The Hindu : Kerala News : Need for effective immunisation programmes

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Tuesday, May 20, 2008
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Kerala

Kerala

Need for effective immunisation programmes

Routine immunisation coverage is sliding in Kerala, which holds the prospect of the
re-emergence of
vaccine-preventable diseases. The Health Department blames propaganda by the anti-vaccine lobby. Is there a crisis of confidence on the vaccination front? Our readers respond:

Matter of concern

The public health-care system, in recent times, has been struggling under the burden of multiple responsibilities. Infrastructure deficiencies, lack of fresh investment and inadequate manpower have made matters worse. A perceptible slackening of interest in immunisation is a matter of concern as it will adversely affect the goal of achieving the health-related ‘millennium development goals.’ Massive infusion of investments can revive the ailing public health-care system which has the primary responsibility to extend the ‘vaccine cover.’ The private health sector can support the efforts of the government in promoting affordable vaccination. There should be a State Immunization Register — a record of vaccination administered to each child born in institutions. This should be periodically updated and utilised to follow up cases so as to achieve universal immunisation. This should be developed as a database and used to evolve strategy. Certain sections of the population like tribal communities are vulnerable to misinformation campaigns. Given the proven track record of immunisation in preventing vaccine-preventable diseases, it should be extensively used and promoted.

V.N. Mukundarajan

Thiruvananthapuram

Action needed

Various studies show that vaccination compliance is declining in the State. There are reports of vaccine-preventable diseases such as diphtheria coming back. This situation warrants action. A case reported from somewhere does not mean that only one person is infected. There may be others who are, in medical parlance, asymptomatic or sub-clinically infected. Diphtheria and tetanus have become very rare in the State and hence most medical students do not get to see a case and the chances are that that they may miss the diagnosis as the index of suspicion is low. Also, the vital drugs to be administered for these diseases are immediately unavailable in the State. My feeling is that there are pockets of very low coverage which influence the statistics very adversely. The immunisation level in Malappuram has been very low for quite some time now. Most of the vaccine-preventable cases reported at Kozhikode Medical College are from Malappuram and Wayanad districts. At least in some places, anti-immunisation groups have contributed to the problem. The government’s attitude also needs to change. Top priority should be given to investigate the problems arising out of the immunisation programme.

P.N.N. Pisharody

Karunagapally

Restore confidence

The use of sub-standard vaccines in unhygienic conditions results in health problems. No sensible person would oppose immunisation by vaccines of proven effectiveness. Such a vital health measure as routine immunisation coverage for vaccine-preventable diseases should not get bogged down by differences of opinion. If the public has lost confidence in the efficacy of any immunisation campaign, the authorities should conduct awareness programmes backed by sufficient scientific and technical expertise to restore people’s confidence.

B.K.S. Nair

Thiruvananthapuram

Poor accessibility

There are places in the State where the people cannot avail themselves of the benefits of immunisation drives due to non-accessibility. A comprehensive door-to-door coverage is the need of the hour with the participation of local authorities such as panchayats.

Abhijith Unnikrishnan

Thiruvananthapuram

Reorient research

The stress laid on disease prevention through immunisation is on the decline. In our situation where a majority of the people depend on government facilities, this issue assumes great significance. The Pulse Polio immunisation programme is worth emulating. The near-perfect manner of covering huge numbers in a short span is commendable. The success of the programme is greatly attributed to the safety of the vaccine and the oral route of administration notwithstanding the customary requirement of cold-chain maintenance and the necessity to set up large number of immunisation booths managed solely by paramedical staff. Oral vaccines can go a long way in saving time, manpower, money and machinery. Vaccine research is to be oriented in such a way that more thrust is given to the development of oral vaccines.

K.C. Prasath

Thiruvananthapuram

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