Locals have resisted polio vaccine campaigns in some places

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[LONDON] Fears of a growing mistrust of vaccinations in developing countries have led academics to set up a 'listening station' that monitors local responses to new immunisation campaigns.

Researchers at the UK-based London School of Hygiene and Tropical Medicine (LSHTM) are hoping their system will alert them when concerns have passed thresholds beyond which there may be a risk to the smooth implementation of a programme.

"I have been seeing an increasing number of episodes of communities, governments and individuals questioning vaccines and refusing them, even in some of the poorest countries," said Heidi Larson, senior lecturer at LSHTM and principal investigator for the project.

"After several years of fire-fighting, I started to see patterns where early intervention could have prevented boycotts," she said.

The project started in November 2009. Data are collected from local media, official and local observer reports and categorised by country, source, type of disease, vaccine and issue raised.

Risk is allocated to three categories, ranging from a potential problem requiring more data-gathering, to immediate action being needed to prevent vaccine refusal.

In Kenya, the researchers are piloting a 'listening system' model that documents local opinion as it emerges following the launch of the pneumococcal vaccine last February.

Today, mobile phones, the Internet and social media are providing new methods of self-organisation for those on all sides of vaccine debates.

Larson and colleagues recently published a case study in The Lancet examining the suggested link between the tetanus vaccine and sterility that disrupted immunisation campaigns across the world and led to a 45 per cent drop in coverage in the Philippines between 1994 and 1995.

They found that the Internet had been crucial in allowing the pro-life Catholic group Human Life International to communicate these fears to its members in over 60 countries, including Mexico, Nicaragua and the Philippines.

The eruption of fear usually results from underlying social and political issues, said the researchers. When fears arose in Uttar Pradesh in India that the polio vaccine might induce sterility, analysts found that mistrust revolved around the person administering the vaccine — often non-local men.

"When you have a group that is marginalised and is very conscious of its marginalisation, it is not a surprise that they would be more suspicious of government-driven initiatives," said Larson.

Thomas Abraham, director of the public health communication programme at the University of Hong Kong, said: "I think that any tool that tells you that there is a problem is useful".

"The question then becomes, what are you going to do about these rumours?"

He said that communication needed to be the starting point for any public health programme. "Health communication, especially around vaccines, is still very much in the dark ages."

Link to case study in The Lancet (free registration required)