KAMPALA – There have been a series of photos circulating online of infant(s) that experienced adverse reactions following the administration of the measles vaccine in Uganda. In healthcare, every life matters and my hope is that all necessary resources and support was provided to the impacted individuals and their families. It’s also imperative that a root cause analysis is conducted to monitor and analyze reported adverse events and determine whether they are likely related to vaccination.
Vaccines like any medication can cause side effects and adverse reactions. In the United States, under the National Childhood Vaccine Injury Act of 1986, healthcare providers and manufacturers are required to record and report suspected adverse events occurring within specific time periods after vaccination. A Vaccine Adverse Event Reporting System (VAERS) is a surveillance program designated to serve as an early warning system to detect possible safety issues of vaccines.
The media coverage of the recent adverse reactions and statements from a section of political actors in Uganda have been reckless and give legitimacy to false and dangerous theories about vaccination. Though there is a lot to criticize about Uganda’s healthcare system/service delivery, delegitimizing (Vaccines) one of the greatest global healthcare successes to score political points is a travesty. Vaccines prevent 2 to 3 million deaths per year and have eradicated diseases such as smallpox, reduced childhood mortality, prevented birth defects and disabilities from polio among others.
The Uganda Ministry of Health launched a vaccination campaign in response to Measles and Rubella outbreaks that had over 300,000 reported cases and 586 related deaths. For such an effort to be effective, it’s critical to have no seeds of doubt in the populace about the efficacy and safety of vaccines. A step towards restoring public trust would include mandatory informed consent by making sure that parents or guardians are educated about the benefits and risks of vaccines in the language they understand. Vaccine information statements with all the pertinent information should be translated in local languages to facilitate informed consent and offer opportunities for questions prior to administration.
I’m not suggesting that adverse reactions to vaccines should not be reported or disclosed to the public. However, the two reported adverse events out of the 20,000,000 doses of Measles and Rubella vaccines and 9,649,500 doses of Oral Polio Vaccines administered have been used to make outlandish allegations that Ugandans are being poisoned through government-mandated vaccination campaigns. Though we all desire liberty from a repressive government, political philosophy is not applicable in the scientific field. Rational thought and evidence based analysis lay the foundation for epidemiology to evaluate, develop and implement effective intervention programs.
There has been public outrage regarding mandated vaccination which makes it crucial to illustrate why numbers matter for society to benefit from vaccines. Herd immunity is the protection of a community (including the un-immunized people) from disease by immunizing a critical mass of its populace. For instance, measles is one of the most contagious viruses known and the greatest killer of children. To establish herd immunity in a community against measles requires vaccinating 93 to 95 % of the population. Could voluntary vaccination deliver these results to guarantee public safety from such killer diseases? And if vaccine critics were to get their wish of voluntary vaccination, can our already strained healthcare system contain infectious disease outbreaks?
It’s crucial that we are cognizant about the impact of the statements and information disseminated for public consumption. There is growing panic about ongoing vaccination campaigns across Uganda. This will negatively impact public confidence in vaccines resulting in parents delaying or declining critical immunization for their children. The consequence is re-occurrence of infectious diseases such as polio, whooping cough, measles, tetanus, TB and diphtheria. And even more concerning is the public losing faith in healthcare intervention services in a country where fast tracked vaccines are needed to contain deadly diseases such as Ebola.
There is certainly a complex historical suspicion of pharmaceutical companies and scientific research in our communities. A highly charged political climate also inevitably leads to resentment against government compulsion of public health interventions such as vaccines. However, it’s important to note that politicizing and polarizing vaccination through unverified reports of adverse effects results in a tremendous amount of damage that would be challenging to reverse. Uganda which on average has only 54% of children immunized would find it difficult to achieve even higher vaccination levels to guarantee public safety.
Daniel Kawuma is a Pharmacy Manager at Walmart Inc , Baltimore Maryland, Managing Director Temba Investments, Founder Ugandan Diaspora Health Network.