Five in one

The National Immunization Programme introduces the vaccine against Haemophilus influenzae type B (Hib) to protect babies against deadly meningitis

The babes in arms cried and whimpered, little knowing that they were in fact getting one “shot” instead of two while gaining protection not only for four but five diseases. The babies with their mothers, gathered at the newly-opened Central Vaccine Store down De Saram Road at the premises of the Epidemiology Unit on January 1, were also the first to get the shots for a new vaccine introduced this year.

The much-lauded National Immunization Programme, one of the great achievements of the Public Health Service of Sri Lanka, has been further strengthened with the addition of the vaccine against Haemophilus influenzae type B (Hib). The Hib bacterium which results in meningitis could be deadly for young children, who if infected but survive could also be left with severe disabilities. Hib also accounts for up to one-quarter of severe pneumonia cases in young children.

“Hib is the leading cause of acute bacterial meningitis in infants and children less than five years old,” stressed Chief Epidemiologist Dr. Nihal Abeysinghe, explaining that bacterial meningitis is fatal unless treated with antibiotics immediately. Even with proper treament, 3-25% of affected children may die and those who survive may suffer permanent disability including deafness, learning disabilities and difficulties in movement.

Earlier this vaccine was available only to a privileged few at a cost in the private sector in Colombo and some towns across the country. The Sunday Times understands that the Epidemiology Unit negotiated with the Global Alliance for Vaccines and Immunization (GAVI) to make it available to the wider mass of children in Sri Lanka.

Explaining the immunization programme, Dr. Abeysinghe said up to last year all children were given two injections on the two thighs, at two months, four months and six months, comprising the DPT and the Hepatitis B vaccines respectively. The DPT covered the diseases diphtheria, pertussis or whooping cough and tetanus.

From January 1, the Hib vaccine has been added to this, making it five in all – Pentavalent – with the number of injections also being reduced to one. Three doses of the Pentavalent vaccine will be given to all children at 2, 4 and 6 months.“GAVI is providing Rs. 520 million for the purchase of the Hib vaccine this year, while the government has to provide only 8% amounting to Rs. 45 million in a co-financing agreement,” said Dr. Abeysinghe, adding that gradually the government will take over the purchase by 2015. By that time, the costs would also have reduced drastically with more developing countries producing this vaccine.

This year one dose of the vaccine has cost US$ 3.6 (Rs. 381). Stressing that the Hib vaccine introduced to the National Immunization Programme, which will be dispensed through all the mother-and-child clinics spread across the country free of charge, is the best available in the world, the Chief Epidemiologist said that there would be no mixing of liquids. “We have purchased the World Health Organization prequalified liquid vaccine through UNICEF. It is very safe.”

Meanwhile, the state-of-the-art Central Vaccine Store, a long felt need, also opened on January 1 added another 10 cold rooms, built and equipped at a cost of Rs. 20 million, to the already existing 15 cold rooms in the districts.

The central store is considered a boon to the National Immunization Programme as it will store all the vaccines and, through a well-equipped vehicle specially purchased for this purpose,vaccine transportation has been made more efficient. It has also further strengthened the cold chain.

Earlier, The Sunday Times understands, that individual vehicles had to be operated manned by a driver, a Public Health Inspector and an assistant to ensure vaccine delivery to each and every district. “Now we can deliver along one direction covering many miles, cutting down on costs and manpower,” adds Dr. Abeysinghe.