Immunisation must go on despite Covid-19 pandemic

Monday, May 4th, 2020 00:00 |
Child immunisation. Photo/Courtesy

Clifford Akumu

Inside the last row of a local health centre in Huruma informal settlement of Nairobi, Mary Avitsa, 29, comforts her nine month old daughter, who cowers at the sight of nurses and doctors.

Avitsa and her daughter have come to the centre for measles immunisation.

For the past two weeks, she has been debating whether to take her daughter for a measles jab.

Since the onset of coronavirus pandemic she has been pondering this. It had taken the intervention of a healthcare worker to convince her.

Like many women with children under five who need these services most, the fear of coronavirus has had enormous effect in their health services seeking behaviours.

“I was worried about the coronavirus. But I had to take the risk after I was advised by community health volunteers who have been doing rounds within the estate,” Avitsa said.

But things have really changed, she explains. Health centres like the one she and her daughter attend, have put in place measures to avert virus spread among patients.

“Unlike earlier, we are now observing social distancing and hygiene guidelines, as directed by health officials” she says, happy her daughter finally got the jab. 

In Kenya, the Immunisation Schedule is given by the Division of Vaccines and Immunisations (DVI) in the Ministry of Health under the Kenya Expanded Programme on Immunisation.

Since the start of 2019, there have been government-led campaigns to tackle polio reemergence. But this year in the shadows of Covid-19, several campaigns have been put on hold or scaled back.

World Health Organisation (WHO) has sounded an alarm on the pandemic’s impact on routine immunisation services for children.

The pandemic has revealed what is at stake when communities do not have the protective shield against an infectious disease. Observing the World Immunisation Week, celebrated annually from April2 4-30, WHO chief, Tedros Ghebreyesus, said immunisation is “one of the greatest success stories in the history of global health” and more than 20 diseases can be prevented using vaccines.

Although more than 116 million infants are vaccinated, there are still more than 13 million children globally who miss out on vaccination.

Concern is growing the number will increase because coronavirus will likely to disrupt vaccination efforts and surveillance of vaccine-preventable diseases.

Dr Garat Ahmed, Doctors Without Borders’ (MSF) deputy medical coordinator based in Nairobi believes immunisation is a routine mothers should not skip even during the pandemic.

It is critical to adhere to the scheduled vaccination programmes, noting they are supplementary routines in curbing mortality rates among children under five.

“So long as they can access vaccination, they should not miss any. Measles might crop up in the event of any let-up in the programmes,” Dr Ahmed told People Daily.

Dr Ahmed, whose organisation runs immunisation programmes in Likoni, says they are encouraging mothers to turn up for the services.

Although there are still fears of contracting the deadly virus, several health facilities across the city are seeing immunisation activities, but at a slower pace. Millions of young lives hang in the balance with such disruptions.

Unicef estimates that 182 million children missed out on the first dose of the measles vaccine between 2010 and 2018, or 20.3 million children a year on average.

This is because global coverage of the first dose of measles stands only at 86 per cent, well below the 95 per cent needed to prevent outbreaks.

Widening pockets of unvaccinated children led to alarming measles outbreaks in 2019, including in high-income countries like the US, UK and France. 

Meanwhile, among low-income countries, the gaps in measles coverage before Covid-19 were already alarming.

Nicola Anyango, a community health volunteer under Fikiria Jamii programme, who has worked on the polio immunisation programme for two years in Huruma Ward, Nairobi, says there is little change in number of hospital visits.

“Mothers are going for vaccination, though not as many as we would expect,” she says.

Anyango, however, pins the reduced number of visits for vaccinations on ‘rumour mills,’  about coronavirus and that health centres have put in place high standards of hygiene.

“We teach our clients safety guidelines, advise them to attend clinics when necessary and avoid going with other family members,” says Anyango.

Tackling cases in rural areas that often lack resources will pose an immense challenge for already strained health systems in Kenya.

“There are limited vehicles or motorcycles to transport teams to villages. Fuel costs and repairs are a hindrance. 

“Some equipment such as refrigerators are unserviceable and tools such as ice packs and cooler boxes may be limited yet necessary to transport vaccines to distant sites in viable state,” says Dr Steven Mutiso from the Non-Communicable Disease Unit at the Ministry Of Health.

Dr Mutiso also highlights factors such as religious and cultural beliefs that also impact on immunisation services. 

“For instance, a community in Illasit/Entarara area of Loitokitok do not believe in formal healthcare structures such as hospital treatment and they hide children,” he says.

Bringing on board the  administration such as office of chief to locate the children and vaccinate them proved useful. - Additional reporting by Manuel Ntoyai.

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