By Eulalee Thompson, Staff Reporter
A vaccine is still one of the safest and most cost-effective ways to prevent disease but many Jamaican children are slipping through the cracks.
IMMUNISATION COVERAGE for the common infectious diseases has fallen below targets set under the Expanded Programme on Immunisation (EPI) and this now concerns health officials.
Dr. Karen Lewis-Bell, Director of the Health Ministry's Family Health Services, indicated that the expected coverage in 2003 was 100 per cent for the common infectious diseases among the target population of children but she said that in many areas the coverage has fallen below 80 per cent of target group.
She said that the EPI is facing many challenges and concerns, including reaching those at risk in the inner city and violence-prone areas; improving coverage in all parishes; dispelling myths about vaccination; enforcing the immunisation regulations and competing with religious and alternative medicine beliefs. There are other challenges too related to the cost of ongoing training of health officials and sustaining the public education and mass media campaigns.
Some possible explanations which Dr. Lewis-Bell identified for the existing fear about immunisation among some group, ironically relate to the general success of vaccines in controlling disease spread.
"The immunisation programme has been successful so parents have forgotten features and severity of the diseases; parents and many health practitioners have never seen many EPI diseases and other diseases are of more concern now, such as AIDS," she said.
Myths about vaccination continue to circulate globally in spite of scientific research that can reasonably dispel them. One persistent myth suggests a link between MMR vaccine and the development of autism a mental disorder in children. Several studies which were conducted in the United Kingdom, USA, and Sweden have concluded that the clinical and scientific evidence cannot confirm the link. The scientists instead suggest that persons may be making an association between the vaccine and disease onset because the MMR vaccine is given to children between 12 and 15 months, the development period when talking and social interaction begins, but also the period when they will be diagnosed as autistic, when these developmental milestones are not reached.
FEAR OF AIDS
Other fears surround the contamination of vaccines with the human immunodeficiency virus (HIV), the virus that causes AIDS. These fears persist though the scientists indicate that vaccines are manufactured under strict sterile conditions that ensure their safety and makes the contamination with HIV highly unlikely
Nationally, coverage for BCG (the vaccine against tuberculosis) stands at 87.9 per cent; for OPV (the vaccine against poliomyelitis) 80.5 per cent; for DPT/DT (the vaccine against Diphtheria, Pertussis, Tetanus) 81.4 per cent and MMR (Measles, Mumps, Rubella) 78.1 per cent. Although the United Nations report on the State of the World's Vaccines and Immunisation indicated that locally the coverage has grown over the last 20 years, and in fact stands at levels comparable to those in developed countries, the concern is that the reservoir of children not being immunised can potentially put everyone at risk.
When the World Health Organisation (WHO) formed the Expanded Programme on Immunisation in 1974, fewer than five per cent of the world's children, under one year old, were immunised against the initial six target diseases diphtheria, tetanus, whooping cough (pertussis), poliomyelitis, measles and tuberculosis. However, the coverage improved significantly by 1990, with almost 80 per cent of the 130 million children born each year receiving the required vaccines before their first birthday.
Dr. Lewis-Bell said that to strengthen the local EPI more surveys of target populations are required; more refrigerators and vaccine carriers are needed to maintain the vaccines cold chain, and there is need to introduce other vaccines, such as pneumococcus for sicklers.
