Health experts have suggested examining measles vaccines and the coverage to understand what kind of immunity has developed in the bodies of the vaccinated children as infections remain high despite a massive campaign.
They also called for conducting surveys to ascertain whether the special measles campaign has achieved the targeted response and whether there are any gaps in the vaccination campaign.
The health authorities this week lodged dozens of new deaths and several thousands of new infections across the country amid a nationwide special immunisation programme apart from the routine campaign since April 5 and vaccination of over 18.46 million children.
The DGHS, however, has no immediate plan to investigate and measure the immunity developed in the children after being vaccinated in the last few months.
They are planning to continue the special campaign after a month and then would calculate the percentage of coverage, DGHS officials told the FE.
One more child died with measles-like symptoms and over 1,140 new infections were reported in the past 24 hours until Tuesday morning.
On Monday, four children died of measles and measles-like symptoms. The total death toll rose to 654, including 93 confirmed cases. The total suspected infections rose to 87,929 and confirmed cases to 10,523, according to the Director General of Health Service (DGHS).
The health authorities are seeing the downtrend of the deaths and infection in recent days as major improvement.
However, health experts talking to the FE said that a timely investigation on the effectiveness of the vaccine and survey on the coverage would help the authorities determine the real scenario and take appropriate measures.
Former DGHS director (disease control) Prof Dr Benazir Ahmed told the FE that he is not "satisfied" with the infection scenario despite having a large vaccination campaign across the country with technical help from development partners, including UNICEF and WHO.
"Immunity generally develops after 7-14 days of a vaccination (with 95 per cent coverage) in a targeted area but we still see hundreds of new infections everyday with casualties," he explained, suggesting an investigation to know if the vaccine works properly and there is no question about its standard.
As infections have not reduced to expected level so there are questions if we have reached a 95 per cent coverage or the vaccine is working, he said.
There are mechanisms to learn about how vaccination works on the population. It can test in the lab and also investigate the children vaccinated to know the immunity and antibody they develop.
If the authorities do so then they will have evidence on the vaccine standard and immunity to what extent the vaccination campaign is working, they suggested.
Public health expert and epidemiologist Dr Mushtaq Husain echoed the same describing the infection and death rate as "abnormal" calling the vaccination campaign strategy faulty.
"Due to the emergency situation, the government failed to have a micro-planning to run the vaccination across the country. The health authorities took the plan sitting before the desk in Dhaka offices and did not survey the real scenario," he added.
According to the expert, the immunisation coverage percentage must be known now as it must be over 95 per cent to stop the death race of children and the current infection rate is because all children are still not coming under vaccination.
He also questioned the target number of 18 million children for vaccination, suggesting developing a micro-plan for the second dose of the ongoing vaccine campaign and must ensure that "health authorities go home to home not bring them to vaccine centres."
DGHS Additional Director General Prof Dr. Md. Zahid Raihan said that there is always indirect evidence when a vaccination campaign works.
"We see the downtrend of measles infection and the deaths have also cut in recent weeks. It (vaccines) works. Immunity has developed on individual levels," he told
the FE.
He, however, said it would take time to develop herd immunity as the country lost it due to low vaccination
over time.
For a herd immunity the national coverage must be 95 per cent or above.
He also explained that there would be some infection in the next few months, most among the children with poor nutrition status and other health difficulties.
"The campaign target we reached last month of over 18 million children remains open and we vaccinated 400,000 more children outside the primary target ended last month," he added.
He described the present downtrend condition of infection as "good sign" and said that they would calculate the coverage status about a month later to learn about the herd immunity.
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