I came across a video and an audio in circulation on social media with a message to tell people that a malaria vaccine that was going to be rolled out in Ghana wasn’t good and should be rejected. It was interesting to know the reaction they incited amongst people with quite a number immediately buying into the message in spite of its obvious lack of any truthful facts. I watched the video and also listened to the audio critically. I don’t know if these two people had done any research about what they were saying but they didn’t appear to have.
The guy in the video started with an issue of Kenyan women being sterilized under the guise of being offered contraception. This is false and a summary article (1) brings all the facts together to prove that. People have raised issues about attempts to sterilize some people using vaccines. Such conspiracy theories are making some preventable conditions persist in some places where people wouldn’t take the vaccine because they are convinced that is an attempt to make them sterile rather than prevent a disease. If it were true that polio vaccines sterilize people for instance, then everyone who has taken the vaccine should have been sterile. However, considering that we have been vaccinating almost every child in Ghana against polio, we have not recorded any decline in fertility rates. There is no single evidence of such anywhere. When was the last time you heard of a child being crippled in Ghana from polio? When was the last time you heard of a child having measles in Ghana? There has not been any of these vaccine preventable diseases in Ghana for years; thanks to immunization programs that were implemented. Yet, there are cases of polio in three places in the world now; Nigeria, Pakistan and Afghanistan (2). This is mainly because of conspiracy theories of the vaccines being a way to make people sterile which makes them reject the vaccine. Also, in the US, there’s been some measles outbreaks recently and that is because some people are not immune because they wouldn’t take the vaccine for some reasons, the chief of which is the link of the measles vaccine with autism. This, however, has long been proven to be falsified information and the publication has even been withdrawn (3, 4). There is no evidence that measles vaccines cause autism or polio vaccines sterilize people. What we need to understand is that the more people that take the vaccines, the better the protection for all.
He also mentioned the biggest priority of Bill Gates being to depopulate Africa which is baseless. He said we are a threat and our population growth is a threat to the “abrofofoↄ” (the white people). Bill Gates has invested a lot of money in helping address a lot of maternal and child health issues. The offer of birth control (which isn’t compulsory by the way) is a way to help control births as we work on the challenges we have with childbirth and neonatal/infant problems. China is a developed country without much of maternal and child health problems like we do but they have a birth planning policy that limits the number of children a couple can have. The Kenyan issue for instance and mass polio vaccination campaigns have all been from the World Health Organization (WHO) which isn’t an organization for just “abrofofoↄ”. The WHO is concerned with international public health and the current Director-General is from Ethiopia.
GSK, the company that manufactured this malaria vaccine is the same company that makes Calpol (paracetamol for children), Bactroban, Augmentin, Ventolin (asthma inhaler), Malarone (an antimalarial drug), Ceftin (cefuroxime) and many other brands widely used in Ghana. They don’t need this vaccine to wipe us out if they intended to. We would have been long gone if that was the mission. In any case, which commercial farmer will kill the members of his village who hardly ever do any farming on their own but rely on his crops to survive? He would be depleting his own earnings. As at yesterday when I checked clinicaltrials.gov, the single largest registry of drug trials, 39% of all drug trials taking place globally are being carried out in the US. The rest of the world shares the rest. In fact, the initial trial phases of this malaria vaccine to assess safety were first done in the US and Belgium before carrying out efficacy trials in regions where the disease is prevalent. How do you trial a drug for efficacy out of the natural environment the disease it seeks to cure occurs? How do you determine whether or not the vaccine is working if you vaccinate someone in America against malaria? There is no malaria there. Do you hear of cancer drug trials in Ghana? Why not? There are a lot more cancer cases where the drugs are made. In a nutshell, nobody is targeting us.
Vaccines go through phases of clinical trials before they get on to the market and so a lot of safety issues are cleared in the early phases before getting to efficacy. Even when it’s approved to go on the market, there’s post-marketing surveillance to see if there are any issues in real world use that may not have been picked up because of the “limited” population size for all the trials before they are approved for the market. Vaccines have been proven to work and when issues are found with them, they’re called off from the market.
