Lots and lots of prior research, as well as direct experience talking to people who run these kinds of experiments. It's practically the #1 most common theme you will hear from anyone who has run a public health campaign in a third-world country.
Just for example [1]: "From the onset, Northern Nigeria presented an extreme challenge. The transmission of polio in Northern Nigeria was due to complex health, economic and social issues such as poor demand for and access to health services, low immunization coverage, few available skilled health workers, extreme poverty, low literacy, and community resistance to immunization and government services. Other factors such as the safety of the vaccine, religious factors, and community distrust of government health systems played a major role in increasing transmission. This led to a reemergence of polio in Nigeria, especially in the Northern states. Even in areas where polio immunization was not controversial, failure to engage parents and discuss why a fully vaccinated child may develop polio disease, for instance, reinforced and increased parents’ negative perceptions of the polio program."
> "mysterious doctor-magician", do you think about what you're implying here?!
I'm not implying anything. I'm saying it explicitly. I'm certainly exaggerating for effect, but I'm saying it explicitly: lots of people in poor countries are fearful of medical professionals.
I don't know why that's surprising -- it's true right here in the USA, as well, and one of the reasons why certain ethnic groups have disproportionately bad medical outcomes.
> less likely to believe in anti vax or other anti science prkpaganda across all classes
Oh, stop. Nobody in this discussion is "anti science" -- I have a doctorate, in a biological science. Nor am I "anti-vax".
It's helpful if you don't characterize people who critically analyze research with an entire class of fictional villains. Because that actually is what scientists do.
Just a quick clarification, I was not accusing you of being anti-science or anti-vax. I was using that as a short-hand for people the who don't want to get vaccinated, I'm sorry if I gave you the impression that I'm talking about you.
Regarding the "reaching only people based on certain educational background" I think choosing a citation about northern Nigeria is quite selective. The assertion that people in Africa are more vaccination skeptical seems to be a gross overgeneralisation and is vaccination acceptance rates vary greatly between countries (not surprising as this is the same in the developed world as well).
> I'm not implying anything. I'm saying it explicitly. I'm certainly exaggerating for effect, but I'm saying it explicitly: lots of people in poor countries are fearful of medical professionals.
Well your choice of language certainly makes an association to stereotypes of "superstitious primitives"
> I don't know why that's surprising -- it's true right here in the USA, as well, and one of the reasons why certain ethnic groups have disproportionately bad medical outcomes.
Yes some ethnic groups, would these somehow be more likely to engage with the medical professionals that engage with the control groups, or go to the hospitals while being opposed to the "mysterious doctor-magicians"? Also the modern "health-suspicious" population in the USA (and other developed nations) is primarily composed of well off, well educated socio-economic backgrounds, e.g. just look at where recent measles outbreaks happened.
Lots and lots of prior research, as well as direct experience talking to people who run these kinds of experiments. It's practically the #1 most common theme you will hear from anyone who has run a public health campaign in a third-world country.
Just for example [1]: "From the onset, Northern Nigeria presented an extreme challenge. The transmission of polio in Northern Nigeria was due to complex health, economic and social issues such as poor demand for and access to health services, low immunization coverage, few available skilled health workers, extreme poverty, low literacy, and community resistance to immunization and government services. Other factors such as the safety of the vaccine, religious factors, and community distrust of government health systems played a major role in increasing transmission. This led to a reemergence of polio in Nigeria, especially in the Northern states. Even in areas where polio immunization was not controversial, failure to engage parents and discuss why a fully vaccinated child may develop polio disease, for instance, reinforced and increased parents’ negative perceptions of the polio program."
> "mysterious doctor-magician", do you think about what you're implying here?!
I'm not implying anything. I'm saying it explicitly. I'm certainly exaggerating for effect, but I'm saying it explicitly: lots of people in poor countries are fearful of medical professionals.
I don't know why that's surprising -- it's true right here in the USA, as well, and one of the reasons why certain ethnic groups have disproportionately bad medical outcomes.
> less likely to believe in anti vax or other anti science prkpaganda across all classes
Oh, stop. Nobody in this discussion is "anti science" -- I have a doctorate, in a biological science. Nor am I "anti-vax".
It's helpful if you don't characterize people who critically analyze research with an entire class of fictional villains. Because that actually is what scientists do.
[1] https://www.ajtmh.org/configurable/content/journals$002ftpmd...