Vaccine hesitancy not new to India

Same dilemma was noted during roll-out of vaccine for plague, cholera in colonial era

Doubts about the efficacy of vaccines is not new in India. The same dilemma was confronted by the British when they rolled out vaccines for plague and cholera over 120 years ago. While religious considerations played a role in the hesitation, a tragic incident where 19 persons died after getting vaccinated added to the reluctance among the citizens.

Fears about religious contamination due to use of taboo meats like cow and pig during the culture of prophylactic vaccines drove large sections of population away from the vaccines. The scientists found a way out by using goat’s meat which was acceptable for culturing the vaccine. “A suitable culture medium has been obtained by digesting goat’s meat in the autoclave at 140°C with hydrochloric acid, and then neutralising the acid medium with caustic soda,” says the Plague Commission Report of 1901.

This solution to religious intransigence was solved by Waldemar Mordecai Wolff Haffkine, a Ukrainian bacteriologist who began working with the colonial administration in Bombay.

Among the religious leaders, Aga Khan gave instructions to his followers after which 81% of the community got inoculated.

Then tragedy stuck. In October 1902, 107 people were inoculated in Mulkowal village in Punjab. Within a few days, 19 people died of tetanus poisoning and the blame fell on Haffkine and his laboratory in Bombay. A Commission of Inquiry reached a conclusion that the vaccine batch was tainted and Haffkine had to quit in disgrace.

At that moment, Ronald Ross, who had won a Nobel Prize for his research on Anopheles mosquito in Secunderabad, stepped in to help Haffikine.

Ross wrote to Nature journal, linking the poisoning incident to vaccine hesitancy. “The public perception that the poisoning was due to carelessness at the laboratory and not to an accident was leading to rejection of the vaccine at a time when 20,000 deaths were occurring per week due to plague,” wrote Ross, who by then was working as a professor of Tropical Medicine in University of Liverpool.

Haffkine was exonerated following pressure by Ross and other scientists. While the efficacy of the plague vaccine was not quantified, the safety of the vaccine was clear. The roll-out of the vaccine gained traction, overcoming all odds.

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