Fear, misconception, alleged plot to reduce Nigeria’s population frustrates polio vaccination exercise
Many children in Lagos State are at the risk of contracting a variant of polio virus as many parents are preventing their children from taking the vaccines rolled out against it by the state government. The polio virus variant is said to have crept into the state through infected people migrating from some northern parts of the country. Innocent Duru examines why parents are keeping their children away from vaccination and the implications of their action for the young ones and the society at large, reports The Nation.
Mrs Johnson, a Lagos housewife screamed to the point of losing her voice when our correspondent approached her to ask if she would allow her child to receive a polio vaccine. Before our correspondent could even complete his question, the light complexioned woman had interjected, asking if he was contracted to mobilise children for vaccination.
“No, I will never allow my children to take any vaccines again! Never!” she said as she made to walk away before she realized, as it were, that she was not done yet. The seemingly harmless question appeared to have roused the pent up anger she was nursing against vaccines and anyone that dared discuss the matter with her.
“Are you not seeing all the videos and messages as to how they want to use vaccines to reduce the population of black people, especially Nigerians?” She asked as she walked back towards the reporter, raising her voice.
“Go online and see some videos on Youtube. One of the videos on young virgins talk about how some young girls who took vaccines either died or became paralysed.
“Once it enters your body, you cannot do anything about it again. The damage would have been done. Why would I expose my children to such a risk that they would have to battle all their lives? I just can’t. Let them take their vaccines elsewhere.”
Our correspondent‘s decision to sound out parents on making their children available for vaccination stemmed from the shocking reactions of some parents on their children’s school platform where the management last weekend shared on the school’s Whatsapp platform a circular by the Lagos State Primary Health Care Board notifying the general public about November 2023 national immunization plus days in the state, asking parents to signify if they would want their children vaccinated when health officials come to the school.
Shortly after the notification was shared on the platform, one of the parents asked the school authorities to leave out her children, saying, “Please don’t give my children. Good afternoon ma. Is it not the same vaccine they want to use to reduce the population of our country? I remember that someone posted it here before. Which one is this? Is it a different one? Because one has to avoid a story that touches the heart. Thank you.”
Immediately other parents read her post, they, in quick succession, began to request that their children be left out of the exercise. Interestingly the parents involved are not illiterate but educated people who could read and comprehend the information contained in the notification. Despite the notification clearly stating that the exercise was for vaccination against polio, the parents completely shut their minds against it.
Incidentally, the position of parents on the school platform of the correspondent’s children reflects the thinking of many other parents in the society. A number of women spoken to by our correspondent also had the same mindset.
“Is it not that thing that they give to people who are not trained to give to people? That thing is contaminated,” one of the women, who identified herself as Bosede, said.
Bosede, who claimed to have worked in a health centre before, said: “The vaccinators are not health personnel. These are just girls that they recruited. I just met one yesterday (Tuesday), she’s just a secondary school leaver. She was with a box that she was moving up and down with. The vaccine is supposed to be in a cooler and well packaged, but the box the girl was carrying was very unkempt.
“When I was working in a health centre, we used to go through training on how to handle people who came for immunization. You must have your hands sanitised and wear hand gloves. These people that are walking up and down and giving vaccines don’t wear hand gloves.
“They just assume that it is an oral vaccine and ask children to open their mouths and take it. We are talking about health here, and when you are talking about health, you have to be extremely careful. The vaccinators are untrained people and I am sure that that vaccine has expired.”
Asked how she knew that the vaccines had expired, she said: “I didn’t check the date but I read Nursing and I have worked in an immunization clinic. That thing is expired and that is one of the reasons I decided not to give my children.
“There is this other thing that they said about reducing the population of the country. To achieve that, they said they brought out some vaccines. So they will now come and name it one thing and claim that it is beneficial to health.”
Joy, a teacher in a faith based school, says the authorities of the school do not allow the pupils to take any form of vaccination.
She said: “The vaccinators don’t come to our school because we don’t allow them to give vaccines to our children. They have tried entering a couple of times but when the authorities said no, they stopped coming.
“The management must have their reason for doing that, but I don’t know why it’s against it. I do allow my children to take it. Even when I am in school and I see them passing, I take my children to them for vaccination. They will only not take it within the school premises where it is seen as a taboo.
Another respondent who identified herself simply as Alhaja raised questions about the source and potency of the vaccines, saying: “These vaccines are not made in Nigeria. Some of them take time before they arrive in the country and maybe by the time they get here they would have expired.
“Some time ago during COVID-19 pandemic, some vaccines were either destroyed or rejected because they had expired. How are we sure that some people had not taken some of those vaccines before they were discovered to have expired?
“That knowledge has put me off anything vaccine in this country, because people just bring anything they like for poor masses just for selfish gains. That is point number one.”
The second point, she said, is about the weather condition at the moment.
“The weather is too hot and the vaccines are supposed to be at a certain temperature. But our people keep carrying it about like people hawking bread inside the sun without minding the consequences.
