SCOTT SIMON, HOST:
The eradication of polio, a highly contagious disease that can paralyze children, is considered one of the world's great vaccination success stories. It's been wiped out in most of the world, save for a few pockets, including Pakistan, where false rumors about vaccines are resulting in a resurgence of the disease.
NPR's Diaa Hadid reports from Rawalpindi on what this means for the country's rollout of the COVID-19 vaccine.
DIAA HADID, BYLINE: Four years ago, Pakistan was close to eradicating polio.
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UNIDENTIFIED PERSON #1: (Non-English language spoken).
HADID: Then, in a key moment, a video went viral that nearly upended Pakistan's mass vaccination campaigns. It showed a man shouting that children were becoming sick after taking the oral polio vaccine.
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UNIDENTIFIED PERSON #1: (Non-English language spoken).
HADID: Look, he shouts. They're unconscious.
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UNIDENTIFIED REPORTER: (Non-English language spoken).
HADID: It was picked up by journalists and broadcast to the country.
RANA SAFDAR: People started even making public announcements in the mosques - please don't get your children vaccinated - and it spread like fire.
HADID: Rana Safdar is a coordinator for Pakistan's polio eradication effort.
SAFDAR: There was some violence as well.
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UNIDENTIFIED PEOPLE: (Non-English language spoken).
HADID: Angry residents torched a hospital.
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UNIDENTIFIED PEOPLE: (Non-English language spoken).
HADID: Gunmen shot dead a security officer guarding polio workers, and the parents of around 3 million children refused to let them be vaccinated. And that helped the disease spread even further. Then the coronavirus pandemic began. Dr. Hamid Jafari is from the World Health Organization.
HAMID JAFARI: There was a nearly five-month pause in vaccination campaigns, which, of course, allowed the poliovirus to expand freely.
HADID: So from seven cases in 2017, the government recorded 167 cases of polio last year. Now Pakistan is trying to get back on track. In January, it held its first mass polio vaccination drive of the year, mobilizing tens of thousands of health workers to reach 40 million children.
UNIDENTIFIED PERSON #2: (Non-English language spoken).
HADID: Zeenat Parveen is vaccinating kids in alleyways in the city of Rawalpindi. She jostles alongside a hawker selling vegetables on a cart.
UNIDENTIFIED PERSON #2: (Non-English language spoken).
HADID: She clutches a clipboard and slings on her shoulder a blue cooler filled with vaccine vials.
ZEENAT PARVEEN: (Through interpreter) I have been vaccinating kids here for two days. Now I am checking to see if I missed any.
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HADID: She knocks on a door, but there's no response. So she barges in and beckons me to follow.
UNIDENTIFIED PERSON #1: (Non-English language spoken).
PARVEEN: (Non-English language spoken).
HADID: I'm from here, she says. Relax.
A woman slaps dough into flatbread in the kitchen. Parveen calls out to some kids who are loitering up the stairs...
FATIMA AKRAM HAYAT: (Non-English language spoken).
UNIDENTIFIED CHILDREN: (Non-English language spoken).
HADID: ...And she looks for an ink mark on their pinky fingernail, a mark that they've been vaccinated.
Outside, Zeenat scribbles on the door with chalk - four kids, vaccinated in January.
This is what the polio vaccination campaign looks like across most of Pakistan. Generally, it's only a small minority who refuse the drops, but even that allows the disease to spread. And it's not just refusals. Militants attack vaccination teams. During the January campaign, gunmen shot dead a policeman guarding vaccinators. Those against the vaccine largely believe it makes Muslim children infertile.
HAYAT: But it has really gotten hold - either the Jewish lobby or Americans trying to prevent Muslims from spreading their seed.
HADID: Fatima Akram Hayat is a health adviser to the Pakistani government. She says anti-vaccination sentiment is strongest in areas where people feel forgotten by authorities.
HAYAT: The government doesn't give a [expletive] about me, so why are these workers coming into my village and vaccinating my child? So it raises some suspicion.
HADID: So what does this mean for Pakistan's COVID-19 vaccine rollout? While some vaccinations began this week, thanks to a gift from the Chinese, it's expected to truly kick off in April. It means tens of thousands of health workers know how to do mass vaccinations. They know nearly every house in Pakistan, and they know how to monitor for vaccine refusals. But Hayat says if conspiracy theories take hold, they're in trouble.
HAYAT: Once a conspiracy theory gets hold or once people's minds are made up, it is much tougher to change them.
HADID: Already, there's a worrying sign. A recent poll says nearly 50% of Pakistanis don't want to get vaccinated.
HAYAT: It's like a game of Jenga. Everything might be going well, and then there's one conspiracy theory that takes hold or one thing we do wrong, and it can all come crumbling down.
HADID: Diaa Hadid, NPR News, Rawalpindi.
(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.
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