Rubella and Measles Vaccine
A friend raised her concern over the Rubella and Measles vaccination campaign that is going on between 16-24th on May driven by the government. I am sure most if not all of you have received that text message from RedCross: Kampeni ya chanjo ya Ukambi- Rubella inaanza kesho! Leta watoto walio miezi 9 hadi miaka 14 katika kituo cha afya karibu nawe, 16 May- 24 May idadi dharura 1199.
I’m all for supporting the government and its process for the well being of its citizens…
i’m a bit confused on this ‘new’ measles and rubella vaccination campaign.
here are my concerns:
1. Is there a new strain of the two diseases and thus need to re-do the vaccinations, especially if our children are up to date with the vaccinations
- What government agencies are licensed to do this.. and how sure are we they are in its purest form, considering we have heard stories of tampered vaccines, case in point Busia children
- What if a child has already suffered measles, should they still get the jab.
- is there a way to better sensitize the public just to kill the speculation and have total by-in from the moms, especially….
This was a response from one of the doctors
Hey moms, Just incase you can’t access Dr. Amakove Wala ‘s response, here goes… copied from her status:
WHO recommendation for eradication of rubella (which mimics Measles in some ways and causes deformities in children whose mothers have it) is to introduce it together with the measles vaccine in either a combination of measles-rubella or measles-mumps-rubella vaccination given at two doses (9 months and 18 months).
Kenya has already introduced the measles vaccine at 9 and 18 months in the public facilities. The uptake of the second measles vaccine is still low since people know vaccines stop at 9 months
Our coverage of measles vaccine at 9 months is approximately 80%. That means we miss 20% of children born in every years.
Out of those who receive measles vaccine (80%), another 15% don’t get immunity. This means that we have some kids who have been vaccinated but not protected.
The combination of 20% (not vaccinated) and 15% (vaccinated but not protected) further increases the number of children not protected every year. If you use compounding statistics, this means that every three years or so, we get an equivalent of a whole birth cohort unprotected. That is when we get cases of measles outbreaks.
To protect against this, it is recommended to have mass campaigns for measles vaccine every 3 years or so to enable more children get protected. And secondly, to introduce the second dose of measles at 18 months of age.
Now, we have many vaccines which are available in the private sector but not in the public sector. The government cannot afford to introduce all of them at a go. This means that every time they get resources to introduce new vaccines for all children, they must evaluate the burden of diseases vis a vis the costs of the vaccines.
So if you have noticed, Kenya was one of the countries to introduce the pneumonia vaccine into the public programs. This was then followed by the rota virus vaccine. And now the intention is to introduce the rubella vaccine.
The decision to introduce vaccines is guided by a team of experts in the vaccine field who study data available locally and internationally. Rubella was thus selected. We do not have much data on mumps. We need to polish up on our data collecting tools.
The burden of disease on rubella as recorded may not be that high but this is also complicated by the fact that many cases get un-reported while others are mistakenly labelled measles due to the similarity in the rash. Furthermore, in the field of epidemiology, once three cases are identified, an outbreak is declared and testing stops as focus is placed on management of the outbreak.
So, the disease rubella, though mainly affecting children, causes the biggest issues in pregnancy. This means that when rolling out a campaign, one has to vaccinate a bigger generation. This is necessitated purely due to the nature of the disease rubella. If we only focus on children, we will in 5 or so years, see a major outbreak of congenital rubella (abnormalities in the newborns) in the women who grow up not being protected.
Before the introduction of rubella vaccine into the routine immunisation program, the recommendation is to have a mass campaign targeting infants to early teens (in our case 9months to 14 years) so that we have them covered. Thereafter, all newborns will then be given routinely at 9 and 18 months.
Kenya will introduce Measles-Rubella vaccine in January 2017 in the routine immunisation at 9 and 18 months.
The association of MMR or MR vaccines with autism was refuted as the doctor had distorted facts and was de-registered.
In public health campaign, the focus is on the public and not individuals. Ideally, proof of vaccination (and immunity) would give you a free pass. Then that is not ideal in our scenario. Therefore, the campaign is targeting every child from 9 months to 14 years irrespective of prior immunisation status.
The vaccine will not be given door to door since it is an injection. For safety and environmental concerns. There will be fixed and mobile vaccination points including schools, government facilities and public places. The campaign will run from 16th to 24th May 2016. Let us support the government in protecting our children.
In 11 pre-selected sub counties, there will be an additional tetanus toxoid vaccine given to women of child-bearing age. These have been identified as areas where neonatal tetanus is still a threat.
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