“I don’t think that is how the makers said it should be done. So, instead of exposing my children to needless dangers, I will rather not allow them to take the vaccines,” she added.
Also speaking, a respondent, who gave her name as Abigail, spiritualised the whole issue, saying: “Polio or whatever they call it will never be the portion of my children. How many children in villages take all these vaccines? I pray that education will not put us into trouble, because most of the things we are apprehensive about don’t worry villagers.
“Go and take statistics of people in the villages and see how many of them take these vaccines. Once you eat healthily and maintain good hygiene, sicknesses will be far from you. That is my belief and practice.
“I won’t allow my children to take what I don’t know about and later start regretting it. Let them go with their vaseline or is it vaccine you call it.”
Dangers of not taking Poliovirus vaccine for children
Parents who are preventing their children from taking the vaccine may be exposing them to serious dangers. For those who care to know, the World Health Organisation said: “There is no cure for polio; it can only be prevented. Polio vaccine, given multiple times, can protect a child for life.
“There are two vaccines available: oral polio vaccine and inactivated polio vaccine. Both are effective and safe, and both are used in different combinations worldwide, depending on local epidemiological and programmatic circumstances, to ensure the best possible protection to populations can be provided.”
Polio, according to the global health body, is a highly infectious disease caused by a virus. “It invades the nervous system and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs.”
One in 200 infections, WHO says, leads to irreversible paralysis (usually in the legs). “Among those paralysed, 5–10% die when their breathing muscles become immobilized. “Polio mainly affects children under five years of age. However, anyone of any age who is unvaccinated can contract the disease.”
Why parents are primarily rejecting vaccine
Findings showed that adamant parents’ position stems from viral campaigns on social media against Human Papillomavirus (HPV) vaccines. Those behind the campaign alleged that the vaccine is not safe, capable of promoting early sexual activity and causes infertility later in life among other health challenges. This fear has sunk deep into many parents, making them prefer not to take vaccines rather than doing so and regretting it in future.
UNICEF defines HPV as a group of related viruses that can infect the genital area, mouth and throat. It is transmitted through sexual contact. Most HPV infections do not have any symptoms. They clear on their own, but some can lead to serious health issues, including cancer.
It said HPV vaccines can prevent several types of cancer, including cervical cancer. “It is most effective when given before exposure to the virus, which is why it is recommended for girls aged 9 to14.
“Widespread vaccination can protect unvaccinated individuals by reducing the overall prevalence of HPV.”
Vaccinators shut out by schools, harassed in communities – Lagos govt
A Permanent Secretary at the Lagos State Primary Health Board, Dr Ibrahim Akinwumi Mustapha, who incidentally signed the notification about the November vaccination exercise, confirmed our findings about parents stopping their children from taking the vaccine.
Beyond our findings, he said some of their vaccinators were beaten and harassed in some communities.
“Like you rightly noted, before now, around early and mid-November, the schools, community members even beat our vaccinators. The schools shut their doors against us. Community members rejected us vehemently in the early days, but now it is getting better to the extent that some schools are the ones calling us to come and vaccinate their pupils. The rejection is going down and we are vaccinating more now, but it is still not what we want.”
Dr Ibrahim noted that the state government was spending a lot on vaccines, adding: “It is not just the state government; the federal government and their partners, like WHO and UNICEF, are spending a lot to ensure that our people get the vaccine.
“I cannot put a figure to the amount spent on the vaccine, but I know it is a huge sum.
“Like I told you, the rejection was very bad earlier on, but it is getting better now. People are getting the vaccines now. But if the rejection had continued, it would have been a lot of money going down the drain because those vaccines have lifespan. Not only that, it will now cause a resurgence of diseases.
“If children are not vaccinated against polio, there would be a resurgence of the circulating variant of the virus. Diphtheria is already rearing its head, tuberculosis will be high, all the diseases that are preventable by vaccines will begin to show their faces.”
Government’s frustration with anti-vaccines campaigners
Also corroborating our findings on one of the reasons parents are not favourably disposed to allowing their children to take the vaccine, Dr Ibrahim said: “Around September, he country planned to introduce Papilloma vaccine, which is an injectable, but we had a lot people campaigning against the Papillomavirus vaccine. What does the Papillomavirus vaccine do? It protects against Papiloma virus which is the most common sexually transmitted infection and it is known to cause more than 70 per cent of cervical cancer.
“Cervical cancer is the second commonest cause of death among women in Nigeria after breast cancer. It is the first commonest in the world. If we have a vaccine that can protect against this kind of cancer, why would we say that our children should not take it? We have a lot of anti-vacs campaigning online and asking parents not to allow their children to take the vaccines.
