ON A pleasant morning earlier this month, the ground in front of the Palathingal AMUP school in Malappuram of Kerala was a sea of pink. Boys and girls in pink-striped shirts and kurtas and blue trousers strolled around the ground during a break from class. Many others looked out from the balcony on the first floor of the government-aided school.
A car arrived with several men and women in white lab coats and carrying bags. Once they entered the school, the loudspeaker announced that the immunisation programme would begin soon, and students were to come back to the classrooms.
“We have a daily target of 400 children. Let’s see,” a health inspector said.
By noon, the optimism had given way to concern. In two days of the camp, only 191 of nearly 700 students got a booster dose.
“What a worrying situation!” said headmistress Jayashree, her head in her palm.
In many schools in Malappuram, a Muslim-majority district, health officials, teachers and doctors are racing against time to ensure 100% coverage of the government’s month-long measles-rubella (MR) vaccination programme that began on October 3. Way short of targets, the government is ready to extend the deadline from the current November 3, PTI quoted Health Minister K K Shylaja.
Of the targeted 76 lakh children in the age group 9 months to 15 years, only 44.30 lakh, or 58%, had been covered in Kerala until October 28. “I am told that the vaccination rate is slightly low in some districts like Malappuram, Kozhikode and Kannur,” Shylaja told PTI. In Malappuram, only 34% (4.27 lakh) had been vaccinated until October 28.
“The anti-vaccine lobby has always been very strong in Malappuram,” Dr Jinesh P S, a prominent medical activist, told The Indian Express. “They hold meetings here and circulate fake messages on WhatsApp. They spread rumours that if you take the vaccine, you may not live long. But the truth is that life expectancy in Kerala has risen above 70 because of vaccination. Somehow, we were not able to clear the doubts of the people.”
Health officials told The Indian Express that a major impediment in Malappuram is fake messages allegedly circulated by some doctors, activists and naturopathy physicians, and intended to churn resistance. “Some parents are asking us how much money we make by vaccinating a child,” said Usha Kumari, a health inspector who oversaw the immunisation drive at the school.
She said in spite of positive campaigning by religious and community leaders, people are unconvinced. “They think this campaign is sponsored by the US government or that it’s a Zionist agenda,” she added.
Doubts that the vaccine is a form of “birth-control” or that it would lower life expectancy are also said to be spreading fear among the community. “Are you trying to eliminate us?” Nalini, an ASHA worker, recalled being asked by a Muslim parent at the school.
Several students at the school approached their class teachers and handed over chits in which their parents had scribbled a request that their child not be immunised. In one such chit, Haseeba, a mother, wrote in Malayalam: “Since there are diverse opinions about immunisation on social media, I refuse to permit the vaccination of my child Fathima, a student of class VI.”
Muhammad Koya, Fathima’s grandfather told The Indian Express via phone: “There has been an attempt to scare us. There are two opinions on WhatsApp and Facebook. Doctors who have done MBBS and MD have spoken in favour of both. So we stood neutral.”
Koya did want his granddaughter to get a booster shot, but said, “I heard that my son-in-law went to school to stop his daughter from getting immunised. That’s why I didn’t force this. If something happens to her, what will I tell him?”
Fathima’s father, Muhammad Rafi, said he wanted to clear his doubts first. “There is no clarity on technical things such as safety precautions being taken during immunisation and the temperature at which the vaccine is being kept. Give me two days, I will decide,” he said.
Umaibath, another parent not in favour of vaccination, told The Indian Express that she made the decision after seeing other parents do the same. “Diseases will come whether you get vaccinated or not,” she replied when reminded of the dangers of measles and rubella.
The state government has warned of strict action on people spreading anti-vaccination messages. “I heard there is a booklet against vaccination selling for Rs 30 in the local market. Also, a mother just came and asked about a child dying in Chemmad after vaccination. Where are they hearing this? It’s fake news,” a health inspector said.
For health professionals in Malappuram, the population size and the need to reach remote areas in this coastal Malabar district is also posing a challenge. “We cannot compare Malappuram with other districts. There are six to eight primary health centres in every block. We may need one or two weeks more,” said Sakina, the district medical officer.
“I took charge here on January 31 and I have attended several conferences and parent-teacher meetings. I feel the resistance is only among 5-10% of the population, 50% are confused. If we can convince them, I am sure they will come forward,” she added.
For the time being, health inspectors and doctors are trying to convince more parents to agree to vaccination through a second round of meetings. They are also working to spread a message through the children themselves.
Inside an open classroom at the school whose walls were plastered with paintings by children, a doctor spelt why taking the vaccine was important. “If you take the vaccine, you are protected for life. You have to do it for the progress of the society. Girl students should inspire others,” a woman doctor said.
Surendranath, the chief health inspector, was hopeful. “A child told me his mother had told him not to get immunised irrespective of who asks him to. But he said he will go back home and ask her again,” smiled Surendranath.