Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 15, Number 6—June 2009

Religious Opposition to Polio Vaccination

On This Page
Article Metrics
citations of this article
EID Journal Metrics on Scopus

Cite This Article

To the Editor: In 1988, the Global Polio Eradication Initiative was formed, with the aim of reducing infection with poliomyelitis virus. Two decades later in 2008, a total of 1,625 children contracted acute flaccid paralysis caused by poliovirus infection (1). This finding represented a 150% increase over the number of cases in 2007 (1) and resulted in the reemergence of polio as one of the world’s deadliest infections. As of 2009, polio remains endemic to 4 countries (India, Nigeria, Pakistan, and Afghanistan); in 2008, cases were also detected in 14 other countries.

Religious opposition by Muslim fundamentalists is a major factor in the failure of immunization programs against polio in Nigeria (2), Pakistan (3) and Afghanistan (4). This religious conflict in the tribal areas of Pakistan is one of the biggest hindrances to effective polio vaccination. Epidemiologists have detected transmission of wild poliovirus from polio-endemic districts in Afghanistan, most of which are located in the southern region of this country bordering Pakistan, to tribal areas of Pakistan (4). This transmission has resulted in new cases of polio in previously polio-free districts. The local Taliban have issued fatwas denouncing vaccination as an American ploy to sterilize Muslim populations. Another common superstition spread by extremists is that vaccination is an attempt to avert the will of Allah. The Taliban have assassinated vaccination officials, including Abdul Ghani Marwat, who was the head of the government’s vaccination campaign in Bajaur Agency in the Pakistani tribal areas, on his way back from meeting a religious cleric (5). Over the past year, several kidnappings and beatings of vaccinators have been reported. Vaccination campaigns in Nigeria and Afghanistan have also been hampered by Islamic extremists, especially in the Nigerian province of Kano in 2003, which has resulted in the infection returning to 8 previously polio-free countries in Africa (2).

Before the Global Polio Eradication Initiative in 1988, a total of 1,000 persons/day were infected with a virus that would cripple them for the rest of their lives (6). To eradicate the disease, 1 major factor will be to gain support of those susceptible to fundamentalist propaganda. Islam is a progressive religion, and religious leaders should be asked to support polio eradication programs. The Imam of the Ka’aba and other influential religious figures should be asked to highlight the plight of children with polio. Vaccinators operating in conflict-ridden areas should be provided protection so that they are better able to perform their duties. Not only will children in these areas be safer, but the disease will not be exported to areas where wild polio transmission has been interrupted by vaccination. Further study of the attitudes of Muslim populations toward vaccination is needed.


Haider J. WarraichComments to Author 
Author affiliation: Aga Khan University Medical College, Karachi, Pakistan



  1. World Health Organization. Wild poliovirus weekly update. 2009 Jan 14 [cited 2009 Jan 17]. Available from
  2. Kapp  C. Surge in polio spreads alarm in northern Nigeria. Rumours about vaccine safety in Muslim-run states threaten WHO’s eradication programme. Lancet. 2003;362:16312. DOIPubMedGoogle Scholar
  3. Ahmad  K. Pakistan struggles to eradicate polio. Lancet Infect Dis. 2007;7:247. DOIPubMedGoogle Scholar
  4. Centers for Disease Control and Prevention. Resurgence of wild poliovirus type 1 transmission and consequences of importation—21 countries, 2002–2005. MMWR Morb Mortal Wkly Rep. 2006;55:14550.PubMedGoogle Scholar
  5. DailyTimes. Health workers boycott polio vaccination in Bajaur Agency. 2007 Feb 20 [cited 2009 Jan 17]. Available from\02\20\story_20-2-2007_pg7_29
  6. Cochi  SL, Kew  O. Polio today: are we on the verge of global eradication? JAMA. 2008;300:83941. DOIPubMedGoogle Scholar


Cite This Article

DOI: 10.3201/eid1506.090087

Related Links


Table of Contents – Volume 15, Number 6—June 2009

EID Search Options
presentation_01 Advanced Article Search – Search articles by author and/or keyword.
presentation_01 Articles by Country Search – Search articles by the topic country.
presentation_01 Article Type Search – Search articles by article type and issue.



Please use the form below to submit correspondence to the authors or contact them at the following address:

Haider J. Warraich, Aga Khan University Medical College, Rm 26, Male Hostel, Stadium Rd, Karachi 34800, Pakistan

Send To

10000 character(s) remaining.


Page created: December 08, 2010
Page updated: December 08, 2010
Page reviewed: December 08, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.