Uganda Rolls Out Compulsory Immunization to Dispel Anti-Vaccine Myths

"They said the vaccines are made out of pigs, wild animals, (that) our children will behave like wild animals." - Minister of Parliament (MP) Huda Oleru

This news article describes one approach to combating resistance to vaccination: passage of a law making it compulsory. Uganda's Immunization Act 2016 is an attempt to address the fact that one in five African children still does not receive all of the most basic vaccines he or she needs, with Uganda ranked lowest in east Africa for immunisation coverage. The Act prescribes fines, a jail term of six months, or both for parents who do not vaccinate their children in the age bracket of five days to one year old against tuberculosis, whooping cough, tetanus, hepatitis B, polio, and measles. The Act also requires the production of an immunisation card before admission to day care centres and pre-primary or primary education.

According to outgoing female MP Huda Oleru, the biggest obstacle to vaccination in Uganda is the 666 cult, made up of more 500 members and "growing" across the country, who refuse to immunise their children. Myths about the polio vaccine, for example, include the false belief that it sterilises the recipient. Oleru is continuing talks with the groups in eastern Uganda, and said she hoped that, eventually, they would come around. But, for now, the law is the "easiest way" of getting them to immunise their children.

There are other factors at play in addition to myths. Coverage is lower in the eastern part of the country, particularly in areas where there are very high hills and no transport. Children were also not being vaccinated due to shortages in a number of facilities at a district level, but Uganda was able to procure solar powered fridges to keep the vaccines in areas prone to power cuts. Furthermore, the influx of refugees from Burundi, the Democratic Republic of the Congo (DRC), and South Sudan, where immunisation rates are low, poses another challenge to Uganda.

According to the new Act, "the government shall provide free vaccines and other related services to every Ugandan required to receive vaccination." Dr. Henry Luzze, the deputy programme manager of the Uganda National Expanded Programme on Immunization (EPI), noted that the law both compels the government to make sure all the vaccination services are in place and "empowers CSOs [civil society organisations] to challenge the government", who could be taken to court over shortages. Luzze said he believed the law would be easy to enforce because "the president, the ministers, the parliamentarians, religious leaders" all supported it. International immunization experts such as Mike McQuestion, director of sustainable immunisation financing at Sabin Vaccine Institute in the United States (US), have praised the new legislation as a "textbook example of good governance....The way the Ugandans created this law was itself impressive," he told IPS. "Several public institutions had to work together to write it, vet it and push it through."

However, there has been some criticism from Ugandans that the law is too harsh, and during a March 2016 mass polio campaign, there were reports that about 2,000 children below the age of five missed out on immunisations in Karamoja, northeastern Uganda. Dr. Moses Byaruhanga, the director of medical and health services for Uganda's police, told IPS the authorities would go on radio talk shows to talk about the law, indicating they would be strict on it. "Police will be able to find out if (parents) did not take their kids for immunization," he said, adding health workers, local leaders, and schools would be the eyes and ears of the community. At least ten members of a Christian group were detained in May 2016 over refusing to vaccinate their children against polio.