Friday, May 6, 2011

Meseals vaccine deaths- need to think???



Friends
Since last March 2010, India lost 21 infants and children due to measles vaccination. These are the absolutely healthy babies who went for the routine vaccination and came as dead body at home. The details of deaths are as follow
On 17th March 2011 – Kutch, Gujarat – 5 infants deaths – Programme error
On 15th Sept 2010 – Gaziabad – 2 infant deaths – No investigation
On 22nd Aug 2010 – Lucknow,UP – 4 Infant deaths – Anaphylactic reaction
On 21 Aug 2010 – Maharastra – 2 infant deaths – post measles complication
On 23rd April 2011 – TamilNadu – 4 infant deaths - Anaphylactic shock
On 13th March 2010 – MP – 4 infant deaths – vaccine used after 3 hours

All deaths were tried to investigate but satisfactory answers are not available anywhere. This is most important weakness in our system. Each death is matter. In present changed era we can not afford to loose any child. Each and every infant and child is precious. The family size is reducing day by day. Two children or one child is norm rather exception. In such scenario if vaccine will kill our precious future generation, it is very high time to think about vaccine policy.
I have read some where that Government of India is revising vaccine policy. We have to keep few important aspects in current scenario.
1. We should not blame anybody in system for vaccines induce deaths, like suspension of vaccinator or worker or doctor. This is escapism from the root. On the contrary, we should protect our ground level staffs, who are really working very hard. They are working as vaccinator or workers as the technical representative of system.
2. All vaccine related deaths should openly discuss in system and all minor details should available on surveillance system like IDSP.
3. Don’t try to find cheap solution as routine we are doing. It is known to all of us that the measles vaccine may lead to deaths either due to anaphylactic shock or toxic shock syndrome, if proper care is not taken. So regular on job training of workers is must.
4. Most important is the emergency services. All vaccinators should have basic training of handling emergency. Measles vaccine should be given only those places where emergency trained staff available. This is most important. In western world also all types of reactions and complications are occurring with measles vaccine but death is rare phenomenon. Because they have good capacity of handling emergency. Do we have?
5. Open to discussion to all learned public health expert, pediatricians, sociologist and community at large.

3 comments:

Prabir said...

Quite balanced Niraj. There is a need to support and re-train health workers regularly. Also a role for emergency services. Almost all these cases are the same - vial open greater than 4 hours leads to toxic shock (vomiting and diarrhoea)- looks like anaphylxis (it is not)- counted as a programme error

funlok said...

Agree with Dr Prabir, but what about lost infant? Any compensation to family in terms of monitory or any other? Any assurance to community that such incidence will not occur in future?
Can't we work in this direction as public health expert?
Niraj

funlok said...

Dear Dr Neraj,
I am very happy for opening a topic.
Mortality and morbidity due to BCG occurred in Scandinavian countries, U.S and other developed countries. So they stopped giving BCG.
Attached files contain the published articles . How to finalise BCG as causative organism in immuno-competant / patients , is suggested in the articles.
--- Prof. Ashok Kale,