What we talk about when we talk about vaccines

Recently, the CDC posted new, sobering numbers on the recent outbreaks of measles, a disease previously thought eradicated by mass inoculation efforts over the course of decades.  Like the spots found in the mouth of a patient, it’s not pretty:

Two hundred and eighty-eight cases of measles were reported to the Centers for Disease Control and Prevention (CDC) in the United States between Jan. 1 and May 23, 2014. This is the largest number of measles cases in the United States reported in the first five months of a year since 1994.

The cause is equally disgusting:

“The current increase in measles cases is being driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the United States and spread to others in communities where many people are not vaccinated,” said Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases.

Keep these thoughts in mind. I’m going to tell you a little story.

As some of you are aware, polio, the debilitating disease that renders a person physically disabled for the rest of their life, still continues to persist in parts of the Middle East, especially the northern provinces of Pakistan. This is mainly due to efforts by the Taliban and related organizations, as well as tribal leaders, to prevent vaccine distribution. Now, from an untrained standpoint, some would suspect the motives of the Taliban’s anti-vaccine efforts have at least some backing in Islamic thought. But that is not really the case: Inoculation has long been used in the Middle East and the Indian subcontinent, predating Western introduction of the practice. While there were previous concerns surrounding the religious validity of modern vaccines, the use of Muslim medical workers alleviated this problem. There is not much religious justification going on against the vaccines themselves.

Rather, the problem is not so much the vaccines as it is the source:

Anxieties and distrust about the polio vaccine and its western providers were rampant in some communities, and suspicions about CIA links with the polio vaccination campaigns, and rumours they were a front for the sterilising of Muslims, had been around for a decade after 9/11.

Given all the attention Pakistan got after 9/11, that the CIA would be rumored to have some sinister involvement in polio eradication did not seem far-fetched for the average Pakistani. Then came the revelation that a Pakistani doctor led a fake vaccination drive as a CIA cover operation to confirm Osama Bin Laden’s hideout in Abottabad in 2011, which caused the whole thing to fall apart. Two years after the fact, the region remains the largest endemic source of polio and continues to grow.