using hCG, and it is possible to prevent pregnancy by this approach, although antibody response against hCG declines with time. Overall, it was not a very good method of contraception, which is why there’s little interest in it today. However, there’s a lot of interest in conflating the tetanus toxoid in the old hCG vaccines tested 20 years ago with the tetanus vaccine. It’s a conspiracy theory based on a profound misunderstanding of what was actually done. It’s also not unique to Kenya but has appeared in the Phillippines and other Third World countries.
So what is the story this time around? There’s no tetanus toxoid in the polio vaccine to produce confusion like this, and besides, vaccination campaigns against polio are focused more on children. The story mentions a derivative of estrogen, which, if Ngare is to be believed (he isn’t), can sterilize children (even if it were in the vaccines it can’t). I can’t really figure out where Ngare got this idea. He’s gynecologist and should know female hormones and what they do. He should know that a small amount of estrogen from a single vaccine is not going to be enough to sterilize a child, but apaprently he doesn’t. At least in the case of the conspiracy theory campaign against the tetanus vaccine, there was a mechanism for the charge that at least sounded superficially plausible. True, it disintegrated rapidly under even a little bit of scientific scrutiny, but it was way more specific than this latest charge of there being “estrogen” in the polio vaccine, which is so vague that Ngare might as well have just said “toxins.”
Naturally, Ngare claims he is not antivaccine:
But Wahome is not, he insists, anti-vaccine. He administers vaccines to patients in his clinic. His children are vaccinated. “Regular immunizations are safe and they must continue,” he says. “You must immunize your child.”
But are his children vaccinated against polio? Against tetanus? Of course, as is the case with our very own American antivaccinationists, most likely Ngare is feeling a little cognitive dissonance at his views on the tetanus and polio vaccines. Also, he knows it’s generally not a good thing to be antivaccine or even perceived as antivaccine, especially if you’re a doctor; so he resolves the conflict by convincing himself he’s “pro-vaccine safety.” Jenny McCarthy couldn’t have done it better. No doubt Ngare thinks he’s protecting Kenyan children from the evil depredations of the United Nations and World Health Organization, but in reality all he’s doing is impeding the efforts of the Kenyan government to eradicate polio.
It’s tempting to stand back and mock someone like Ngare, and, given his medical education, he really should know better. However, we have our very own antivaccine doctors—pediatricians, even!—right here in the good ol’ U.S. of A.; so we shouldn’t feel too smug. Also, given the history of colonialism and exploitation of Africa by European powers, it’s not surprising that distrust of outside institutions like the WHO is easily stoked there:
In Kenya, vaccine suspicion has taken its own local strain, aimed less at vaccines themselves than at the international bodies, like the U.N. and WHO, that distribute them. The distrust has been fueled by WHO’s decision to blanket Kenya with polio vaccines, well over and above routine injections, in an effort to boost population immunity. The idea is that some of the people reached by the campaign will have already been vaccinated, but some will not. The WHO says there’s no harm in giving extra vaccines to children who are already vaccinated.
Which is true, but you can see how that might raise suspicions, particularly after this incident:
Their concerns heightened after a recent unrelated incident in which about 30 children who received an injection of an anti-malarial drug in a dispensary in western Kenya appeared to be paralyzed. The drug, believed to be quinine for advanced cases, was found to contain the pain drug paracetamol, according to the bishops. Paracetamol is also known as acetaminophen.
In particular, the CIA fed these sorts of conspiracy theories when it was revealed that in 2011 it organized a fake vaccination drive in Pakistan to get a hold of Osama bin Laden family DNA.
Fortunately, the Kenyan government isn’t taking this lying down and is working hard to counter this latest bit of antivaccine misinformation:
…the vaccination programme is necessary to control any recurrence of the disease and the bishops’ opposition has been met with dismay by officials.
The ministry of health released a statement from Dr Nicholas Muraguri, director of Kenya’s medical services, who said: “Any attempts aimed at mobilizing the public against taking their children for vaccination is a serious violation of the right of children to health and survival.
“The ministry of health once again reassures the public of the safety of all vaccines used in Kenya. I therefore appeal to all stakeholders, especially the leadership of the Catholic Church, to continue supporting” the immunization campaign.
And, in response to the Catholic Bishops’ demand that the vaccines be tested by an outside agency:
However, health cabinet secretary James Macharia said that the ministry could not accede to demands made by different religious groups. “We have different religions with different doctrines. If we allow health to be managed based on people’s beliefs, we will have major problems in this country,” he said.
“We are not about to back down on campaigns because of one religion. The bigger picture is the children who are at risk.”
Exactly. Antivaccinationists, be they religiously-motivated or motivated by pseudoscience (or both), should not hold a government campaign to eradicate a deadly disease. Fortunately, it appears to be working, at least for now.
Maybe the five women in the meme above should pay Dr. Ngare and the Kenyan Catholic Bishops a visit to knock some sense into their heads. That, I would love to see.