Avoid immunization, go to jail. Eek.

Via Foreign Policy:

In Nigeria, avoiding a shot could mean going to jail

As Bill Gates unveiled his plan this week to rid the world of polio, health officials in the northern Nigerian state of Kano announced their own assault on the disease. “The government will henceforth arrest and prosecute any parent that refuses to allow health workers to vaccinate his child against child-killer diseases, particularly polio,” said a health ministry official.

This news, which was announced at the outset of the government’s four-day vaccination campaign targeting six million children, marks a shift in government policy toward immunization programs in the north of the country. Nigeria’s polio vaccination program stalled for more than a year after Muslim leaders raised doubts over the inoculations’ safety in the summer of 2003 — resulting in bans issued by some northern state governments….

I’m not familiar with every vaccination law in the world, but this seems like a first to me. If not a first, at least an exception to the norm. I don’t like this more coercive approach. If you have enough resistance to a policy that you feel you need to threaten jail time, then actually making that threat — and following through on it — seems likely to breed more resistance.

I think governments can and should both incentivize vaccination and make it difficult to avoid without a really good reason. Any government policy should make it easier to get vaccinated against childhood diseases than avoid vaccination, because having a fully-vaccinated population is a classic public good. I like the fact that most states in the US have opt-out provisions for religious objections to vaccination, but I also think that states should not design a policy such that getting that exemption is simpler — in terms of time and money — than getting a child vaccinated, as is the case in many states.

But threatening to throw parents in jail? Way too heavy-handed to me, and too likely to backfire.

30

07 2011

4 Comments Add Yours ↓

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  1. 1

    I´m a German healthcare manager working in Macedonia. I was similarly irritated about a new law that will fine parents who refuse to have their children vaccinated in free government programs with 500 €. No awareness-raising, no educating the public.
    500€ are more than double of the average per capita income, in a country with unemployment rates close to 40%, so it´s quite draconic.
    Macedonia is seeing growing polio numbers, and a whole group of south-eastern Europe has been troubled by an ongoing uncontrolled morbilli epidemic since last year.

  2. 2

    Yeah, it’s one of those ideas that I’m sure sounds good to legislators because they don’t think through all the implications in both the short and long term. One question is which (if any) public health people are pushing such laws…

  3. Elizabeth C #
    3

    Thanks for drawing attention to this issue, Brett. As someone who is currently working in Nigeria and who has spoken to a couple of northerners about the history of vaccine refusal, I agree that this law is coercive and hinders health promotion efforts in the long-term. People in northern Nigeria have been hesitant to embrace many things from the West, for instance Western education because it came with the condition that Christianity also be allowed in.

    A very reliable source here told me that years ago, one of the Western drug companies deceived the people into thinking that they were receiving a vaccine. Even the local traditional leaders had gone to the manufacturing facilities ahead of time to make sure that what they said was true. But in reality, the company was developing another drug concurrently and using the people as test subjects. Once the people found out the truth, it ruined any trust they had built and continues to foster suspicion and fear of vaccines today.

    These new laws seem so counter-productive.

  4. 4

    Elizabeth — I haven’t heard that story, but maybe it’s a version of the very true Pfizer meningitis trial controversy (http://www.guardian.co.uk/business/2010/dec/09/wikileaks-cables-pfizer-nigeria) filtered through a lot of hearsay? Or maybe something different entirely. For some info on more recent polio vaccine controversies in Nigeria this link is interesting: http://amckiereads.com/2011/05/06/review-the-politics-of-polio-in-northern-nigeria-by-elisha-p-renne/



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