Hopes and fears in new vaccination campaign

Trizah Atieno* shrugged off the consent form she got from her son on Thursday evening.  She took one glance at it and checked “No”. “I did it without thinking twice,” she tells the Nation.

The form, stamped and signed by the County Director of Health, Kiambu County, gives teachers a nod from the parents to either allow students to get the Measles-Rubella and Typhoid vaccines or decline it.

This is part of an ongoing campaign from the Health ministry starting on July 5 to 14.

It is not the first time Trizah is declining the inoculation of her child in school. She did it last year during the polio vaccine campaign, but she still went ahead and vaccinated her child at a hospital in Nairobi. Her fear stems from previous adverse events reported on social media.

“I don’t want my child to be the next statistic. As a parent, I am just trying to exercise caution. If I go to a hospital, I know who to hold accountable. I wouldn’t know who to ask in school,” she explains, asking for the government to share more details.

Trizah has some level of education, and she says that the consent form should be more detailed and in a language that all Kenyans can understand.

David Mwere also received the same form, and, just like Trizah, he did not give consent after concerns that his daughter reacted to a vaccine last year. Even though the symptoms did not last long, the teachers have never provided a clear explanation. This time he was more cautious.  

“There is no elaborate explanation in the consent form on why the children need the vaccines. The communication needs to be clearer. I can consent, but I need to know ‘why’,” he says, adding that other communication channels should also be activated for people to gain confidence.

We also spoke to David Kariuki, a parent who said he had received such a consent form. “It is the lack of information that made me make that decision (decline consent). Again, I need to be told why now. Is there an epidemic or something? I also wish to know why it is being given to children only and not adults,” he said.

In public information released this week, Health Cabinet Secretary Aden Duale asked parents, caregivers and communities to trust in immunisation to save lives. “Rising drug resistance, climate change and urbanisation have increased typhoid burden, raising the urgency of prevention,” he said.

This year alone, the country has had a measles outbreak in about 18 countries, recording about 2,949 cases and 18 deaths. “We look forward to achieving our goals of 80 per cent Typhoid Conjugate Vaccine coverage and 95 per cent for Measles Rubella vaccination,” he said.

On Saturday, Mr Duale officially launched the 14-day campaign for the Measles-Rubella and typhoid vaccines targeting children aged 9 months to 14 years. 

Dr Ahmed Kalebi, an independent consultant pathologist, told the Nation that vaccine apathy in a country could be as a result of a complex mix.

“It could arise from misinformation, some level of socio-cultural resistance, some people weigh the benefits versus risk ratio and we also have a lot of conspiracy theories,” he says. “The government and stakeholders are not communicating enough regarding the benefits versus the risk in regards to getting a vaccine.”

As an expert who specialises in examining, explaining and advising on the results of blood tests, smear tests or tissue removal through complex laboratory tests, he says every other time, he receives cases of measles, for example. He worries that people think about vaccination individually, saying that if they don’t see the risk or benefit for themselves, they don’t put much thought into it.

“We get cases of measles even for patients who end up in the Intensive Care Unit. People don’t care about it when it has not happened to them. Rubella causes a lot of problems to new-born babies,” he explains.

Dr Kalebi explains that under the Kenya Expanded Programme on Immunization (Kepi), children get mandatory vaccines that have saved lives over the years.

“If these vaccines were to cause infertility, or autism, then all of us could be affected. The risk of getting vaccines in Kenya is negligible,” he says.

He added: “Eating food carries a risk of choking, but are we going to stop eating because we are afraid of getting choked? Everyday somebody chokes and dies. But the number of people who choke is so small and we continue to eat every day,” he explains.

Director General of Health Patrick Amoth was baffled as to why some people were shunning crucial vaccines. “Those three vaccines are for serious vaccine preventable diseases. Any reasonable parent should be able to take their child for vaccination,” he said.

He explains some of the consequences for severe measles infections; it could lead to severe pneumonia, blindness or deafness. Some of the dangers of Rubella include miscarriages, stillbirths, early infant deaths and congenital malformations, which require long-term care.

He said that children under 15 years are predisposed to getting typhoid and the severity of the diseases could lead to intestinal perforation, severe sepsis as well as septic shock that could lead to death.

“It is important that parents come out and take those vaccines. Measles and Rubella are not new vaccines; typhoid is the only new one. We have introduced it because countries with a high burden of typhoid disease have the potential for antimicrobial resistance,” he said.

“For us to use a vaccine, it takes a lot of research and data collection on safety, the viability of administering the vaccine and we have followed the whole process. We cannot introduce a vaccine before the approval of Kenya National Immunisation Technical Advisory Group, which is separate from the Health ministry.”

Dr Amoth says that the vaccines are being taken in schools because that is where the target population is at, but the vaccines are also available in hospitals and market places. “Taking the vaccine is voluntary, but the benefits of taking the vaccine outweigh the potential risk,” he said.

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