A pamphlet circulating within the Jo’burg Muslim community that warns of the dangers of vaccination has been slammed by doctors and paediatricians, who say not vaccinating children puts them and the wider community at risk.

The pamphlet, titled “Islam, vaccines and health”, argues that vaccines are harmful and contain haraam substances, which Muslims are not permitted to use. It claims that vaccination is ineffective and based on “a long discredited theory”.

But local medical associations have warned that this type of information puts the most vulnerable in South Africa at risk.

The pamphlet in question has been printed and distributed by the Young Men’s Muslim Association in Benoni, but its origin lies a continent away.

The very same article has been circulating online for the past five years, and is attributed to Dr Abdel Majid Katme, a British psychiatrist who affiliates himself with the Islamic Medical Association (UK).

Katme’s tract first made the rounds in the UK in 2007. He urged Muslim parents to forgo vaccinations and to instead practise natural defences against disease. He suggested, among other things, frequent hand-washing, fasting, prayer and eating honey and black seed.

An internet search turned up a number of instances of Katme’s article. But it takes quite a bit more digging to find the voices of those who oppose Katme’s view.

An article in the British Medical Journal, which points out that the organisation Katme represents has no membership, staff or offices, and is only accessible to subscribers.

When the article was first published, Katme was criticised by the British Medical Association, the department of health, and Muslim groups in the UK who said his beliefs could lead to a rise in infectious diseases in Muslim communities.

The Islamic Medical Association of South Africa (IMA SA) has also spoken out against the information being put out. The organisation’s president, Dr Ebrahim Khan, told the Mail & Guardian that the IMA did not endorse this or any other anti-vaccination campaign.

“The IMA distances itself from any of these campaigns that advise people not to vaccinate,” he said. “The IMA position is that vaccination is an essential tool in the prevention of disease.”

Khan pointed out that in some cases, the same parents who opted not to vaccinate their children received vaccinations themselves as this is mandated for pilgrims who travel to Saudi Arabia for haj.

He appealed to those handing out the information to “refrain from misguiding people”.

Lobby groups simmer in South Africa

Vaccination became a cornerstone of modern medicine in the late 19th century. It has led to the eradication of the deadly smallpox virus and saved the lives of millions of children who in earlier times would have died or been permanently disabled as a result of complications from measles, whooping cough (pertussis) and polio.

Yet there is a small but vocal thread of dissent from people who choose not to vaccinate.

Some trace this anti-vaccination sentiment to the work of British surgeon and medical researcher Andrew Wakefield, who put forward the now-discredited theory that the MMR (measles, mumps and rubella) vaccine is linked to autism.

Wakefield’s theory took off in the 1990s and there was a subsequent drop in the rate of vaccination and an increase in illness and death from measles, mumps and rubella.

It was later found that Wakefield had falsified his research and had sought to launch a business selling diagnostic kits to parents who feared an adverse reaction to the MMR. He has since been barred from practising medicine in the UK.

Yet Wakefield’s influence lives on. Two years ago, a dangerous outbreak of whooping cough in the state of California in the US resulted in the deaths of ten newborns.

Polio, once on the verge of eradication, has also reared its head once more in Nigeria and Pakistan, where the edicts of religious leaders encouraged communities to refuse the polio vaccine.

Although seemingly centred in the US and UK, South Africa also has its share of parents who choose not to vaccinate.

Rosemary Burnett, a senior lecturer in epidemiology at the University of Limpopo at Medunsa, together with her colleagues, has recently started researching the phenomenon in South Africa.

“From anecdotal reports given to us by healthcare workers during the recent measles outbreak, it is clear that some parents are refusing to have their children vaccinated,” she said.

Although her team has not yet built up a clear profile of the people who choose not to vaccinate, or quantified their impact on vaccination uptake, preliminary research suggests they are mainly educated and white.

This seems to mirror the situation in other countries, where people who choose not to vaccinate are predominantly educated and upper-class.

The case against vaccination

Shakirah Gathoo is a mother of three and a former paramedic who has chosen not to vaccinate her children.

“The human body has the innate ability to fight off infections and illness itself,” she told the M&G. “I have a problem putting something that is basically impure into my body and the body of my children.”

Gathoo believes that contracting an illness or not is down to fate, and said she tries to protect her children by ensuring that they have ideal nutrition and are in peak health. She’s turned to alternative medicine in times of need and at one point nursed her toddler, who had contracted pneumonia, at home.

“It’s not that I don’t believe in medicine but as I’ve studied, I’ve realised the deficiencies in the conventional medical system,” she said.

Gathoo said in an ideal world, vaccine and conventional medicine like antibiotics would not be needed, but admitted that fighting illness with alternative medicine requires patience and perseverance and said it’s not something that would be right for everyone.

She said that in a country like South Africa, especially in informal settlements where nutrition, health, hygiene and sanitation isn’t up to scratch, vaccination does help.

But she defended her choice saying: “Different people have different points of view and some people’s views are stronger than others. They need to respect that as an individual it’s my decision.”

Her choice, she said, was informed and supported by her paediatrician.

Losing sight of the danger

But Dr Yaseen Joolay, a paediatrician at Groote Schuur Hospital in Cape Town, said many parents and even healthcare practitioners have lost sight of how dangerous infectious diseases, like measles, can be.

“Because we vaccinate and there’s less infectious disease, and less severe cases of it, its kind of gone out of people’s minds,” he said.

In developing countries measles kills one in five infected children. Globally, it causes pneumonia in one in 20 children and encephalitis — acute inflammation of the brain — in one in 2 000.

“To not vaccinate is akin to child neglect,” said Joolay.

Some children who are not vaccinated are spared childhood illnesses because their peers have been vaccinated against them. But Joolay warned that if vaccination rates continued to drop, this “herd immunity” will be eroded, allowing infectious diseases to gain a foothold in communities and spread.

“By not vaccinating, you’re putting the entire society you’re living in at risk,” he said.