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WHO and Catholic Church headed for fresh clash over tetanus vaccination

By Gatonye Gathura | Updated Sat, February 25th 2017 at 00:00 GMT +3

Narok Woman Representative Soipan Tuya Kudate gets a tetanus vaccination at Nairegia-Enkare in Narok County. WHO wants mass tetanus vaccination drive launched by June. [Photo: Robert Kiplagat/ Standard]

The World Health Organisation (WHO) has issued new guidelines on tetanus vaccination, which could set off another round of controversy with the Catholic Church leadership in Kenya.

The WHO has proposed new mass vaccinations for women and girls in Kenya to kick off by June.

WHO termed concerns raised by the church over the vaccine in 2014 as unjustified rumours.

A calendar prepared by an expert group of the WHO, for high risk countries plans to have Kenya declare elimination status by next year. It also indicates funds for the exercise are fully available.

The calendar proposes that the country adopts mass vaccination campaign and routine immunisation strategies. However, the Catholic church leadership is opposed to the former. After what has been a stuttering global tetanus elimination campaign, including Kenya’s controversy in 2014, last year the WHO had engaged an expert group to review the matter.

Following the work of the Strategic Advisory Group of Experts on Immunisation (Sage) the UN agency last Friday (10th February) issued new tetanus vaccine guidelines.

WHO affirms that the vaccine is safe and recommends mass campaigns targeting girls and women of reproductive age in 18 high risk countries including Kenya.

It also justifies the involvement of UN and other foreign agencies in tetanus control activities.

In its recommendations, Sage said the 2014 tetanus controversy in Kenya, bred from poor communication, which is one of the greatest challenges facing the fight against neonatal and maternal tetanus.

To avert the confrontation, SAGE called for early engagement with concerned parties and participating communities. In 2014, the church opposed mass vaccination campaigns arguing there was no tetanus crisis in the country. But a report published on February 8th, by the Global Burden of Disease 2015, an affiliate of the WHO, showed there is a tetanus crisis in Kenya. The study funded by the Bill and Melinda Gates Foundation is published in the journal BMC Public Health.

The study analysed global deaths from tetanus between 1990 and 2015. “The highest rates of newborn tetanus deaths in 2015 were observed in Somalia, South Sudan, Afghanistan, and Kenya,” said lead author Hmwe H. Kyu.

In 2015 the report showed that there were 3,983 newborn, adolescents and adult deaths caused by tetanus in Kenya, more than the estimated 2,451 deaths of women caused by cervical cancer annually.

The UN seems to use these figures to justify the proposed mass vaccination of girls and women of reproductive age despite the Church opposition.

“The fact that this campaigns only target women, shows that there is something fishy about it, otherwise even men and children should be vaccinated,” John Cardinal Njue, the head of the Catholic Church in Kenya argued.

The June 2, 2016 Bulletin of the WHO indicated that young and adult men are also at a high risk of tetanus infection and require immunisation.

A team from the WHO reported 13 cases of tetanus infections linked to the voluntary male circumcision with eight of them resulting to death.

“The cases, recorded from April 2012 up to March 2016, were from five of the 14 male circumcision priority African countries: Kenya, Rwanda, Uganda, Tanzania and Zambia,” the Bulletin read in part.

This prompted another study by among others the Kenya Medical Research Institute and the US Centers for Disease Control and Prevention to determine the levels of tetanus vaccination in males in Kenya, Tanzania, and Mozambique.

The study published on December 5, 2016 in the American Journal of Tropical Medicine and Hygiene reported huge disparities in tetanus vaccination levels between men and women in Kenya.

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