There’s an interesting and troubling story playing out in Kenya, where the World Health Organization has been pitted against the Kenyan Catholic bishops over claims that a tetanus vaccination program is being used as a cover-up for a mass sterilization campaign. The bishops allege that they have evidence provided by the Kenyan Catholic Doctors Association, which claims to have sent samples to labs in South Africa, proving that the tetanus vaccine is “positive for the [pregnancy hormone] HCG antigen...They were all laced with HCG.”
The bishops and doctors warn that injecting women with HCG, which mimics a natural hormone produced by pregnant women, causes them to develop antibodies against it. When they do get pregnant, and produce their own version of HCG, it triggers the production of antibodies that cause a miscarriage.
The World Health Organization has strongly rejected these allegations: “These grave allegations are not backed up by evidence, and risk negatively impacting national immunization programs for children and women," wrote WHO's Dr. Custodia Mandlhate and Dr. Pirkko Heinonen from UNICEF. "WHO and UNICEF confirm that the vaccines are safe and are procured from a prequalified manufacturer," they said. "This safety is assured through a three-pronged global testing system and the vaccine has reached more than 130 million women with at least two doses of TT vaccines in 52 countries.”
Let me say this first: The bishops aren’t entirely unreasonable in their concern about fraudulent vaccination and sterilization programs—after all, it’s happened before. From 1909 to 1979, authorities in California forcibly sterilized tens of thousands of women in state institutions for the “feebleminded,” Latinas disproportionately among them, as part of a legalized eugenics program. Just a couple of years ago, the CIA used a polio vaccination program as a front for tracking down Osama bin Laden. And there’s a long history of medical programs being conducted without obtaining informed consent from test subjects. Whenever programs like these come to light, they have a long term effect on the trust communities place in the medical and public health organizations that are trying to reduce the spread of and eradicate preventable diseases in the world.
But does that mean this is what’s happening in Kenya? Not necessarily. In fact, the current fracas sounds suspiciously similar to a similar scheme alleged to have been carried out in the Philippines about 20 years ago. Then, as now, allegations were made by Catholic medical groups that a World Health Organization tetanus campaign was a mass sterilization exercise. Then, as now, WHO vigorously denied the allegations. So what’s going on? How did an ordinary vaccination campaign come to sound like a plot to a dark conspiracy novel?
It starts back in the early 1990s when a research paper was published on a clinical trial for a potential new contraception vaccine. The vaccine worked by basically provoking the human immune system into producing an antibody to a naturally occurring pregnancy hormone called hCG. Because the human immune system would not naturally produce such an antibody, the hormone must be carried on something else that will provoke the immune system. In this study, the researchers used tetanus toxoid and diphtheria toxoid. Why these? Simply put, they’re easy to work with; they can be grown easily in labs and they’re easy to deactivate. The trials seemed promising, preventing pregnancy effectively with few if any side effects, but ultimately the vaccine never made it to final testing and never went on the market, and today, 20 years later, there’s still no effective contraception vaccine available.
Just a couple of years later, while some of this research was still taking place, the World Health Organization conducted a tetanus vaccination program in the Philippines. Catholic health groups there raised objections to the vaccination program on concerns that it caused miscarriages and disrupted fertility cycles, leading to suspicions that it was a mass sterilization scheme.
In an interview earlier this year, Heidi Larson, head of the Vaccine Confidence Project of the London School of Hygiene and Tropical Medicine, said that the contraception vaccine studies were “misinterpreted by a Catholic pro-life network, which sent a message to Catholic communities in 60 countries telling them that the tetanus vaccine sterilized its recipients.” The network isn’t named in the interview, although a Catholic pro-life organization called Human Life International published a report in 1995, now archived on an anti-vaccination website, called Global Vaccine Initiative, with the very claims being made by the Catholic health groups in the Philippines in the mid-1990s—the same claims being made today in Kenya. Though the older allegations were likewise rejected by the World Health Organization and remain largely unproven, the consequences were dramatic:
Tetanus vaccine coverage fell around the world from Mexico and the United Republic of Tanzania to the Philippines, where the mayor of Manila halted tetanus vaccination—a move that led to a 45 percent drop in coverage. WHO officials even held a meeting at the Vatican to set the record straight and engage leaders of the Catholic Church to help dispel the rumours.
A precipitous drop like that can have grave consequences for public health. Global vaccination programs save the lives of 2 to 3 million people every year. Tetanus, while rare in the United States, still kills over 200,000 newborns every year, mostly in developing countries, which is precisely why women of childbearing age are specifically targeted for tetanus vaccination—even though the selection of this population group for vaccination is one of the factors that raised concerns both in Philippines 20 years ago and in Kenya today.
Gabriel Dolan, a missionary priest in Kenya, did not mince words in a recent column in Kenya's Daily Nation: “The bishops have so far not produced any evidence that the vaccine was a birth control method, but two million women targeted in the exercise deserve an explanation…The bishops have a moral duty to produce the evidence or apologise to women and Ministry of Health.” If in fact the bishops and the Catholic Medical Association are right about the tetanus vaccination program and they have the evidence to prove it, they must produce it for independent verification rather than merely claiming they have it; the confidence we place in global vaccination programs may depend on this information being brought into the light.
Unfortunately, this story sounds all too familiar to one that happened before, and if it turns out that the current controversy has its roots in misinformed analysis and anti-vaccination groups, then the credibility of the church may be damaged, and the lives of those in Kenya and beyond may be endangered.