Poor routine immunisation could prove fatal for Sindh’s infants

Many parents fail to avail govt provided second and third pneumonia vaccinations

KARACHI: Nazia Tariq’s nine-month-old son contracted pneumonia – which is considered the number one infectious killer of children - a few days ago. Although he is now on the mend, Tariq still worries because he is her only son.

The child – a resident of Orangi Town - has been vaccinated against pneumonia once before – when he was six months old - and will be administered vaccinations twice when he is 10 and 14 months old respectively.

Dr Khalid Shafi, who is the Pakistan Paediatric Association general secretary, told The Express Tribune that it is a myth that vaccinated children cannot contract pneumonia. “Vaccination is against germs but there is a need to adopt safety measures to keep children safe from pneumonia as winter is approaching. “

What is pneumonia?

Pneumonia is a lung infection and is caused by bacteria or viruses. Dr Ali Saleem, who works as an assistant professor and infectious diseases specialist at the Aga Khan University Hospital, said some of the main symptoms are rapid breathing, shortness of breath, a child turning blue and if it does not feed. If the child has a fever it means they have severe pneumonia, he added.



Poor coverage in Sindh

Dr Saleem said routine immunisation coverage is poor in Sindh. Newborns till the age of five should be administered vaccines. “Newborns and children below the age of two years are at a higher risk of contracting pneumonia.”

He said there are three pneumonia vaccines administered to children at six, 10 and 14 months. In Sindh, almost 76% newborns are vaccinated but parents avoid the two other vaccines. Therefore, only 50% children receive the last vaccine, which increases the risk of pneumonia among children.

Dr Saleem says it is negligence on the part of both parents and expanded programme on immunisation centres. “We should provide routine coverage in schools too and keep record of children who have been vaccinated.”

The government has failed to convince parents and there is a need to incentivise them and create awareness about the importance of routine immunisation, said Dr Saleem.



Dr Shafi said the government has provided free vaccines for children, yet they remain unvaccinated. “The coverage in Sindh has improved in the last two years. According to an estimate, it is now between 45% and 50%, which is still low and should increase to 90% if we really want to save our children. With short-term factors the situation can be improved,” he explained.

Invest in child health  

World Pneumonia Day is being observed on today (Sunday) across the world and this year’s theme is ‘Stop Pneumonia: Invest in Child Health’.

Dr Shafi said as far as providing vaccines is concerned, the government cannot be blamed. “The government’s facilities are underutilised when it comes to routine vaccination. There is a lot of negligence on the part of doctors, paramedical staff and parents too,” he said. “The government provides vaccines worth Rs24,000 to every child at birth but these vaccines are not utilised.”

Poor health seeking behaviour

Dr Shafi says it is a pity that people generally avoid taking children to doctors until their condition deteriorates. “Sometimes children are brought in a very bad condition where even injections don’t work on them.”



He added that about 30% to 45% children are malnourished and if they contract pneumonia they are likely to die. There is no dearth of food in the country, he said, adding that people do not know what and when to feed children.

Dr Shafi said pneumonia is a preventable disease but early detection and prompt decisions are a must to save the child’s life. “We need to motivate people and create awareness among the public about the importance of routine immunisation.”

In Sindh there are not enough doctors to provide health cover, according to Dr Shafi. He said a lot of people go to quacks and end up losing their children. “It’s not that pneumonia cannot be identified immediately, rather people only pay attention to symptoms when their children’s health starts deteriorating.”

Prevention

Dr Saleem says prevention is easy because vaccination is being provided at universal level. “These vaccines provided by the government are free and safe. “Breastfeeding is very important as it saves children from pneumonia. According to an estimate, only 38% of women in Pakistan breastfeed their children and more focus in on formula feeding which is not a good option.”



He adds children should be breastfed at least till the age of six months right from their birth. They should be protected from indoor pollution like burning of coal inside the house. “Improper use of anti-biotic can also cause pneumonia.”

MNA Zahra Fatemi told The Express Tribune that in Sindh there is no social commitment on the part of the government. Ensuring availability of vaccines is not enough and they should make sure every child is vaccinated, she said. “People will vaccinate their children if they know the importance of routine immunisation. Therefore, awareness campaigns should be launched. Diseases can never be eradicated unless our all children are vaccinated,” she warned.

The role of parliamentarians is that they should go to their constituencies and educate people about routine immunisation, Fatemi said. “I do play my part and others should do too.”