Rumors targeting vaccines are often of a political nature, launched by some forces due to the conflict or as a result of religious distortion launched by others drawn to conspiracy theory. However, these rumors cause confusion among some people, making them to refrain from vaccinating their children, and herein lies the danger.
Indeed, Yemen had previously begun the process of immunizing children regularly since 1996, through the World Health Organization, without recording any risks for these vaccines, while the same organization declared that Yemen has been free of polio since 2006.
During the past period, entities and figures affiliated with the Ansar Allah group (Houthis) in Sana'a have raised a widespread controversy after adopting events and a wide campaign against children's vaccines, considering them a conspiracy and useless, which leads to the question of the reason: why a group organized a symposium against vaccinations, entitled “vaccines are neither safe nor effective,” especially at this particular time, despite knowing that vaccines are not newly born or a spur of the moment.
The resurgence of Polio
In August 2020, the World Health Organization declared a new outbreak of circulating vaccine-derived poliovirus type 1 (cVDPV1) in Yemen, and the organization said that about 15 cases of polio infection had been recorded in the districts of Saada governorate, which is under the control of the "Houthis", in the north-west of the country.
While the Ministry of Health and Population in the capital, Sana'a, which is under the control of Ansar Allah (Houthis), declared that it recorded 226 cases of polio, this came in the Ministry's report on diseases and epidemics of the year 2022.
The report added that 18,597 cases of measles were recorded, of which 131 died, during the past year, while the number of people infected with the malaria epidemic reached about one million and 136 thousand cases, of which 19 died, and the number of dengue fever cases reached about 28,157, of which 37 died. whereas the number of viral hepatitis B and C cases reached 20,248—of which two died—and 14,039 cases of viral hepatitis A and E, in addition to 105 cases of diphtheria, of which 76 died.
In the context, the Deputy Director of Health Education and Information at the Ministry of Health's office in Taiz, Tayseer Al-Sami’i, tells “Khuyut” that the rumors spread by users of social media networks and the Houthi group (Ansar Allah) against vaccinations have affected some people in the northern regions of Yemen, which led to the emergence of cases of polio, measles, and other diseases in those areas, considering this matter a health disaster and relapse, especially after Yemen obtained the World Health Certificate in 2006 for being free of polio.
“Killer childhood diseases can only be prevented through immunization with vaccines, and when children are not vaccinated, their lives and communities are vulnerable to health risks.”
Al-Sami'i explains that the Health Office in Taiz is making great efforts to confront these rumors and prevent their impact by conducting educational campaigns for citizens about the effectiveness and safety of vaccines and that they are similar to treatments and medicines available in pharmacies, which must be done by all health offices in the various governorates because it is primarily a social responsibility.
"The ongoing situation requires us to re-intensify immunization campaigns and raise awareness about the importance of vaccines, so that the situation will return to what it was previously after 2006," Al-Sami’i adds, pointing out that the campaigns carried out by the Ministry of Health are not a substitute for the routine childhood vaccinations—the vaccines that are provided in health facilities—but are also considered booster doses for vaccination.
Spreading Malicious Rumors
According to doctors and officials in the health sector and to reports of international organizations, reviewed by "Khuyut," that refraining from taking the vaccines or refusing them is a health disaster for children, which may lead to death, mental retardation, or permanent physical injuries, leading to what the spreaders of rumors and misinformation are striving for against the safety and efficacy of the vaccine.
Furthermore, the director of the immunization program in Taiz Governorate, Dr. Fahd Al-Namir, confirms, during his interview with "Khuyut," that there is malicious propaganda and rumors spread by some means of communication and users of social media networks for the purpose of confusing citizens not to accept vaccines, “calling on all citizens to take vaccinations and not listen to distorters, rumor mongers, and messages that cause disruption in the health of society,” he adds.
On the other hand, he stresses that these rumors have led to a decrease in community immunity and a reluctance to vaccination in some areas, which resulted in the emergence of epidemics such as polio, measles, and whooping cough, whose results were disastrous. Further, since the beginning of this year 2023, 7 children under the age of 10 have died of measles in the Taiz governorate alone, whereas all the dead and infected cases were unvaccinated because of their refusal of vaccines.
In February, the Ministry of Public Health and Population of the internationally recognized government of Yemen declared that more than 200 cases of polio had been recorded in Yemen over the past two years. What's more, “the number of infections increased, according to the ministry, in the northern governorates controlled by the Houthi group, which is based on myths and “global conspiracy” to justify the prevention of child vaccination campaigns,” the Ministry confirms.
