CDC en Español

Search:

ISSN: 1080-6059

Volume 15, Number 6–June 2009

Letter

Religious Opposition to Polio Vaccination

Haider J. Warraich Comments to Author
Author affiliation: Aga Khan University Medical College, Karachi, Pakistan

Suggested citation for this article

To the Editor: In 1988, the Global Polio Eradication Initiative was formed, with the aim of reducing infection with poliomyelitis virus. Two decades later in 2008, a total of 1,625 children contracted acute flaccid paralysis caused by poliovirus infection (1). This finding represented a 150% increase over the number of cases in 2007 (1) and resulted in the reemergence of polio as one of the world's deadliest infections. As of 2009, polio remains endemic to 4 countries (India, Nigeria, Pakistan, and Afghanistan); in 2008, cases were also detected in 14 other countries.

Religious opposition by Muslim fundamentalists is a major factor in the failure of immunization programs against polio in Nigeria (2), Pakistan (3) and Afghanistan (4). This religious conflict in the tribal areas of Pakistan is one of the biggest hindrances to effective polio vaccination. Epidemiologists have detected transmission of wild poliovirus from polio-endemic districts in Afghanistan, most of which are located in the southern region of this country bordering Pakistan, to tribal areas of Pakistan (4). This transmission has resulted in new cases of polio in previously polio-free districts. The local Taliban have issued fatwas denouncing vaccination as an American ploy to sterilize Muslim populations. Another common superstition spread by extremists is that vaccination is an attempt to avert the will of Allah. The Taliban have assassinated vaccination officials, including Abdul Ghani Marwat, who was the head of the government's vaccination campaign in Bajaur Agency in the Pakistani tribal areas, on his way back from meeting a religious cleric (5). Over the past year, several kidnappings and beatings of vaccinators have been reported. Vaccination campaigns in Nigeria and Afghanistan have also been hampered by Islamic extremists, especially in the Nigerian province of Kano in 2003, which has resulted in the infection returning to 8 previously polio-free countries in Africa (2).

Before the Global Polio Eradication Initiative in 1988, a total of 1,000 persons/day were infected with a virus that would cripple them for the rest of their lives (6). To eradicate the disease, 1 major factor will be to gain support of those susceptible to fundamentalist propaganda. Islam is a progressive religion, and religious leaders should be asked to support polio eradication programs. The Imam of the Ka'aba and other influential religious figures should be asked to highlight the plight of children with polio. Vaccinators operating in conflict-ridden areas should be provided protection so that they are better able to perform their duties. Not only will children in these areas be safer, but the disease will not be exported to areas where wild polio transmission has been interrupted by vaccination. Further study of the attitudes of Muslim populations toward vaccination is needed.

References

  1. World Health Organization. Wild poliovirus weekly update. 2009 Jan 14 [cited 2009 Jan 17]. Available from http://www.polioeradication.org/casecount.asp
  2. Kapp C. Surge in polio spreads alarm in northern Nigeria. Rumours about vaccine safety in Muslim-run states threaten WHO's eradication programme. Lancet. 2003;362:1631–2. PubMed DOI
  3. Ahmad K. Pakistan struggles to eradicate polio. Lancet Infect Dis. 2007;7:247. PubMed DOI
  4. Centers for Disease Control and Prevention. Resurgence of wild poliovirus type 1 transmission and consequences of importation—21 countries, 2002–2005. MMWR Morb Mortal Wkly Rep. 2006;55:145–50.
  5. DailyTimes. Health workers boycott polio vaccination in Bajaur Agency. 2007 Feb 20 [cited 2009 Jan 17]. Available from http://www.dailytimes.com.pk/default.asp?page=2007\02\20\story_20-2-2007_pg7_29
  6. Cochi SL, Kew O. Polio today: are we on the verge of global eradication? JAMA. 2008;300:839–41. PubMed DOI

Suggested Citation for this Article

Warraich HJ. Religious opposition to polio vaccination [letter]. Emerg Infect Dis [serial on the Internet]. 2009 Jun [date cited]. Available from http://www.cdc.gov/EID/content/15/6/978a.htm

DOI: 10.3201/eid1506.090087

Comments to the Authors

Please use the form below to submit correspondence to the authors or contact them at the following address:

Haider J. Warraich, Aga Khan University Medical College, Rm 26, Male Hostel, Stadium Rd, Karachi 34800, Pakistan; email: haider_warraich@hotmail.com

Return email address:

Please note: To prevent email errors, please use no web addresses, email addresses, HTML code, or the characters <, >, and @ in the body of your message.

Comments to the EID Editors

Please contact the EID Editors at eideditor@cdc.gov

The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

This page posted May 20, 2009

Safer Healthier People

Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, U.S.A
Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435