The Hindu : Kerala / Thiruvananthapuram News : Pulse Polio drive needs a booster shot

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Sunday, Jan 07, 2007
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Kerala - Thiruvananthapuram

Pulse Polio drive needs a booster shot

C. Maya

Growing resistance to mass immunisation drives in Idukki and northern districts

Thiruvananthapuram: Even as the State is holding another round of Pulse Polio drive on Sunday, health administration authorities fear that immunisation coverage may go down in northern districts and Idukki.

Over the years, there has been a growing resistance to such mass immunisation drives in these places. The reason cited is misinformation campaigns.

The death of a girl and hospitalisation of other students in her school in Kozhikode, allegedly following routine tetanus vaccination shots, has also cast a shadow over the Pulse Polio programme.

Though the authorities had said that the vaccine shots administered were safe, fears in the minds of people seem to have not been allayed. According to reports, in many places in Kozhikode, posters put up by the health authorities on the Pulse Polio campaign were destroyed.

Steady decline

The steady decline in routine immunisation coverage in the State over the past few years has been a cause for much concern among public health activists.

Strengthening routine immunisation coverage, observance of national immunisation days and surveillance of acute flaccid paralysis cases in the community are the major components in the polio eradication drive, launched by the World Health Assembly in 1988.

The slide in routine coverage, especially in the last four years, can affect Kerala's march towards polio eradication.

The State used to have the highest proportion of "fully vaccinated" children in the country in the past. The last National Family Health Survey (1998-99) put the proportion of such children in Kerala at 84 per cent, behind Tamil Nadu (92 per cent).

A 2004 study conducted by the Achutha Menon Centre for Health Science Studies in five districts reported that the State's immunisation coverage was 72 per cent. Malappuram had the lowest immunisation coverage at 36.5 per cent.

The figures quoted by UNICEF in its latest immunisation coverage evaluation survey, 2005, put the proportion of fully vaccinated children in the State at 82 per cent. The survey shows that immunisation coverage has been sliding in Idukki, Wayanad and Kannur.

The figures for 2006 also cannot be better, as community outreach programmes broke down last year following the six-month strike by Government doctors.

"Manpower shortage, infrastructure deficiencies such as lack of vehicles and general complacency among health workers regarding routine field activities that focus on prevention have all affected our routine immunisation programmes. Our records show that there has been an increase in number of measles and whooping-cough cases, two vaccine-preventable diseases, in some parts of the State," says P.K. Jameela, Deputy Director (Child Health).

The last case of polio caused by wild polio virus in the State was reported from Kondotty in Malappuram district in 2000. Since then, though there have been cases of acute flaccid paralysis in the community — 215 each in 2005 and 2006 — , none of these has been polio, according to officials.

But the Indian Medical Association's National Consultation on Polio Eradication, held in New Delhi in May 2006, noted that there was no rational explanation for the increasing number of such cases being reported from all parts of the country. It also expressed concern that no information was available in the public domain about polio that could be caused by the vaccine itself (vaccine-associated paralytic polio)

Public health activists have also been debating if Kerala needs to rethink its strategy on polio eradication, considering the fact that there has not been a single case of polio caused by the wild virus in the last six years.

However, officials argue that the outbreak of polio in Uttar Pradesh this year can be a threat to Kerala also, because of the movement of migrant labourers from there and Bihar.

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