A new paper in the Journal of the European Economic Association, published by Oxford University Press, indicates that distrust generated by a 2011 CIA-led vaccination campaign ruse designed to catch Osama Bin Laden resulted in a significant vaccination rate decline in Pakistan.
Using a local doctor, the US Central Intelligence Organization planned an immunization plan in Pakistan to obtain DNA samples of children living in a compound in Abbottabad where American authorities suspected Bin Laden was hiding in order to obtain proof of Bin Laden's location (because the presence of close relatives would be a likely indication of Bin Laden's presence). Without consent from the Pakistani health authorities, the doctor began to administer hepatitis B vaccines to children in Abbottabad. The Guardian published an article revealing the vaccine project shortly after a United States military special operations unit killed Bin Laden on May 2, 2011.
Even prior to this campaign extremist groups in Pakistan have worked to discredit formal medicine and vaccines. By discrediting such services (which are provided by the state) extremist groups may increase the credibility of non-state actors such as the Taliban.
The Taliban increased propaganda efforts against vaccines in the aftermath of the publication of the Guardian article. In particular, the Taliban issued several religious edicts linking vaccination campaigns to CIA espionage activities and later used violent action against vaccination workers.
Using data from the Pakistan Social and Living Standards Measurement on children born between January 2010 and July 2012, researchers have investigated the effects of the disclosure of this vaccination ruse on the extent to which children in Pakistan received doses of the polio, DPT, or measles vaccine. Their estimates indicate that the vaccination rate declined between 23% and 39% in districts with higher levels of electoral support for an alliance of parties espousing political extremism relative to districts with lower levels of electoral support for such groups. The researchers' investigation also revealed that the decline in girls' vaccination rates is larger than the decline in the vaccination rate of boys.
"The empirical evidence highlights that events which cast doubt on the integrity of health workers or vaccines can have severe consequences for the acceptance of health products such as vaccines," said Andreas Stegmann, one of the paper's authors. "This seems particularly relevant today as public acceptance of the new vaccines against Covid-19 is crucial to address the pandemic."