Vaccine ineffective?: Cold chain broken, says EPI official

Store officer says cold storages not functional in 10 districts.

Ali Usman July 10, 2013
Epidemic: 185 children have died from measles in the Punjab, according to the Health Department. PHOTO: FILE


The quality of the measles vaccine used in the province has been called into question by the official who manages the cold chain for the Expanded Programme on Immunisation (EPI).

Dr Waqar Ahmed, the provincial EPI store officer, wrote to the EPI director for health services on June 28 stating that the executive district officers for health in 10 districts   Okara, Kasur, Vehari, Bahawalnagar, Gujrat, Sialkot, RY Khan, Jhang, Khanewal and Mianwali   had reported that cold storages were not functional.

The storage rooms in these districts were 10 of 14 built as part of a Unicef project to strengthen the vaccine cold chain in the Punjab. “[The] cold chain assistants of the federal as well as the provincial level were not involved in the installation process,” states the letter, a copy of which is available with The Express Tribune.

Keeping vaccine stored at low temperatures is essential to maintaining its potency, quality and safety. Cold storage backed up by generators is particularly important in view of the power crisis.

“If the cold storage isn’t working properly, nobody can guarantee the efficacy of the vaccine. Anti-measles campaigns have been launched in all these districts, but if the cold storage system isn’t available, one can certainly question the credibility of the anti-measles drive,” said a doctor who works at the EPI.

As many as 185 children have died and 21,817 have been infected over the last six months in an ongoing measles epidemic in the Punjab, according to the Health Department.

According to the EDOs of the 10 districts, states the letter, the cold storages are not functional because of technical reasons. “The cold rooms are of 220V having a single-phase connection with a three-phase 440V stabiliser and three-phase 440V generator, instead of the original requirement of a single-phase 220V stabiliser and single-phase 220V generator. As such, the operational cost of each unit is 10 times the original [estimate],” reads the letter.

Dr Ahmed called for the formation of a technical committee to investigate the functioning of the cold chain in 14 districts. “It is evident that Punjab’s share of GAVI Alliance (formerly known as the Global Alliance for Vaccination and Immunisation) funds is not being utilised in the best public interest ... a technical committee may be constituted to probe the matter for the smooth running of the cold chain system in 14 districts,” the letter states.

The letter was forwarded to the health secretary, the health director general, the national programme manager, the federal EPI Cell and others.

Dr Ahmed told The Express Tribune that he had attached the reports from the EDOs with the letter. So far, he said, he had received no official response. He said that he felt it had been his duty to write the letter.

EPI Director Dr Tanveer Ahmed said that the store officer should have reported any problems to him directly rather than writing a letter and forwarding it to officials in Islamabad and Lahore. “This is completely absurd,” he said.

He claimed that the cold rooms in 11 of the 14 districts were functioning properly and there was no need to form a technical committee. “The measles outbreak had nothing to do with this. Even when Unicef hadn’t installed these cold rooms, we had the capacity to maintain a cold chain,” he added.

Published in The Express Tribune, July 11th, 2013.

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