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Vaccines only work if they’re actually used

A simple fact: The main obstacle to a world free of polio is not science, biology or virology. Rather, it is guns, fear and fake news. The world's long and ambitious quest to conquer polio has come tantalizingly close to success, only to slip away because of unforgivable behavior by thugs and exponents of ignorance. To defeat the polio virus, the world must also defeat human behavior of the worst sort.

The most recent and glaring example of this came in shootings and panic that rocked the polio vaccination campaign in Pakistan, one of only three countries where polio is endemic. The others are Afghanistan and Nigeria. Pakistan has made serious strides in vaccinating against poliovirus, which is highly contagious, largely strikes children under age 5 and can cause permanent paralysis. In a vaccination drive that ended April 27, Pakistani workers were able to reach more than 37 million children, nearing the target of 39 million. Pakistan has wisely enlisted Muslim religious scholars to endorse the vaccination campaigns. But there are still pockets of hard-line Islamist forces that spread irrational beliefs that vaccines are either contaminated or are part of a Western plot to sterilize Muslims, and they promote violence.

A mob set fire to a government health facility in Peshawar on April 22 after rumors spread that expired vaccination drops were being administered to children. Officials said the vaccine was neither expired nor dangerous, but still, thousands of parents swamped local hospitals and demanded their children be examined. One day after the health facility was burned, a police officer guarding health workers was killed. The next day, another police officer was killed. At least 700,000 families have refused polio vaccination in the province that includes Peshawar because of rumors and panic.

On April 25, two gunmen on a motorcycle shot and killed a polio vaccinator in the southwestern Pakistani city of Chaman. All the incidents have a knock-on effect, causing delays and suspensions in the vaccination campaign, which in turn leads to swathes of population not being inoculated, making them vulnerable to infection.

The trouble is not only gunmen. Social media easily spreads alarmist and false rumors about vaccinations. Pakistani officials noticed a wave of vaccination refusals recently - up to 10,000 a day in Islamabad, compared with 200 to 300 in the previous campaign. Babar Atta, a Pakistani official leading the effort, said that anti-vax propaganda on Facebook was becoming a major obstacle to eradication of poliovirus, and called on the platform to take down offending posts.

In the age before vaccines, millions of people were afflicted by disease and there wasn't much they could do about it. Nowadays, vaccinations are a critical firewall against illness caused by polio, measles and Ebola. But vaccines only work if people are inoculated - and they won't be if frightened by false information on social media or gunmen on a motorcycle.