Parents are in panic after the directive by the ministry of Health to give school-going children a Covid-19 jab without their consent.
Amidst the lack of a cure and compromised health systems, Uganda National Expanded Program on Immunisation weighed in but only heightened the controversy. Fever-pitch debate has ensued, with general consensus that the directive is unsighted as consent on whether to vaccinate or not remains the prerogative of parents.
Undoubtedly, vaccines are crucial public health instruments, as outbreaks can have devastating consequences. Uganda has registered less fatality, but Covid-19’s effect stalled school programmes for almost two years and continues to lay siege on the economy.
A history of public health shows that infectious diseases have ravaged the world in the past, with each outbreak presented in a novel way. Smallpox, almost lost to prehistory, was one of the deadliest due to its debilitating effect across all continents.
Humanity has suffered in the throes of Spanish flu, polio, avian or bird flu, and HIV/Aids. Measles, whooping cough/pertussis, mumps, tetanus, and diphtheria had their onslaught.
In recent years, outbreaks such as swine flu (H1N1), Ebola, and Zika virus, first isolated from a monkey in Entebbe in 1947, are persistent. Coronaviruses, SARS, MERS, and Covid-19 periodically desolate public health tranquillity.
Every pandemic has elicited public health concern to understand, cure or prevent it. The WHO, for example, is always at the forefront to offer short and long-term guidance. Among its priorities, vaccines are recommended as the most effective interventions offering long-term responses to save lives, time, and other resources. They neatly fit in the prevention is better than cure adage.
Even when vaccines prevent deadly pathogens, they court controversy. When Covid-19 reached peak levels, concern for vaccine development to control it received heightened attention.
The danger posed by pathogens and bioterrorism gives impetus to vaccine development. But circumventing ambivalence surrounding them is more elusive than it is fueling it.
The primary theme for the opposition is that vaccines cause more harm than they prevent. The DPT vaccine in the 1960s and 1970s is a case in point. Given in a single combination to prevent diphtheria-pertussis-tetanus, thus the DPT acronym, was to blame for causing brain damage and autism in children.
Advance in technology enhances success and practice, but doubts always emerge regarding vaccine risks and benefits. The Pandemrix vaccine manufactured by GlaxoSmithKline, meant to protect against the swine flu (H1N1) outbreak in 2009 and 2010, resulted in adverse effects.
It caused narcolepsy, a neurological disorder causing an inability to wake and sleep in some recipients. But it is intriguing how authorisation by governments in Canada, the USA, the UK, France, and Germany, was quickly done to protect the vaccine against lawsuits for risks it would cause.
Sceptics maintain that vaccines are schemes for pharmaceuticals and philanthropists to make money. The RNA-based vaccine made news when The Bill and Melinda Gates Foundation injected financial support into the biotech company, CureVac, responsible for its development. To this day, sceptics allege that Covid-19 is lab-orchestrated, therefore a delight for pharmaceuticals and donors to make money and that its vaccine is compounded with microchips to monitor people.
Conspiracy theories on biomedical developments are part of the cause of activism against vaccines and vaccination. Misinformation contributes to undermining confidence in vaccines. Anti-vaccination organisations have become a part of the national and international networks buoyed by social media.
The association of vaccines with compulsory immunisation policies linked to school attendance, as seems to be the case in Uganda now, sustains hesitancy. Enforcement to ensure immunisation compliance agitates more than it appeases.
Since the 1950s in the USA, vaccination programmes are compulsory for schoolchildren. To this day, other countries replicate the same model. But vaccination programmes spark resistance when they become compulsory and when those in contravention receive fines or jail terms.
The perception that vaccination programmes intrude on religious beliefs, as well as personal liberties, is persistent. In the context of religious sentiments, vaccination, as well as contraception, are viewed negatively.
Clinical trial mistrust, likewise, bears evidence in historical circumstances, particularly in the brutal and unethical treatment of Africans in medical experiments and practices. Medical research in the USA and elsewhere is abound with accounts of unethical standards bereft of compassion applied to people of native ancestry and low-income statuses.
African Americans were abused as specimens for dissection, testing modern technologies and remedies on account of ascertaining medical progress. For 40 years from 1932 to 1972 in the USA, the Tuskegee Syphilis Study was the longest nontherapeutic experiment known for its human rights notoriety.
The experiment fortified mistrust after media leaks that African Americans were abused as observation groups to investigate the natural history of untreated syphilis. Even after the discovery of penicillin in the 1940s, participants were denied the antibiotic even when they started dying.
In the early days of Covid-19, when two French doctors appeared on TV suggesting that Africa should become clinal trial territory for vaccines, they sparked outrage. Dr Tedros Adhanom Ghebreyesus, the director general WHO, termed the suggestion a ‘colonial mentality’ hangover.
Vaccine hesitancy is common among complementary and alternative medicine (CAM) practitioners, such as homoeopathy, chiropractic and naturopathy. CAM practitioners promote non-conventional therapies rather than vaccines. They posit that the body only requires natural remedies to facilitate or trigger an immune response.
In confronting public health crises predisposed by pandemics, vaccines are the best and most effective medical interventions in absence of therapies. However, the history of hesitancy and refusal is plagued by inconsistencies in their development and immunisation programmes.
The author is enlisted for a Management of Technology and Innovation MSc at Da Vinci Institute for Technology Management.