The malaria vaccine being rolled out has gone through to phase 3 and shown some efficacy (39%). It was also found to have an acceptable safety profile (5, 6, 7). Ghana was part of 7 sub-Saharan African countries where this phase 3 trials were conducted. It is therefore not true when someone says the vaccine hasn’t been tested before and they are now bringing it to Ghana to test it on people. Also, to ask that “if it was good, why is it not being used where it was made” makes it clear that the person speaking doesn’t understand what they’re saying. The vaccine is given where the disease is or can be transmitted to prevent that disease. About 90% of malaria cases occur in sub-Saharan Africa so who needs this vaccine more? (8) The vaccine is not only being rolled out in Ghana but also in Kenya and Malawi and this is in collaboration with the WHO.
In the epidemiologic triad, there’s a host (in this case humans), an agent (disease causing organism) and the environment with sometimes a vector in the middle (in the case of malaria, that’s the mosquito). In an attempt to tackle a disease, there are efforts to address all the angles. Cleaning of gutters as the guy said falls within the environment bit. Drugs tackle the agent (plasmodium parasite, which has developed resistance to some drugs over time) and vaccines create host immunity against the disease. This malaria vaccine’s efficacy shows that it can prevent roughly 4 out of 10 malaria cases. When immunity is built in a child, the body is able to destroy the parasite when a mosquito “dumps” them in the child’s body so the child doesn’t get diseased and also there would be no parasites to be transmitted from that child to another child to cause disease. As the immunity increases in the population, in addition to other control mechanisms for the disease, malaria will gradually be eliminated and possibly eradicated.
It is said that malaria takes the life of one child every 30 seconds and over one million people die from malaria each year. The cost of control and treatment of malaria also has a huge impact on economies (8). Malaria is a big problem in our part of the world and so it is good it’s being tackled on all fronts and a lot of money is invested in malaria research to find solutions to the menace.
People may try to say things to people out of good will but if this is misinformed, it will end up causing more harm than good. Two people have tried to tell Ghanaians not to accept the malaria vaccine (which actually is going to be beneficial to them) even though they appear to have no knowledge of what it is. It is therefore imperative that we as a people try to dig into what people throw around on social media to ascertain their veracity before drawing any conclusions or taking any actions. We need to be like the Bereans who “received the word with all readiness of mind, and searched the scriptures daily, whether those things were so” (Acts 17:11).
Our leaders also need to create awareness and educate people when things like this are about to happen so that the people will not be misguided in their decisions when someone out of the blue throws out some non-factual information. This will also go a long way to build trust.
By Oswald Tetteh & Justice Boakye-Appiah
Oswald Tetteh, MD, MPH is a graduate of the University of Ghana School of Medicine and Dentistry and the Johns Hopkins Bloomberg School of Public Health. He is currently a Clinical Research Compliance Specialist for the ClinicalTrials.gov Program at the Johns Hopkins University Institute for Clinical and Translational Research.
Justice Boakye-Appiah is a Medical doctor and PhD Researcher in Immuno-vaccinology at Institute of Infection and Immunity, The St George’s Hospital, University of London.
References:
1 https://www.snopes.com/fact-check/tetanus-vaccine-sterilization/ (Accessed on May 2, 2019)
2 https://www.who.int/news-room/fact-sheets/detail/poliomyelitis (Accessed on May 2, 2019)
3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/ (Accessed on May 2, 2019)
4 https://www.historyofvaccines.org/content/articles/do-vaccines-cause-autism (Accessed on May 2, 2019)
5 https://www.afro.who.int/news/ghana-announces-roll-out-malaria-vaccine-implementation-programme-mvip (Accessed on May 2, 2019)
6 https://www.who.int/malaria/media/rtss-phase-3-trial-qa/en/ (Accessed on May 2, 2019)
7 https://www.malariavaccine.org/malaria-and-vaccines/rtss (Accessed on May 2, 2019)
8 https://www.unicef.org/health/files/health_africamalaria.pdf (Accessed on May 2, 2019)