Pakistan’s government has made vaccine rollout a priority, with anyone 18 and over able to walk into a nearby vaccination centre to receive the jab. Additionally, the National Command and Operation Center has worked towards disseminating accurate information regarding the vaccines and encouraging the citizens to avail of them. On the 14th of June, all of the countries’ major newspapers printed ads urging people to get vaccinated. The NCOC even released videos aiming to educate people about the vaccines and dispelling rumours. Yet, the country is unable to meet the inoculation goals it set for itself. In Punjab, for example, the government was hoping to vaccinate 420,000 people per day, but only 52,000 people have been opting to get the dose.

To combat the low numbers of people willing to be vaccinated, the Pakistani government has enacted a set of policies detailing strict repercussions for those who refuse to get vaccinated. Civil servants who aren’t vaccinated won’t be paid a salary starting July. A deadline of 30th June has been set by which all government officials needed to get the dose. On 8th June, all organisations, offices, and businesses were given two weeks to get their employees and staff vaccinated. Following the two week period, random checks would take place, and those that had not complied would be penalised. The Punjab government also threatened to block the mobile phones of those who do not get the vaccine.

While the government has implemented stricter measures than most others, they might have been necessary when analysed in the context of Pakistan’s struggle with vaccine rollouts. Dr. Abdul Ghafoor Shoro of the Pakistan Medical Association believes it could take up to a decade to inoculate every citizen if the country continues its vaccination drive at the current pace. As of 20th July, only about 22.8M citizens have been vaccinated. Even some of those working in healthcare believe taking the vaccine would be harmful. Additionally, according to National data, approximately 300,000 of those that received the first dose of the vaccine haven’t returned for a second dose. 

Currently Pakistan offers Covid vaccines produced by 6 companies – Pfizer/BioNTech, CanSino, Sputnik V, Oxford/AstraZeneca, Sinopharm (Beijing), and Sinovac. The country has not reported any additional side effects or reactions to the vaccines that could have led to the widespread distrust held by the citizens. Furthermore, Pakistan’s vaccination drives have struggled to inoculate its citizens long prior to COVID-19. Distrust of vaccinations and rumours regarding their dangers are particularly persistent  in Pakistan. In fact, the country remains one of the last three countries where polio is endemic due to people not getting vaccinated. 

Why are Pakistan’s citizens reluctant to be inoculated? The failure of the drives has been attributed to the citizens’ mistrust of vaccines and the strength of anti-vaccine propaganda. Pakistan’s relationship with vaccines is largely characterised by a botched CIA operation, extremist propaganda, and religious anti-vaxx sentiments. 

The CIA’s operation and resultant anti-vax campaign boost

In May of 2011, CIA agents recruited a senior Pakistani doctor, Shakil Afridi, to organise a vaccination drive. The drive was carried out in an attempt to obtain DNA evidence that Osama bin Laden was residing in the compound the CIA had traced him to. DNA that was collected of children from the compound would be compared to that of bin Laden’s sister who died in 2010 in Boston. In order to make it seem more authentic, the vaccination drive was started in a poorer part of the town, Nawa Sher. After administering the first dose, instead of returning to administer the second, Afridi instead moved the drive to the suburb bin Laden was believed to reside in, leaving the children in Nawa Sher unvaccinated. They used the ‘ruse’ of vaccinating a large group of poor children and never even gave them the entire course of the vaccination.

In July of 2011, The Guardian released an article detailing the operation. The reports of the CIA’s project lent credibility to the anti-vaccine campaigns that existed in the country. These were no longer conspiracy theories, but backed by trusted news sources. It furthered Islamic extremist parties’ distrust of vaccines and rumours that polio agents were Western spies. In retaliation, Taliban leaders banned immunisation drives and attacked healthcare workers, killing 70 of those working with the drives. Additionally, the Taliban issued a number of fatwas – religious edicts – in which they accused health workers of regularly conducting espionage activities for the United States and related polio vaccination campaigns to attempts to sterilize Muslim girls. 

A study conducted by the Centre for Monetary and Financial Studies has shown that the CIA’s ruse and the resulting campaigns caused a “significant vaccination rate decline in Pakistan”. According to the data, a one standard deviation increase in the support for Islamist groups leads to a 9% to 13% larger decline in the likelihood that children have received the first dose of a number of different vaccines. Additionally, as a result of the sterilisation rumours, girl children were considerably less likely to be vaccinated. This had a direct impact on the health of the people in these communities. Districts with a greater support for Islamic extremism had 1.66 more cases of polio on average compared with districts with lower levels of support – almost twice the average number of cases per district. 

The people in the above mentioned districts were more exposed to and thus more influenced by the retaliatory anti-vaccine propaganda campaigns by extremist parties. Without the CIA’s operation making global news these groups would not have had the ammunition necessary to effectively spread these rumours. Additionally, had the ruse not been directly tied to a US intelligence agency targeting an extremist, these groups might not have had as high levels of wariness and animosity towards vaccines. 

Covid Vaccines and Conspiracy Theories

Anti-vax movements have been gaining traction around the globe. However, having a factual event to base propaganda off of gave the movement a springboard in Pakistan. Considering the pre-existing mistrust of vaccines, it is not surprising that conspiracy theories regarding the Covid vaccine have influenced the decisions of millions.  According to a report published in November 2020 by Gallup Pakistan, 49% of the population was reluctant to get vaccinated against Covid even if the vaccine was offered free of cost.

The original claims – reinforced by the CIA operation – continue to remain the underlying narrative of the anti – vax movement and are visible in the more widely accepted rumours relating to the Covid vaccine. The fear of the West using the vaccine to control or hurt the Pakistani population persists. Claims that the vaccines are a ploy used by global powers to spy on individuals have run rampant. Many believe that since the vaccines are foreign-funded they are accompanied by ulterior motives. It is rumoured that the vaccines are being used to install “surveillance microchips” in the bodies of its recipients or that the vaccines will alter the DNA of those who take it. One political commentator even claimed that the vaccine was “designed to allow Jews to rule the world, and to include nano-chips embedded in the bodies of people to gain control through 5G towers”. 

Conclusion

The events that took place in Pakistan are not a one-off. Even after being discredited and “debunked” multiple times, claims against health infrastructure can be powerful and long-lasting. The emergence of the original anti-vax movement has been credited to the publication of an article in the medical journal The Lancet in 1998, which linked autism to the MMR (measles, mumps, and rubella) vaccine. The movement resulted in a rise in children remaining unvaccinated in many countries, which caused several previously eradicated diseases to reemerge. The article has since been thoroughly discredited and its writer struck off the medical registry as a result of the fraud. However, the movement has only continued to gain traction.

The narrative bolstered by the news surrounding the CIA scheme has continued to plague health services in Pakistan 10 years later. Inaccurate information regarding healthcare and health services affects the lives of millions. Considering the research into and evidence of this, it has become increasingly important to regulate this information and ensure that interference in public health is kept to a minimum. Legislation must be introduced to punish those who spread dangerous rumours relating to topics in the public health domain. Policy of this nature could save lives globally on a large scale.

Wynnona Fernandes is a third year Political Science major at Ashoka University