EPI for children being disrupted

The essential immunisation for children to protect them from vaccine-preventable diseases has seen an unprecedented disruption in Dhaka and many other parts of the country due to the supply shortages of some vaccines.
Bangladesh is still a success case in immunization, but this disruption may undermine achievement and its health status.
Officials have attributed the supply shortage due to timely fund release to procure vaccines.
The health authorities collect vaccines through the UNICEF in co-financing with the Vaccine Alliance Gavi.
This trouble has raised concerns among parents and experts as long delay in the vaccination for newborn or long periodical gap between the subsequent doses could affect the effectiveness of the vacancies against the preventable diseases.
Bangladesh initiated the Expanded Programme on Immunisation (EPI) with the support from the UNICEF and the WHO in 1979.
With time, the immunisation programme got strengthened to prevent 11 vaccine-preventable diseases of children under 11 months.
The government administers five vaccines - pentavalent, BCG, PCV, OPV and MR - free of cost under the EPI to about 4 million children every year.
According to officials, they mostly see shortages of PCV, BCG and Penta.
The timely vaccination has been disrupted in different parts of the country since December last ahead of the 12th national election, they said.
Sheuli Akhter, 26, a resident of Badda Adarsha Nagar area in Dhaka city, came to get vaccination for her four-month-old baby boy at Al Sami Hospital on Tuesday. She waited for about two months to get the 2nd dose of PCV vaccine (protection from pneumonia).
"My baby was born in our village in Rangpur district, but our child was not vaccinated with PCV dose due to supply shortage. We got two PCV doses out of three in Dhaka after we returned," she told the FE when this correspondent visited the centre.
A paramedic working at an immunisation centre in 21th ward of Uttar Badda told the FE, requesting not to be named that the disruption has taken a serious look since last December.
"We wrote so many times to the EPI office, certainly for PCV. They suggested stopping immunising newborns for time being but we managed it by delaying some subsequent doses of PCV and continuing the immunisation," she explained.
She, however, said the situation improved following the fresh shipment which created a long queue at her centre on Tuesday. The scenario is the worst in the countryside.
According to a document obtained by the FE, there was no PCV vaccine in Rangpur last week against a yearly demand for 56,135 doses. BCG stock was 3,080 against a yearly demand for 22,488 at the same period.
AD syringe stock was 300 against a yearly demand for 46,152 in the same period. Most of the vaccine doses are in a similar crisis.
Dr Md Wajed Ali, civil surgeon in Rangpur, on Wednesday claimed that they received some vaccine shipment in the last three days while some will be supplied on February 20.
He said they still need some while the health authorities in Dhaka assured them of sending those soon.
Dr KM Shafiquzzaman, civil surgeon in Bhola, echoed the same voice, saying that he could not see such a shortage of supply in his three years' duty in the district.
"The first dose of the first vaccine is required to be given within 42 days after a baby is born. So, babies born during this period got delayed or denied immunisation," he elaborated.
He also said some doses came on Wednesday and hoped that the situation would return to normality soon.Masud Hossain, EPI superintendent in Bhola, told the FE that they received 15,000 pentavalent (protect child from diphtheria), 4,000 PCV against a monthly immunisation of 64,000 children in the district.
Some shipments are in the pipeline, he said, adding that his office has never witnessed such shortages in recent times.
Be-Nazir Ahmed, public health strategist and former director of the Directorate General of Health Services (DGHS), told the FE that such a disruption to the vaccination is a big health concern.
"Bangladesh eliminated a number of preventable diseases successfully. So, if we fail to keep the trend of successful operation, on time supply and delay in successive doses, it could return some disease we eliminated," he said.
"It could affect all the health indicators of the country," he feared, urging the authorities concerned to end the crisis immediately," said Mr . was involved in the EPI programme earlier, said Mr Ahmed who was involved in the EPI earlier.

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