World immunisation week: Of vaccines, war and confusing information

The World Immunisation Week comes this year, even as polio workers face death threats in regions like Pakistan and challenges in strife-torn places like Syria.

In another part of the world, public health workers are dealing with a measles outbreak in the United States, as they try to dispel fear stemming from reports linking the measles vaccine to autism.

Of the two, which proves to be the larger public health challenge – war or information that confuses people?

It depends on the region you are in, says Mathuram Santosham, Senior advisor at International Vaccine Access Centre and Professor at Johns Hopkins Bloomberg School of Public Health. “If you are in Pakistan or Middle East it is war and the anti-vaccine lobby is a non-issue. If you are in India or the developed world, it is the anti-vaccine lobby,” says Santosham, also a senior advisor with the Indian Health Ministry. The concern on measles vaccines and autism have been “well studied and analysed and there is no basis,” he adds.

The World Immunisation Week starts tomorrow and according to the World Health Organisation (WHO),vaccination annually averts 2 to 3 million infant deaths globally from diseases such as diphtheria, hepatitis B, measles, mumps, pertussis, polio and tetanus.

And yet, one in five children, or an estimated 21.8 million infants worldwide miss out on basic vaccines. And of them, nine million infants, more than one-third, live in WHO’s South-East Asia Region. For example, in 2013 about 26 per cent of the global measles deaths, almost 38 000, occurred in this region, 27 500 in India alone, the WHO says.

The immunisation programme in India has been strengthened and new vaccines targeting pneumonia, rotavirus and the pentavalent vaccine have been introduced. But information on the importance of vaccines is key, and this needs to be communicated to politicians, as the absence of vaccination directly hurts their constituencies, he says.

Responding to apprehensions of doctors and parents, who prefer that their children develop natural immunity rather than become “pin-cushions”, he says, it is an “understandable” sentiment. However, in cases like chicken pox or measles, there is a possibility the child can die of it. And no parent wants to take that chance, he adds.

Santosham places the responsibility of educating people and politicians at the doorstep of public health workers. “Companies can continue manufacturing the vaccines. But the recommending expert body need not recommend all vaccines for public use,” he points out.

And given the raging debate in the country on conflict of interest, when industry finds representation on expert bodies, he clarifies, industry is allowed to make presentations. But they do not have a say or voice on introducing a vaccine into a public health programme. That decision is by the committee of public health experts who have no links to the industry, he adds, emphatically.

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