COVID-19 and Vaccination Campaigns as “Western Plots” in Pakistan: Government Policies, (Geo-)politics, Local Perceptions, and Beliefs

Abstract

Vaccination encounters multiple context-specific challenges—socio-cultural, economic, and political—that substantially affect its uptake. Likewise, natural disasters and health emergencies considerably impact immunization endeavors, such as the coronaviurs 2019 (COVID-19) pandemic that has overwhelmed the entire world. It was already anticipated that the pandemic would severely affect Pakistan's vaccination programs due to interruptions in routine vaccination and the overstretching of healthcare systems. Consequently, there are anticipations of outbreaks of other vaccine-preventable diseases (VPDs). Yet empirical evidence is missing. Drawing on qualitative research, this article focuses on the impact of COVID-19 on routine vaccination programs in Pakistan. Our data come from a small village located in Pakistan's Sindh province where local people refused the routine polio vaccine that was stopped for a while, then resumed in July 2020. They suspected both the vaccine and COVID-19 to be a “Western plot.” We argue that these perceptions and practices can be seen against the backdrop of economic, socio-cultural, and (geo)political forces, which are encoded in “societal memory.” Not only is there a need to reverse the significant impacts of COVID-19 on routine vaccination by arranging supplementary immunization activities (SIAs), but also the government must deal with other pressing issues that affect the vaccination programs in the country.

COVID-19 Vaccination: Concerns About Its Accessibility, Affordability, and Acceptability

“…These complex processes may affect the vaccine's affordability, accessibility, and acceptability, especially in the face of the "infodemic" surrounding COVID-19 (4,5). For instance, many people in Pakistan have considered the pandemic "Western" "plot, " "political game, " or "fake" (6)(7)(8), and consequently, they have refused polio vaccination (9). Therefore, this commentary first provides an overview of the vaccination, the situational analysis of the COVID-19 vaccination, and factors that may affect its uptake, its such as various forms of disparities.…”

Doctors Dealing With COVID-19 in Pakistan: Experiences, Perceptions, Fear, and Responsibility

“…Nonetheless, Pakistanis, in general, do try to affect their destinies via prayer, the performance of religious rituals and, in the case of COVID, via the conscientious use of PPE—at least in urban areas, rural people living in small communities are far less likely to use PPE and far more likely to use ritual and prayer. Some rural people in Sindh province do not even believe that COVID-19 exists; they too consider it to be a “Western plot” or conspiracy ( 33 ).…”

“…Although it has been mentioned by several studies [e.g., ( 32 , 33 )], in this section, we provide a brief overview of COVID-19 in Pakistan, and especially in Sindh province, to give our readers an idea of the overall situation with which our interlocutors are having to cope. Pakistan reported its first infection of COVID-19 in two men who returned from Iran on February 26, 2020.…”

Improving the Covid-19 Vaccination Rate in Pakistan—A Multipronged Policy Approach

“…In Pakistan, the Covid-19 vaccine hesitancy is a real challenge amid all the rumors and disinformation about the vaccine (1). As a researcher who is witnessing the reckless manner in which Pakistanis are reacting to the vaccine (2), the observation raises red flags and grave concerns for fellow countrymen.…”

“…Compared to the first three waves (8,9), the fourth wave of Covid-19 has been extremely lethal (10), causing a severe strain on the already burdened healthcare system in the country. Hesitancy toward the Covid-19 vaccine, driven by various factors ranging from cultural and religious beliefs (2) and concerns about vaccines' side effects (11) to many half-baked conspiracy theories and social media rumors about the vaccine's reliability, origin, and efficacy, further adds to the strain (1,2). Consequently, the country has been able to vaccinate only 18.2% of its population, as per the recent statistics shared by the Government of Pakistan (10).…”