A major challenge is the variation in vaccine coverage across the geo-political zones of the country –Akinsete

Biography

Anne Akinsete is the CEO of Sickle Cell Foundaon, Nigeria, a Consultant, Public Health Physician. She was Director (Public Health Department) of the Federal Ministry of Health for many years and has represented the Federal Government of Nigeria at several occasions locally and internationally. As a Public Health Physician, Akinsete has worked in every level of government in Nigeria – from local, State to Federal levels. At global level, she has contributed to World Health Organisaon (WHO) publications on Non Communicable Diseases (NCDs), served as WHO Fellow in Geneva and as UN Cares Facilitator at the United Nations  HQ in New York. She remains a key resource person on NCDs for the West African Health Organisation.

Background

Immunisation has been around for over 200 years, yet it remains unpopular in many communities and in different parts of the world. For some, it may be a question of trivialization, just because they do not see the need for any form of “treatment” intervention in a seemingly, perfectly healthy individual. This if course smacks of ignorance and lack of awareness and is common in underdeveloped and socio-economically-challenged communities. Pneumococcal infection is diagnosed by microscopic examination and growth of the bacteria from blood, sputum or other specimens. PCR (polymerase chain reaction) testing in a pathology laboratory is sometimes used. Pneumococcal vaccine prevents or fights against Bacteremia or Sepsis (Infection of the blood), Otitis media (middle ear infection) and Bacterial meningitis. Illness prone to Pneumococcal infection includes Sickle Cell Disorder, HIV infection, Diabetes, Malignancies, Asthma, Chronic bronchitis, COPD, Chronic renal failure, Chronic liver disease. People at risk include Infants and children, Persons 65 years and over, Persons with Sickle Cell Disorder and those immunocompromised.

Statistics

Currently, globally, about 2 – 3 million deaths are prevented every year from immunization with the basic/routine vaccines (deaths that would have resulted from diphtheria, tetanus, pertussis (whooping cough), and measles)

Sadly, globally, nearly 20 million infants are still not receiving these basic/routine vaccines annually.

By the end of 2015:

86% of infants worldwide received 3 doses of diphtheria-tetanus-pertussis (DTP3) vaccine

86% of infants worldwide had received 3 doses of polio vaccine (Polio is targeted for eradication; the virus has been cleared in all countries except for thre, namely – Afghanistan, Pakistan and Nigeria)

85% of children had received 1 dose of measles vaccine by their second birthday,

Pneumococcal vaccine was introduced in 129 countries by the end of 2015, and global coverage was estimated at 37%.

For Nigeria, the stats are disappointing with wide variations by zones):

According to the National Nutrition and Health Survey (NNHS) 2015:

50 % of infants received 3 doses of DTP/Pentavalent vaccine (75-80% in SW & SE zones; 17 – 26% NW & NE)

The report lamented a drop in coverage from 2014

Common misconceptions about vaccination include:

1, Immunisation causes infertility

2, Vaccines cannot be given credit for disease prevention because human populations were already beginning to experience better health from improved hygiene before vaccinations were introduced

3, Most people who come down with diseases are people who have received vaccinations

4, There are specific “Lots” of vaccines that are known to cause disease and these must be avoided

5, Vaccinations have harmful side effects and can lead to death, so they are best avoided.

6, Vaccine-preventable diseases have been eliminated from my country so there is no need for my child to receive any

7, Giving a child multiple vaccines for different diseases can overload the immune system.

Global report on pneumococcal infection

Pneumococcal infection is a major cause of morbidity and mortality worldwide. WHO estimates that pneumococcus causes 1.6 million deaths annually and most of these deaths occur in poor countries.

Advice to government

Government has already instituted policies and programmes for immunization in Nigeria. Political will is strong. A major challenge is the variation in vaccine coverage across the geo-political zones of the country. This continues to pull down our coverage statistics. Specifically-tailored interventions (that address socio-cultural and religious considerations) need to target the North West and North East zones where coverage is by far the least in the country.   

Furthermore, non-governmental actors should be mobilized to collaborate with government in implementing its policies, plans and programmes.

Kemi Ajumobi