Trust in vaccination efforts needs restoring
by Thu Huong Le
It has been nearly two weeks since three infants died after being administered Hepatitis B vaccines in Quang Tri Province. Despite commitments from health authorities and Government officials, we are yet to receive any concrete answers on the real cause of death.
Recently, in May, the Health Ministry temporarily suspended the use of Quinvaxem after nine child fatalities within several weeks. The vaccine is routinely used to combat childhood infections such as diphtheria, tetanus, whooping cough and hepatitis B.
In June, the World Health Organization confirmed that Quinvaxem was safe for continued use in Viet Nam.
At that press conference in June, Director of the National Expanded Programme for Immunization (EPI) Professor Nguyen Tran Hien explained that among the 43 cases of adverse reactions associated with Quinvaxem since 2010, only 9 were found to be directly related to the vaccine. The 27 fatalities had been attributed to other causes or the findings had been inconclusive.
Whilst a recommendation from the WHO to continue the use of a vaccine isn't untrustworthy, these statements left two important questions: what the other causes were and why the findings were inconclusive?
Whilst these statements might have been swept under the rug in the past, the frequency of vaccine related deaths has made the public sick of "inconclusive" explanations and fearful of lifesaving vaccines.
The "conclusive" answers could come from anywhere: the quality of the vaccine, storage procedures, the immunization procedure, the professional level of healthcare staff or the infant's health pre-vaccine.
In the meantime, mothers can only trust their instincts. For many, that is to have their children vaccinated within 24 hours of birth or wait until conclusive evidence emerges. The clock is ticking.
A moratorium on vaccines poses a significant challenge. Why? Free vaccinations have been an important cornerstone of our achievements in public health. And more work needs to be done.
The National Expanded Programme for Immunisation (EPI) was founded in 1981 and has achieved remarkable results in the face of major challenges such poor health facilities and limited funding.
Since 1985, EPI has expanded its reach to 100 per cent of communes. Up to now, 8 vaccines have been introduced through the EPI and delivered free of charge to children under the age of one, to protect them from infectious diseases such as tuberculosis, tetanus or hepatitis B.
The WHO warns that each year 600,000 people die from an illness related to hepatitis B and argues that vaccinations prevent death in up to 95 per cent of cases.
It is simple: we can't afford to have mothers question the vaccine's credibility and prevent their children from being vaccinated because they're fearful of ‘inconclusive' results. In the long term, the consequences would be disastrous.
On Tuesday, Deputy Health Minister Nguyen Thanh Long said the ministry had officially requested the Public Security Ministry to instruct relevant agencies to investigate the cause of the deaths in Quang Tri. The Ministry is also providing regular updates to the Prime Minister.
Samples of the vaccine given to the three infants have been sent abroad for testing, with assistance from the WHO.
The Health Ministry has also asked provincial and local authorities to abide by strict safety procedures when administering vaccinations and discuss the pro's and con's of the vaccine with local residents.
This may be enough. But the results will speak for themselves.
If testing affirms that the vaccine is safe, efforts must be made to isolate the ‘other causes' of death, whether it is related to storage procedures, the vaccination procedure or the professional abilities of healthcare staff.
If testing reveals that the vaccine is harmful, then immediate suspension is a must and safer alternatives must be explored.
Nationwide, efforts must be made to detect violations. We can't allow the use of outdated vaccines or work with unqualified staff who don't comply with national regulations.
Nguyen Van Tien, deputy head of the National Assembly Committee for Social Affairs, recently told an online newspaper that the Government was responsible for providing compensation to victims who adversely react to vaccines, according to the Law on Prevention and Control of Infectious Diseases.
Tien also argues that an independent committee is needed to assess and consult on the work conducted by the EPI, which includes the work of private entities and NGOs.
Vaccinations are an important key to better public health and economic development. We cannot allow violations to go unchecked and unpunished.
All of these must be done even though for the families of the babies who died in Quang Tri, surely no compensation is deemed enough. — VNS