Likewise, statistics, reviewed by "Khuyut," reported the outbreak of the epidemic, according to the ministry, in 228 cases of the mutated poliovirus type 2, in various Yemeni governorates, especially those under the control of the Sana'a authority.
In this regard, the director of the Epidemiological Surveillance Department at the Health Office in Taiz Governorate, Dr. Yassin Al-Shuraihi, says that the cause of the spread of the new mutated polio is the result of contact between an unvaccinated child and another vaccinated one, which leads to the infection of the unvaccinated child with the mutant polio epidemic.
Al-Shuraihi explains the method of infection that occurs as follows: the polio vaccine is given orally, which passes after that through the intestines and is excreted with the feces, but, before that, it goes through several stages, changes, and mutations in the intestines of the vaccinated child. So that, when it is excreted with feces, it causes contamination to the unvaccinated child, causing him acute flaccid paralysis.
According to the Epidemiological Surveillance Department, there were 48 cases of mutated polio disease "acute flaccid" recorded in Taiz Governorate during the past year 2022, while the suspected measles cases reached 751, of which 74 cases were laboratory confirmed, of which two cases died after the symptoms of the epidemic doubled, indicating that all of these cases were often unvaccinated.
Vaccination is the first line of defense for health, whether at the level of the target group of children under one year old or at the community level in general.
Epidemic Prevention
Doctors and experts of the World Health Organization consider that immunization is a scientific success story achieved by health in various countries of the world, as vaccines protect against 12 diseases, including deadly diseases such as polio, according to Dr. Al-Namir’s speech. In addition to measles, diphtheria, whooping cough, and hepatitis B, this success was achieved thanks to the importance of vaccinations and by raising community immunity against these deadly diseases.
Killer childhood diseases can only be prevented through immunization with vaccines, and when children are not vaccinated, their lives and communities are vulnerable to health risks.
On the other hand, Al-Namir points out that some of these diseases in the past centuries caused the deaths of millions of people, but this number has been reduced to a minimum, thanks to vaccines and vaccination.
In Yemen, it is estimated that a child dies every 10 minutes from vaccine-preventable diseases, according to the United Nations Children's Fund (UNICEF).
According to UNICEF, the total number of vaccines administered in 2020 and 2021 reached 19,992,050 doses, against vaccine-preventable diseases. This figure covers the BCG vaccine, bivalent oral poliovirus vaccine (bOPV), DTP-HepB-Hib vaccine (pentavalent vaccine), pneumococcal conjugate vaccine (PCV13), measles-rubella (MR) vaccine, rotavirus vaccine, inactivated poliovirus vaccine (IPV), and tetanus-diphtheria (Td) vaccine.
Types of Vaccines
Vaccines differ according to their functions and efficacy for each epidemic. However, there are multiple stages through which the child is immunized since his birth, as he is given the first dose of vaccine within 24 hours of birth, called the “zero dose,” which is vaccinated against viral hepatitis B. While the second dose is given at the age of one month, which is also considered a zero dose, the child is vaccinated against polio and tuberculosis.
The third dose is given at the age of two months; it is called the “first dose,” which is against polio, and the DTP-HepB-Hib vaccine, which is a combined vaccine, provides protection against diphtheria, whooping cough, tetanus, hepatitis B, and influenza. It is given in two ways: orally and by subcutaneous injection.
Then comes the vaccination at the age of 4 months, which is the "second dose," which includes the vaccination against both polio and the DTP-HepB-Hib (pentavalent) vaccines. Thereafter, in the sixth month, the "third dose" is given, which contains the same antibiotics as the previous dose. After that, in the ninth month of the child’s life, comes the "fourth dose," which is given against polio and also contains a vitamin A supplement.
At the age of 12 months, the "dose of the year" is given against the epidemics of measles, mumps, rubella, and polio. Then, at the age of one and a half years, comes the last of the routine vaccinations, with a dose called the "booster dose," in which it provides vaccination against polio, diphtheria, whooping cough, tetanus, measles, mumps, and rubella, and it also contains a vitamin A supplement.
As for the house-to-house immunization campaigns carried out by the Ministry of Health, these campaigns are considered necessary in order to deliver the vaccine to all target groups. However, they are not a substitute for the routine childhood vaccinations—the doses mentioned above—but are considered booster doses for vaccination, and their purpose is to deliver the vaccine service to all children in the community.
