Pakistan is one of the few regions left in the world where the debilitating poliovirus continues to infect dozens of children.

Polio endemics were common for hundreds of years in various regions of the world before the mid-20th century. In 1908, an Austrian physician, Karl Landsteiner, hypothesised that a virus caused the polio infection. It took another 50 years for science to produce a vaccine against the virus. But it was only from the 1990s onwards that the virus was vanquished in a majority of countries, because of vigorous vaccina­tion programmes. 

One of the main reasons the poliovirus is still a threat in Pakistan is the reluctance in some segments of the population to get their children vaccinated. The reluctance is fed by some entirely absurd beliefs, the most prominent one being that the polio vaccine causes impotence. The fact that Pakistan is the world’s fifth largest country in terms of population, doesn’t seem to matter to those who reject the polio vaccine. 

Read: Refusals against polio vaccination haunt KP children

People who oppose any kind of vaccination are often referred to as ‘anti-vaxxers.’ The many antiviral vaccines that we take for granted today did not fully materialise until the mid-20th century, even though the first ever vaccine was formulated in 1796 in England. It was an anti-smallpox vaccine. Smallpox had been killing millions of people for centuries. Still, it wasn’t until 1979 when smallpox was completely eradicated, thanks to more intensified international vaccination programmes, initiated in the late 1960s.

Vaccine hesitancy is not a ‘third world’ phenomenon alone. After the outbreak of the Covid-19 pandemic in early 2020, health experts in some of the most developed countries were aware of the presence of anti-vaxxers in their own backyard. This was even before the first Covid-19 vaccines became available in late 2020. 

Some think the anti-vaccination worldview needs to be empathetically addressed. Unfortunately, the fact is, viruses have no such empathy

Anti-vaxxers have appeared in countries as advanced as the US and France. With governments and the World Health Organisation (WHO) in a hurry to get as many people vaccinated as soon as possible in a race against a virus that is constantly mutating, they are being frustrated by large anti-vax groups. These groups are not only refusing to get vaccinated, but many are also spreading the most diabolical conspiracy theories against the Covid-19 vaccines from online platforms, and even from some sensationalist mainstream media outlets. 

Read: From bogus to bizarre — A roundup of some common Covid-19 vaccine myths

It is easy to dismiss such behaviour as being irrational, selfish and maybe even suicidal. In a recent book Anti/Vax, Bernice Hausman argues that governments and health experts need to exhibit a more empathetic attitude towards the concerns of the anti-vaxxers, so that they could be drawn into having a more fruitful (and less hysterical) discourse on the issue.

Indeed, this can work in the long run. But Hausman’s argument just doesn’t sit well in a reality where a lethal virus is getting deadlier by producing multiple variants and putting millions of people in hospitals and thousands in their graves every passing day. So, the kind of touchy-feely, navel-gazing exercise Hausman suggests should be kept for another day, when this virus is hopefully neutralised like so many before it. Mandatory vaccination is the only way out of this. 

However, one can agree that to engage with the anti-vaxxers, at least some knowledge is required to understand why they behave the way they do. The answer to this may lie in the history of vaccine hesitancy and how it was addressed. Interestingly, the first ever batch of anti-vaxxers emerged with the introduction of the first ever vaccine.

In 1843, when the British government made it mandatory for people to get inoculated by the anti-smallpox vaccine, groups of people threw up their arms in protest. All sorts of messaging emerged from these segments. Some argued that getting sick is part of God’s plan, while others wagged their fingers at the government, claiming that it had no right to tell people what to do with their bodies.

In 1905, when a similar problem occurred in Boston, the US Supreme Court had to intervene. The court ruled that the Board of Public Health had the mandate to make vaccination compulsory. According to the British anthropologist Heidi Larson (quoted in the January 26, 2021 issue of The Guardian) anti-vaxxers have surfaced with the emergence of every serious viral outbreak and immunisation drive.

She adds that, with each outbreak and vaccination programme, also emerge what she calls ‘white knights’ — populists harnessing fears and conspiracies against vaccinations to drive their own agendas. Larson gives the example of one Dr A. Ross, who authored a pamphlet in Montreal in 1885, claiming that smallpox vaccines kill children and that the best way to cure smallpox was ‘to breathe pure air.’ 

During a time when so many populists are at the helm of various states and governments, people such as Dr Ross have assumed greater political authority. Cynically, or in some cases, as a matter of actual belief, men such as the former US President Donald Trump, the former Tanzanian President Magufuli, the Brazilian President Jair Bolsonaro, Indian PM Narendra Modi and some others, have behaved like Larson’s white knights. 

They entirely cater to a mindset that is extremely sceptical towards science and is actively searching for not-very-scientific ideas in a bid to recreate a world that was supposedly an uncomplicated utopia before the advent of science and other ‘complicated’ products of modernity. Their audience likes to romanticise the pre-modern world, conveniently forgetting that it was a world cramped with disease, ignorance, high child mortality rates and plagues.

To many, this is a coping mechanism in the face of the complexities of modernity. As an attitude, it is about failing to come to terms with these complexities and trying to simplify things by adopting convoluted explanations of a complex world, and concocting a facile idea of ‘simpler times.’ 

Some may advise that such a worldview needs to be empathetically addressed. But unfortunately, the fact is, viruses have no such empathy.

Historically, governments have had to aggressively push through immunisation programmes, whether some people like it or not. Had this not been done, we would still be trying to helplessly evade every kind of virus, that for centuries have ravaged populations. Smallpox, measles, polio, influenza, et al — many of these can now be neutralised with dedicated vaccines. This is what makes vaccines some of science’s greatest achievements.

Let’s be grateful of this rather than empathise with those who treat vaccines as abominations, and thus putting their own lives, and more importantly, lives of others in danger.

Published in Dawn, EOS, August 8th, 2021