“This Papilloma vaccine that people are rejecting, the well-to-do in our society are paying for it in private hospitals to have themselves and their children vaccinated. Now the government has brought this vaccine free of charge and it is already tested by NAFDAC and certified for use for Nigerians; why would we not avail ourselves the opportunity of protecting our children against human papilloma virus that is the causative agent of cervical cancer, which is the foremost killer of women even in Nigeria?
“It is this rejection that people who are anti-vaccine are now spilling over to other routine immunisation vaccines. Because of that rejection, we found that they also rejected any form of vaccine that was coming their way. With campaigns, with public enlightenment and with advocacy, we have been able to let people know that this vaccine is good for their protection.
“Now the rejection is going down. The only way the awareness can be intensified is through all these things we are doing – raising the awareness on the socio media, tv, newspapers, bill boards, one on one interaction and so on.”
Types of immunization
Speaking of the different types of immunization available in the state and the country at large, Ibrahim said: “Immunisation campaigns are in different phases. There is something we call routine immunization. This is when you have a child and you take the child to the hospital to get vaccination or immediately you give birth to a child, the child has to be vaccinated.
“We also have what we call National Immunisation Plus Days. They are only to intensify routine immunization so that we can vaccinate more children beyond those who would ordinarily be given birth in hospitals or those that their mothers will take them to a clinic to vaccinate them. That is when you will see people going from house to house just to have people properly vaccinated.
“We have outreaches through which we further reach children not captured in the other programmes. In addition to that, there is what we call an outbreak response. Sometimes we have what we call variants of the polio virus.
“The country since 2010 has been declared wild polio virus free but we still because of movement of people that don’t get vaccinated have a variant of polio; but not the wild polio virus.” He said the recent vaccination exercise was prompted by the need to check a variant of polio virus that found its way into the state.
Dr. Ibrahim said: “There was a variant of polio virus that occurred somewhere in Katsina or Jigawa, if I am correct. That same variant was also discovered in Lagos. This occurred because of the movement of people.
“We do surveillance to pick some of these. When we do surveillance and we pick, we do what we call an outbreak response. This is done to further stem the tide of polio virus in our communities.
“The essence of that is to protect the children against contracting polio virus. If any child gets infected, the child will develop paralysis, and when a child develops paralysis, what happens? The child most likely will not achieve what he or she is supposed to achieve in life, and that is if the child does not die.
“You know the other challenges that are associated with somebody with paralysis. The full potential of that child cannot be attained, and this is what the polio vaccine is out to guard against.
“There are other vaccines within our routine immunization exercise. When you give vaccines, you are protecting the child against Diphtheria, tuberculosis, tetanus, yellow fever, among others, that can lead to death.
“The COVID-19 pandemic caused some disruptions in our immunization efforts because of the restrictions. And what happened thereafter? We started to see all manner of diseases coming up. Diphtheria, which we didn’t see for a long time, started rearing its head.
“So we need to intensify the vaccination exercise. This is not the time we want parents to refuse vaccination, because if they do, it will not just be a problem to the child that is not vaccinated but also to other children. Other children will be affected, and this is what we don’t want.”
UNICEF clears air on HPV vaccines
The United Nations Children’s Fund (UNICEF) and NAFDAC have cleared the air on the safety of the Papilloma virus vaccine.
Contrary to widespread fears about the human papillomavirus (HPV) vaccine, which has made many parents prevent their children from taking the polio vaccine, the UNICEF said HPV vaccine is a safe and effective vaccine that protects against HPV infection.
“HPV is the most common sexually transmitted infection (STI) in the world, and a leading cause of cervical cancer.”
In Nigeria, UNICEF said cervical cancer is the third most common cancer and the second most frequent cause of cancer deaths among women aged between 15 and 44 years. “In 2020 – the latest year for which data is available – Nigeria recorded 12000 new cases and 8000 deaths from cervical cancer.
“The HPV vaccine is most effective when given to girls and boys before they become sexually active, which is why it is recommended for girls aged 9-14 years old.
The organisation, on its website, went on to provide basic information about the HPV vaccine, which would guide people to understand the importance of the HPV vaccine, debunk the myths surrounding it, and answer frequently asked questions.
Aggressive enlightenment campaign needed to save massive investment on vaccination exercise
The government at federal and state levels may have to do a lot more to change the negative thinking about the people towards vaccines to make sure that the huge money spent on procuring vaccines and other attendant costs are not a waste.
The government from time to time spends whopping sums of money on getting the citizens vaccinated.
Only in 2018, the country approved a $150 million loan from the World Bank to help eradicate polio and scale up immunization. This excludes previous and subsequent spending on tackling polio virus in the country
It would amount to a huge loss if the government so invests in vaccines and they end up not being taken by the citizens.
To disabuse the mindset of Nigerians about vaccines, the government at federal and state levels may have to embark on more rigorous and aggressive enlightenment campaigns.
The campaigns will have to be ongoing as a one off campaign may not achieve the desired result.
If this is not done, the huge sums of money spent on importing vaccines and carrying out the vaccination exercise may end up going down the drains.
