Deaths and vaccines
The government needs to move quickly and decisively if the measles vaccination drive is not to be knocked off track.
It would be wise to exercise a degree of caution around reports of linkages between measles vaccinations and the deaths of children that had received doses of the vaccine in Charsadda and Peshawar. The parents of the children who died claim that the vaccine was administered by mobile health teams and that their children began having an adverse reaction which ultimately led to their deaths. In one case, a doctor involved attempted to dispel the notion that the vaccine had caused the death, saying that reactions to the measles vaccine occur immediately after it is injected, while this particular child had died after a passage of 24 hours.
That said, clearly there is something amiss. There are reports of children falling unconscious after receiving the vaccine in Shangla and at a public school in Peshawar. Another 15 children are said to have fainted in Bazarkot. They were rushed to the district hospital but were discharged after being given first aid. The district health officer pointed out that out of 120 children vaccinated only 15 had a negative reaction, whereas if the vaccine itself was faulty then all those that were vaccinated from the same batch would have become ill. The cases have predictably created hysteria among local people, with some deciding against vaccinating their children.
A far more likely explanation in most cases, hysteria aside, is human error. There are strict protocols surrounding administration of the vaccine. One vial is to cover a maximum of 10 children, and a new syringe to be used for each dose. There are reports that this and other protocols were not observed strictly, and that some doses were administered intra-muscularly rather than subcutaneously, which affects absorption and may lead to adverse reaction. As we have seen with the polio campaign, disinformation quickly becomes the prevailing narrative. We cannot allow for this to be the case here. A spread of a measles epidemic is the last thing we need. The government needs to move quickly and decisively if the measles vaccination drive is not to be knocked off track.
Published in The Express Tribune, May 30th, 2014.
That said, clearly there is something amiss. There are reports of children falling unconscious after receiving the vaccine in Shangla and at a public school in Peshawar. Another 15 children are said to have fainted in Bazarkot. They were rushed to the district hospital but were discharged after being given first aid. The district health officer pointed out that out of 120 children vaccinated only 15 had a negative reaction, whereas if the vaccine itself was faulty then all those that were vaccinated from the same batch would have become ill. The cases have predictably created hysteria among local people, with some deciding against vaccinating their children.
A far more likely explanation in most cases, hysteria aside, is human error. There are strict protocols surrounding administration of the vaccine. One vial is to cover a maximum of 10 children, and a new syringe to be used for each dose. There are reports that this and other protocols were not observed strictly, and that some doses were administered intra-muscularly rather than subcutaneously, which affects absorption and may lead to adverse reaction. As we have seen with the polio campaign, disinformation quickly becomes the prevailing narrative. We cannot allow for this to be the case here. A spread of a measles epidemic is the last thing we need. The government needs to move quickly and decisively if the measles vaccination drive is not to be knocked off track.
Published in The Express Tribune, May 30th, 2014.