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ANALYSIS: Why does an old, false claim about tetanus vaccine safety refuse to die?

Under the guise of tetanus vaccination, the Unicef and World Health Organisation is supposedly conducting a “mass sterilisation exercise” in Kenya.

Or so a French content aggregator of health information, Sante Nutrition, recently “revealed”.

The article is actually a translation of a 2014 report on another website called LifeSiteNews. This Canadian “pro-life news” website said that the Kenya Catholic Doctors Association “found an antigen that causes miscarriages in a vaccine being administered to 2.3 million girls and women by the World Health Organization and UNICEF. Priests throughout Kenya reportedly are advising their congregations to refuse the vaccine.”

Stories from Sante Nutrition are often republished by websites in the West African region and shared on Facebook.

But the sterilisation claim is more than 20 years old and has been repeatedly debunked by World Health Organisation (WHO) and others ever since.

From 787,000 babies dying to 49,000

Tetanus is a bacterial disease that causes muscles to painfully tighten. When it affects the jaw, people battle to breathe and can die.

It is completely preventable through immunisation, using a vaccine containing inactivated tetanus toxin, known as the tetanus toxoid vaccine (or TT vaccine).

Anyone stepping on a rusty nail would receive this but it is particularly useful in preventing tetanus among newborn babies, who are at risk when unsterile instruments are used to cut their umbilical cord.

When the unborn child’s mother is immunised at least twice through her pregnancy, she passes on her tetanus immunity to the baby. Five doses of the vaccine protect her (and her future children) for life.

Back in 1988, an estimated 787,000 babies died worldwide of tetanus. The latest available WHO data shows that the death toll has dropped to approximately 49,000 in 2013, thanks to the immunisation programme.

Ironically, West African countries like Senegal, Cameroon, Ivory Coast, Guinea-Bissau and Sierra Leone, has managed to eliminate neonatal tetanus. Yet babies in Guinea, Mali, Niger and Nigeria - and Kenya - still remain at risk.

How the rumour started back in ’94

The first campaigns against the tetanus vaccine were based on a misunderstanding of a scientific study in India in 1994 that tested a birth control treatment.

The study’s active ingredient was a subunit of a hormone necessary for pregnancy to happen and that is also produced in large amounts throughout pregnancy. It is called human chorionic gonadotrophin, or hCG for short. Home pregnancy tests show up positive when this hormone is present in a women’s urine.

For the Indian trial, researchers used a protein similar to the tetanus toxin as a carrier for the hCG. This would then cause the woman’s immune system to eliminate hCG to prevent pregnancy. The process was reversible, though.

An American anti-abortion organisation, claiming support from the Vatican, used this information to call for a congressional investigation into Mexico’s tetanus vaccination programme. Human Life International claimed that the tetanus vaccine being administered contained hCG which would leave women infertile.

The organisation questioned repeated vaccinations, why women were targeted and why women of childbearing age were “being treated as nothing more than uninformed, unwitting, unconsenting guinea pigs”.

But the WHO said there was “no connection” between their tetanus vaccine programmes and the Indian trial, which was “not sponsored, supported, nor executed” by them.

(Note: In Africa, the origin of tetanus vaccine skepticism appears to be a Catholic mission hospital in the southern part of Tanzania. The hospital’s medical director read about the tetanus vaccine rumours and shared it at a regional meeting in 1994.)

‘Rumours totally without any scientific basis’ - WHO

After the rumours spread, some people used home pregnancy kits to detect for hCG in the tetanus vaccine. This method is inappropriate, as it is designed for use on urine or blood serum, not vaccines.

Nonetheless, because of this, low levels of hCG-like activity was detected in the vaccines. But when proper lab tests were conducted on the vaccines in six laboratories around the world - including a lab chosen by the Vatican - no hCG was found.

The WHO then said in a statement: “These rumours are completely false and totally without any scientific basis”.

When the rumour resurfaced in Kenya in 2014 the WHO again issued a statement saying that the tetanus vaccine is safe: “The vaccine has been used in 52 countries, to immunise 130 million women to protect them and their newborn babies from tetanus. There is no hCG hormone in tetanus toxoid vaccines.”

So what’s triggering the rehashing of refuted claims?

Dr Heidi Larson - who previously headed UNICEF’s Global Communication for Immunization and is currently based at the London School of Hygiene and Tropical Medicine - focuses on managing risks and rumours about health programmes and technologies, particularly vaccines.

Facts alone won’t stop the rumour from resurfacing, she told Africa Check. Larson pointed out that the bishops probably felt excluded when the Catholic Church were not represented on a couple of health ministry committees, as they claimed in a press statement.

A researcher on managing the communication of health programmes at the London School of Hygiene and Tropical Medicine, Dr William Schulz, said that while it is dangerous to generalise about an entire region like Africa “there is good evidence that ‘sterility stories’ have a lot of resonance with the general public in many African countries”.

“Furthermore, these controversies tend to thrive when the vaccination programme is organised or supported by a former colonialist nation that left a lot of long-lasting unpleasant memories. Under these circumstances, a public leader who promotes suspicion about the vaccine benefits politically, since they are in a way demonstrating their independence from outside influence,” he added.

“Finally, a vaccine-suspicious leader benefits by appearing to be concerned for the welfare of the public, even if they turn out to be wrong in the end.”

Why we must - and Africa Check will - keep debunking rumours

However, promoting suspicion of vaccines for whatever reason can have severe consequences. This happened in Nigeria in 2003, when the country was on the brink of eradicating polio.

In that year, a group of religious and political leaders in northern Nigeria advised their followers against having their children vaccinated against polio. They claimed that the vaccine would make them infertile as part of a Western-led plot to reduce the population in the Muslim world.

Tests on the vaccines showed the claims were baseless. But the media still reported the claims without checking and, by the time they were withdrawn, the damage had been done. Polio surged from 202 cases in 2002 to 1,122 cases in 2006.

The episode planted the first seed of Africa Check in the mind of our founder, Peter Cunliffe-Jones. “It’s a very practical example of the failure of us as journalists to carry out our fuller, proper duties of not simply reporting what people say, but looking into them,” he said.

And that’s why Africa Check will continue looking into and debunking dangerous rumours.


Additional reading Is a Kenyan tetanus vaccine campaign really a secret sterilization effort?

Vaccines for women for preventing neonatal tetanus (Review)

Performance and potency of tetanus toxoid: implications for eliminating neonatal tetanus

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