Opposition to vaccinations in Kenya, again

The Catholic church in Kenya has once again come out and said they need assurance about the safety of the polio vaccine.

http://www.nation.co.ke/news/Catholic-Church-polio-boycott-/-/1056/2817854/-/h4kqmsz/-/index.html

There is a lot written about that in the local newspapers in Kenya.

This is not the first time this has happened and just last year, there was the biggie on the tetanus vaccine, again voiced by the Catholic church. I wrote a blog related to this.

On vaccines and fertility

 

I do however feel that ministries of health in Africa should re-think how they do things from my own personal experience.
Because the Coast is close to the border to Somalia, we are often the target of polio campaigns. I have had polio vaccinators at my gate several times. I will site just one of these.

I opened the gate one Sunday morning to find this nice looking lady, name tag hanging from her neck, with her small cool-box.
‘I am from Ministry of health, polio vaccination. Do you have any children 5 years old or younger?’
At this point, she is peering over my head (I am short) and looking at my kids that are playing in the compound.
‘No, my kids are old’
‘And that one?’ she says, pointing at my daughter.
‘She is over 5’
‘Really?’
I give her the look.
A look that says – ‘I am done with you my dear, please leave’
She leaves.

She never checked my children’s immunisation cards to see how many immunisations they had received – she just wanted to give them the vaccine like yesterday and did not care about anything else.

I do not like the aggression with which these vaccinators approach our homes. My children have all received 3 doses of infant polio vaccine and a preschool booster. They do not bother to ask me this or explain why the kids needs all those extra boosters.

I have asked this to mathematical modellers before, beyond how many drops are these polio boosters doing absolutely dot? Should the vaccinators not be checking your immunisations card and saying something like…..

‘Ah, good, your (insert name of child here) has received 3 doses, now she/he needs just this one booster and you will never see me again’

……believe you me, there would be greater success than pumping kids with drops without even caring who they are – the vaccinators are handling little children, should they not be a little bit warm?

Yet I am in public health. I know they mean well and they are protecting the population from disease – but should the training not be for them to be more persuasive rather than aggressive? AND that niggling query – how many boosters of this thing is adding value?

As I have written before, it is only during the campaign time that rumours begin, never as a result of the usual infant vaccinations at the local clinic. This is why when PCV10 was introduced in 2011, it met little resistant despite it being a 2nd injection in the system, because it came through the trusted nurses at the local hospital.

Africa needs to rethink the way vaccine campaigns are done – if something keeps giving you the same results – bad rumours that can end campaigns – perhaps it is time to do things differently.

I was at a meeting where the former director of the division of immunisations in Kenya, a most brilliant woman called Dr Tatu Kamau, talked about how she handled the problem of rumours on the Coast of Kenya during tetanus campaigns.

She said the population was concerned that only girls were being vaccinated, why not men and boys yet they also get tetanus?
Her solution – vaccinate male and female alike.

The campaign was a success.

Why do other programs find it so hard to do what Dr Kamau did with ease?

Why do programs ignore people’s queries, assume people are just ignorant and continue to do the same thing over and over again?

We have not seen the worst of the rumours – unless someone does something differently – how will we immunise girls against HPV in Africa without getting into real problems?

HPV immunisations can be painful and occasionally some girls faint – we need to collectively think through this issue instead of shaking our heads at the Catholic church.

The way in which the fears related to the tetanus vaccination were treated are feeding back into all these other vaccinations. One of the lab results claimed there were traces of HCG, a hormone produced during pregnancy, in the tetanus vaccine.

http://www.nation.co.ke/news/Church-misinterpreted-test-results/-/1056/2523968/-/smap3pz/-/index.html

http://www.matercare.org/news-publications/medical-news/catholic-doctors-speak-tetanus-vaccination-campaign-is-all-about-population-control/

There was no closure with that one, to the point where people I did not expect to have any doubts had started to wonder what was going on. Kenyan scientific institutions and universities also failed to come in and repeat these tests and reassure the public. The matter was left to fester.

Yet we are at the point now where researchers are developing more vaccines for diseases as technology gets easier and hopefully cheaper.

Currently children are receiving vaccines at age 6,10 and 14 weeks, the schedule in the next year or so will be:
6 week: pentavalent injection + PCV10 injection + oral polio +oral rotavirus
10 week:-Pentavalent injection +PCV 10 injection + oral polio + oral rotavirus
14 week:-Pentavalent injection + PCV 10 injection + polio INJECTION + oral rotavirus.
That was not a typo – at week 14, one of the oral polio vaccinations will be injectable as the trivalent vaccine is being replaced by a bivalent vaccine…….. I will write more about this later….

Opposition against vaccinations increases as the success of the vaccine goes up. Simply because people are no longer seeing the disease for which they are receiving the vaccine for, they start to see only the negative aspects of the immunisations.
This is not unique to Africa, measles has made a return in parts of the UK because parents stopped vaccinating their children against a disease they could not see – especially after a rogue doctor declared in a paper published in The Lancet journal that the vaccine was linked to autism.

Africa is however home to most of the vaccine preventable diseases – we do not need to keep doing the wrong thing in the hope that it will get better….it won’t.

The Catholic Church however also needs to temper its accusations unless they have some concrete evidence. A decade ago, Muslims in Northern Nigeria told their populations to boycott the polio vaccine – that the vaccine was laced with stuff to cause infertility among Muslims – this resulted in a return of polio with a vengeance in the population and it spread to a few neighbouring countries. The outbreak was contained when Nigeria imported the vaccine from Muslim manufacturers – but for the hundreds of children paralysed during this period, help came too late.

In the 80-90’s, leaders from the Catholic Church stood their ground against President Moi when very few people could. They said in public the things the citizenry would have loved to tell the President to his face – they spoke for the masses. Because of this history, when the Catholic Church takes on established systems – people listen – the Catholic Church more than others has people’s trust. And more than others, its leaders have to be extremely careful about what they say.