Health dept goofs up in vaccination drive

16 March, 2002
The Times of India
By Balwant Garg
Bathinda http://www.healthlibrary.com/search.html

BATHINDA: It was not too long ago when Chauke village of Bathinda hit the headlines after as many as 10 persons fell prey to Hepatitis-B in April last year.

The then Punjab chief minister Parkash Singh Badal directed vaccination of all residents in the village to stem the immediate crisis.

But then, the health department has goofed up in various places in adopting the vaccination drive in the village.

The first controversy erupted on August 24, when the first camp was organised in the village for administering injections.

The villagers allegedly caught two health workers stealing hepatitis-B vials and subsequently there were allegations that the some of the residents were administered distilled water injection instead of hepatitis-B.

The second controversy was about variation in the use of vials for the first, second and third doses. The health department purchased 750 vials on July 20, 2001 for roughly about 10,300 residents.

If health department authorities are to be believed, 750 vials were used to vaccinate 7,500 people (one vial contains 10 injections dose). So it implies that 2,800 residents were left without vaccination during this period.

Then on August 17, 2001, the health department purchased another 400 vials for giving the second dose of the vaccine.

Going by the authorities' logic of vaccination of one vial containing 10 injections, 4,000 people were administered hepatitis-B injections in the second phase.

While for the final and third dose of the vaccine, 477 vials (meant for 4,770 people) were purchased on January 10, this year.

The big question is why there was discrepancies in the use of vials for first, second and third dose?. HS Dhillon, civil surgeon, Bathinda told Times News Network," There were about 1500 surplus vials in the first phase, this excess stock was used for the second dose."

This clearly shows that in the first phase only 6000 of 10,300 residents were given vaccination, thus contradicting the earlier claims of the health department authorities that 7,500 residents were vaccinated in the first phase.

This also puts a question mark on the number of vials bought in the second phase.

Dhillon said that a lot of people in the village had already got vaccination from private doctors hence only the remaining people were given hepatitis-B vaccination.

Regarding the purchase of 477 vials for third dose, the civil surgeon asked the correspondent to come to his office for "all the details."

A total of Rs 7 lakh (Rs 5 lakh from Chief Minister's Fund and Rs 2 lakh from District Red Cross) were sanctioned for the vaccination drive.

It is this double-speak and credibility gap of the health department that only the well-to-do people in the village are considering the option of getting vaccinated all over again.

A report on the efficacy of Hepatitis B vaccines being questioned by a section of the press, based on a warning given by a city based voluntary organisation is getting controversial. Two city based English dailies had carried a report on People for Economical and Effective Medicare (PEEM), warning about the mass vaccination camps being organised in the city by various organisations against Hepatitis B. These dailies have quoted the agency to have stated that a number of manufacturing companies and voluntary organisations are competing with each other for sponsoring such camps. The report further states that a PEEM spokesperson had commented that the vaccination camps have become a game for business promotion of the manufacturing companies and a game of numbers for the voluntary organisations.
According to these dailies, Dr PVR Bhaskar Rao, chairman, PEEM convened a press conference and said that the vaccinations had adverse reactions like paralysis and sudden death in some cases and neurological complications, arthritis and diabetes in children would also occur if the vaccinations were done indiscrimately. Dr Bhaskar Rao seem to have told that these vaccinations were not compulsory and in advanced countries like the US, UK and France, there were mass protests against them, the report alleged. The report further states that the people for economical and effective medicare was in possession of sufficient data to prove that hepatitis B was not a killer disease as was being made out by certain vested interests and vaccination was not necessary for everyone.
The vaccine was essential only for those new-born to infected mothers. In others, taking certain precautions without vaccination could easily prevent it and its side effects, the report said. The dailies further adds Dr Bhaskar Rao saying, that in the interest of the public that the People for Economical and Effective Medicare had opened a Vaccination Reaction Information Centre with the aim of educating people about adverse effects that were known to occur after vaccination, collecting data about such effects and offering free medical advice to the people who suffered the effects. The Indian Academy of Pediatrics (National), convened a press conference immedietely on the misleading report on the section of the press on Hepatitis-B vaccination. Dr Y C Mathur, president, IAP questioned the authenticity of the press report and said that they have got enough evidence to establish that there is no side effects at for administering Hepatitis-B vaccine. “There are paediatriacians and gastroenterologists who have put in 15 to 20 years of services and they could not find any side effects, then how can persons who don’t have hands on experience comment on the efficacy of the vaccine,” Dr Mathur wondered. 
Leading gastroenterologists of the city, Dr Sethu Babu, Dr PN Rao, leading paediatrician from Bombay Hospital, Dr Swati Bhave and city based leading paediatrician Dr Sudarshan Reddy voiced their anguish against the press statement in unison. Dr Mathur said that large scale hepatitis B immunisation programmes in Taiwan, Alaska and New Zealand have observed no association between vaccination and the occurrence of serious adverse events. Furthermore, surveillance of adverse events in the United States after Hepatitis-B vaccination have not shown a clear association between Heapatitis B vaccine and the occurrence of serious adverse events including Guillain-Barre syndrome, transverse myelitis, optic neuritis, and seizures. Dr Mathur provided the abstract of the New England Journal of Medicine’s February issue about Hepatitis B vaccination and the risk of multiple Sclerosis. The abstract suggests that the reports of multiple sclerosis developing after hepatitis B vaccination have led the concern that this vaccine might be a cause of multiple sclerosis in previously healthy subjects.
The conclusive part of the report suggests that these results indicated non association between Hepatitis B vaccination and the development of multiple sclerosis.

JALANDHAR, MARCH 25: If you are planning to get yourself
administered Hepatitis-B vaccination at any of the camps organised by
big and small NGOs, think again. The vaccination given in such camps is
of no use. 
Despite the fact that Hepatitis-B vaccination is not required for everybody,
various NGOs in the city are forcing the people to get vaccinated. Rs 50
to Rs 120 are being charged by them for every minor and adult
vaccination respectively. Many NGOs have brought down rates which is a
major attraction for the people. The health authorities reveal that the
vaccine meant for disease is not kept in the required temperature which
makes it a simple water injection, which has no use. The untrained
people cannot administer the vaccine. 
It may be noted that since last year, various NGOs, including various big
clubs, have been organising the H-B camps at a regular basis and
distributing literature about the disease. The literature mentions that
Hepatitis-B is more dangerous than the AIDS and only prior vaccination of
it can save the person from the disease. Civil Surgeon Dr D.P.S. Sandhu
says that a number of NGOs attract more and more people to camps by
distributing fearful literature. They do not keep the vaccine in proper
temperature. He adds that as per the health department orders, it is
compulsory for every NGO, which is organising such camps, to take
permission of the civil surgeon. ``I never give permission unless I visit the
spot and see the proper conditions for the vaccination,'' he says.