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Religious teaching blamed for diphtheria outbreaks

Jakarta Post - June 17, 2015

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Hans Nicholas Jong and Ina Parlina, Jakarta – With faith-based opposition to vaccination drives having contributed to outbreaks of diphtheria in some provinces, physicians are calling on parents to prioritize the health of their children over dogmatic adherence to religious teachings.

The Indonesian Pediatrics Association (IDAI) said on Tuesday that Muslim communities in some province had resisted vaccination, as they believed that the program was a conspiracy and that the materials used in the vaccine were not halal.

"There have been many negative responses to vaccination since 2012. Social media makes it easier to spread doubt. In Muslim communities, some believe that vaccination is part of a Jewish conspiracy and that it is haram," IDAI secretary Piprim Basarah Yanuarso said on Tuesday.

Opposition to vaccination had resulted in diphtheria outbreaks in Padang, West Sumatra, and Aceh, he said, claiming the lives of at least four children. Padang and Aceh are home to majority Muslim populations.

In Padang, 62 people are suspected to be infected, with six diagnosed positive and two dead, while in Aceh, 16 are infected and two have died from the disease. The city of Padang has declared the outbreak of diphtheria a public health emergency.

"When we traveled to Padang [during the outbreak], officials from the local health agency explained that there had been growing opposition to vaccination. People there deemed vaccines haram after hearing certain people saying so at the mosque. In strongly religious regions, these rumors are quite effective in turning people against immunization," Piprim said.

Data from the West Sumatra health agency show the immunization level of the province plunged to 35 percent in 2013, down from 93 percent in 1992. Meanwhile, in Aceh, the IDAI found that only two in 10 mothers wanted their babies vaccinated.

There were 432 cases of diphtheria reported in Indonesia in 2006. By 2014, the figure was down by 8.7 percent to 394 cases, 74 percent of which involved children under 15.

"The immunization level only needed to take a small hit, such as from 80 percent to 60 percent, for an outbreak to happen, as has happened in Padang and Aceh," Piprim said.

Diphtheria, like polio, had successfully been eradicated in the country before the outbreak in Aceh and Padang.

The Health Ministry's director general for disease control and environmental health, HM Subuh, called on people to lower the tone of religious teachings. "People should prioritize the safety of our children rather than getting bogged down in questions of halal or haram," he said.

In 2008, the Indonesian Ulema Council (MUI) declared a GlaxoSmithKline vaccine used by pilgrims to avoid meningitis to be haram, as it contained swine enzymes.

In 2010, the MUI defended its fatwa, declaring that two other brands of the meningitis vaccine were halal, and dismissing experts' claims that no vaccines for the disease were porcine-free.

Besides meningitis, two other vaccines contain swine enzymes, polio and rotavirus, the most common cause of severe diarrhea, according to Piprim, the founder of a medical facility offering affordable immunization.

MUI chairman Din Syamsuddin said on Tuesday that he stood by the fatwa. "The MUI has long been dealing with the issue. Therefore, we expect, through MUI's fatwa, that vaccines containing swine elements will no longer be used, except in an emergency," he said.

Source: http://www.thejakartapost.com/news/2015/06/17/religious-teaching-blamed-diphtheria-outbreaks.html.