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In Karachi, Pakistan—one of polio’s last strongholds—door-to-door vaccination campaigns arouse suspicion even among those who favor immunization. Rumors spread that the vaccine sterilizes children, fueled by mistrust of governments and international organizations.

Their suspicions are not unfounded. Svea Closser’s research found vaccine refusals pervaded when “when a lot of emphasis was placed on polio in a context where other health services were neglected”—meaning many children miss out on the full course of immunization.

Hence, while fundamental services like basic health care, sanitation, and infrastructure “are not sexy,” Closser writes, they must be prioritized if disease-specific programs are to be successful.


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