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Editorial: The pentavalent vaccine pause

29 October, 2009 – The death of four infants immunised with the pentavalent vaccine, introduced this September, has left many parents, who readily received the five in one vaccination, worried.Although it is not confirmed that the vaccine caused the deaths, officials have also not ruled out the possibility. Meanwhile, the move to withdraw the vaccine has left many questions unanswered.

The vaccine was introduced with the intention of protecting infants against pneumonia, one of the leading causes of death in children under 15 years in Bhutan, and meningitis. It was also expected to help the health ministry in their commitment to reduce childhood mortality by 40 percent.

Health officials, who now say that there were aware that could be adverse side effects, did not make such information available at the launch. In fact, during the launch, health officials said that, Besides redness, swelling and pain in the place where the vaccine is injected, and fever, there are no other serious side effects from the vaccine.

In Sri Lanka, where the vaccine was launched before Bhutan, it gave similar problems and several babies died. The World Health Organisation (WHO), which approved the use of the vaccine and reviewed the problem in Sri Lanka, cleared the vaccine as the cause of death.

Today, Bhutan is in a similar situation with the health ministry waiting for WHO experts to review the problem with the vaccine. As much as the health ministry, many parents hope the deaths are not related to the vaccination because then it means something else.

People are already questioning that, if the vaccine gave the problems in Sri Lanka, on what basis did the health ministry introduce the vaccine in Bhutan? Having known that such a situation had already occurred in the region, why the decision to go ahead? Is it because the vaccine is given at a concessional rate?

Infants have a weak immune system and could die of many diseases, but it would be an irony if a child dies of a vaccination meant to protect it.

Unfortunately, we do not have the expertise to review the problem ourselves and will have to go by what others say of the vaccine. If WHO, which approved the vaccine, says there is no evidence of relationship between the Pentavalent and the deaths, should the vaccine be re-introduced?

Immunising children in Bhutan is still a big issue. With childhood mortality still one of the highest in the world, the government must work to reduce it. Much of the deaths occur in rural Bhutan where government initiatives, like the immunisation programme, not only receive good response but the trust of the people. Villagers always think the government mean well for them and will not question them.

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