Government race to trace and immunise vaccine defaulters

Jael Aran, the nurse in charge of vaccination in Kisumu administers a vaccine on an infant at Nyalenda health center. [Harold Odhiambo, Standard] Nila Kadogo, a mother of twins, dangles one of her babies gently and with a sigh of relief as her younger sister plays with her other child while seated at the maternal unit of Nyalenda dispensary in Kisumu. A few meters from where they sit, a nurse is going through the clinic book of another child brought to the facility earlier to get a dose of the lifesaving Bacillus Calmette-Guerin (BCG) vaccine. The vaccine is a critical intervention given to newborns shortly after birth and protects against Tuberculosis disease (TB). However, despite its significance, health facilities in Kisumu and Vihiga counties ran low on supplies at the end of last year, effectively putting the lives of thousands of newborns at risk. Kadogo's twins are among thousands of children in the two counties who missed the critical vaccine after she gave birth in November last year. Others missed the malaria vaccine which should be given to infants at six months and also the vital first and second doses of polio vaccine that should be administered at two and four months. Several attempts and travels to other health facilities in search of the vaccine were a waste of time as the region grappled with a vaccine shortage crisis affecting nearly all health facilities. Now, however, county and national government officials from the two counties in collaboration with PATH organization, are running against the clock to trace nearly 30,000 newborns who missed the critical vaccines. The project inked on a last mile model, targets to identify all vaccine defaulters who missed critical vaccines when a dire shortage ravaged the country late last year. This is after health facilities received critical vaccines from the national government three weeks ago to bolster the fight to strengthen the immunity of infants. The facilities have adopted a hybrid system of tracing the parents and caregivers of defaulters and have developed a database of all new births and those that have already received vaccines. "This has been a huge relief for me. My daughters were very vulnerable after missing out the critical vaccines," explains Kadogo. Spot checks by The Standard across several facilities established that several new mothers had lined up at the maternal units with their children to get a jab of the vaccine they missed. At Nyalenda health facility, a group of Community Health Promoters escorted parents and caregivers of some of the infants who missed the vaccine to the facility. "We have been following up on them through phone calls to come for the vaccines for their infants because the vaccines are now available," said Maurice Ouma, a CHP. Similarly, at Kuoyo dispensary in Kisumu East, mothers who had missed the vaccine lined up patiently after they were tracked down by CHPs to come for the vaccinations. While they expressed optimism that the new supply is a major boost for them, others claimed they are unsure how long the vaccines will last and if the government will make additional efforts to put in place a permanent solution. CHPs dialogue meeting in Bukika Community Health Unit, Busia County. [Courtesy] Pamela Awuor, another new mother who gave birth on January 15 told The Standard that she was discharged after missing out on critical vaccines. "I was told to come after two weeks. I hope my baby will not miss any other vaccines," she says. According to Florence Oketch, the county nursing officer, the county ran out of BCG and tetanus vaccines in November and December. "We have received doses to administer to those who missed. They will last for about two months," she said. Jael Aran, the nursing officer in charge of vaccinations in Kisumu explained that they are on a mission to trace about 4,000 defaulters. "We are making comparisons to find out those who missed critical vaccines and trace them to come to the facilities," she explains and admits that late vaccination is dangerous to infants. In Vihiga where about 19,000 infants are on the vaccination list of 98 health facilities, county officials have initiated a mission to trace at least 7,000 defaulters with the help of PATH and other partners. This is after the devolved unit restocked 23,000 doses of BCG and Rubella vaccines. The county also has doses of vaccines of BCG, oral polio (OPV), IPV, Pentavalent vaccine, PCV-10, Rotavirus, Malaria, measles, and rubella (MR). Dubbed the "Big catchup", the program targets to map out all infants that missed vaccines on their dates of appointment for clinical visits. "We are carrying out daily mobilization to identify the defaulters. We have in place a community health strategy where CHPs help us trace mothers and caregivers in their areas," explains Edith Andere, the Immunization Coordinator. She encouraged all caregivers and parents with children aged between 0-59 months, and those with girls aged between 10-14 years to visit their nearest health facility and receive the vaccines that they missed during the previous months when there was vaccine stock out. At Hamisi Sub-County Hospital, the facility's management told The Standard that they have already received all the critical vaccines. Similarly, the remote Kaptech dispensary, located next to Kakamega forest was also a beehive of activity as mothers and caregivers lined up for vaccines. Christine Mwavali, a mother of a one-month-old infant narrated to the Standard how her several visits to other facilities in search of vaccines proved futile. "I have been taking precautions and preventing even some of my family members from interacting with my baby because she missed vaccines and was very vulnerable to diseases," she explains. In some facilities with a high number of customers, the new stocks they received from the government projected to last a month, are almost being depleted while others are already missing other vaccines. As part of the efforts to avoid any disruption of exercises, smaller facilities are redistributing their vaccines to those that are low on stocks. Despite the supplies, anxiety clouds what the future holds after the US government paused its aid work. Health experts fear the move will affect the availability and distribution of vaccines and further worsen the perennial shortages. The US, through USAID and PEPFAR, has played a critical role in strengthening Kenya's healthcare sector by supporting malaria treatment, distributing vaccines, and training healthcare providers.

Government race to trace and immunise vaccine defaulters

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Government race to trace and immunise vaccine defaulters

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