Stung by a Vaccination
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|Thu, 05-22-2008 - 1:16pm|
STUNG BY A VACCINATION
Ukraine is a country that continues to integrate into the world community, receiving assistance from other countries along the way. The donors gain, for example, by making Ukraine a better trade partner or preventing an outbreak of an infectious disease among its population. But sometimes the international assistance is not met with open arms - or even outstretched ones with rolled up sleeves.
On May 13, Ukraine's Health Ministry suspended an internationally sponsored vaccination campaign to prevent measles and rubella following the death of a 17-year-old boy in eastern Donetsk Region who had received the vaccination. To date, the Ukrainian authorities have provided no evidence of a link between the vaccination and the schoolboy's death; however, around ninety other young people who were given the same vaccination have since checked into hospital.
Last week, the Emergencies Ministry reported that around 85 mostly school kids in Donetsk Region were under hospital observation for signs of “a post-vaccination reaction.” All of them, from the city of Donetsk and the Donetsk Region town of Kramatorsk, had sought medical care on May 15-16. The vaccination campaign in Ukraine began on May 5. The Kramatorsk schoolboy died on May 12.
Health Minister Vasyl Knyazevich reported to President Yushchenko on May 17 that it was still impossible to say with certainty whether the vaccinations, which Ukraine had received free of charge through the United Nation's Children's Fund (UNICEF), were themselves at fault. In statements relayed by the president's press service, Knyazevich could only confirm that the continuing investigation had established that the 17-year-old had not been properly treated by local medical personnel.
Nevertheless, citing "public concern", the health minister said the suspension of the vaccination campaign would continue until the entire matter was cleared up. How long that will take, nobody knows. Knyazevich added that the investigation would be joined by "international specialists" but didn't specify whether these would include UNICEF officials. Currently, a deputy health minister is on the scene with a group of medics.
In other parts of the country, particularly Kherson Region, a much smaller number of individuals who had received the rubella/measle vaccination have checked into hospital, bringing the total number of cases to over 90. However, around a third of all hospitalized kids have since been released by doctors.
In keeping with international commitments, the Government of Ukraine ordered that Ukrainians between the age of 16 and 29 should be vaccinated against rubella and measles starting this month. Technical assistance, including training for local Ukrainian medics, was provided by the World Health Organization (WHO). The vaccinations were produced by an Indian company and prequalified by WHO.
In a joint statement released on May 20, WHO, UNICEF and the Centers for Disease Control and Prevention expressed “regret” that Ukraine had suspended its campaign to vaccinate children against measles and rubella. The international organizations warned that, “The decision will have long-term implications not only for the measles and rubella campaign but for routine immunization coverage resulting in the potential for outbreaks of other infectious diseases.”
In 2005-2006, Ukraine witnessed a severe measles outbreak, in which 50,000 young people were infected. This comprised 80 percent of the European measles cases for that period. In 2002, there was a serious outbreak of rubella in Ukraine numbering over 100,000 cases. On average, around 20,000 young Ukrainians get rubella each year.
The international organizations said that Ukraine would again experience outbreaks of the highly contagious diseases if it doesn’t restart vaccinations.
WHO has set itself the goal of eliminating measles and rubella in Europe by 2010 –a goal that Ukraine has committed itself to.
Rubella is a virus that affects the skin and lymph nodes. Although its effect on children is generally limited, it could cause birth defects in the babies of pregnant women who contract it.
Before a vaccine was introduced in 1969, rubella epidemics occurred every six to nine years. Non-immunized adults are most often infected.
Measles is a respiratory virus that causes a skin rash and flu symptoms. It usually runs its course in children within two weeks.
WHO and UNICEF said they particularly regretted that “The decision to suspend the campaign and withdraw vaccines from use was made prior to the receipt of the official results of the investigation.”
They said that the measles and rubella vaccine used in Ukraine is certified by WHO “and produced in accordance with the highest international standards by the Serum Institute of India, the largest producer of measles and rubella vaccine globally.”
According to WHO and UNICEF, two out of three children across the world get their vaccinations from the same manufacturer. The rubella vaccine has been used on 1.3 million people in Ukraine since 2002.
This year the vaccination administered in Ukraine was for rubella as well as measles.
But the UN and WHO stand behind its quality.
“This measles–rubella vaccine has an excellent track record and has been successfully used in countries across Europe and the Commonwealth of Independent States (CIS), immunizing over 34 million young people,” reads the joint statement.
In addition to the cessation of vaccinations, international authorities expressed concern about a loss in public trust in Ukraine.
Therefore the UN and WHO “strongly encourage health officials to handle this difficult situation in a transparent manner, so as to best serve the interests of the health of Ukrainian people.”
For their part, Ukrainian immunologists have reportedly argued that there was no urgent need to hold mass vaccination against measles and rubella in Ukraine in the first place, and that the Indian vaccine may be not be right for Europeans (i.e. Ukrainians).
No doubt the Ukrainian authorities were right in suspending the vaccinations - not so much for the single tragic death of the 17-year-old boy but because of the numerous health complaints that followed. If any more deaths had occurred, the government would have been roundly condemned for not taking action.
As it stands, either Donetsk Region has been hit by mass hysteria or something went wrong with the vaccination campaign. This, of course does not rule out local incompetence in the administering of the vaccinations. The only thing for UNICEF and WHO to do for now is find out exactly what happened, make sure the public is adequately informed, and take measures to prevent it from happening again. The sting has already been felt, now it's time to let the medicine work.