By Our Reporter
SHILLONG, Sep 4: The Health department is grappling with a significant challenge as vaccine hesitancy continues to impede immunisation efforts across the state. Despite ongoing campaigns and awareness programmes, it is learnt that many parents are refusing to vaccinate their infants against various vaccine-preventable diseases, which are administered in government health centres.
Speaking to The Shillong Times, Joint Director of Health Services (Maternal and Child Health & Family Welfare), Badira Mawlong, explained that the Oral Polio Vaccine (OPV) is only one component, as they have combined it with other vaccines for preventable diseases such as measles, diphtheria, pneumonia, and others.
“We are administering the various vaccines in one go to prevent multiple contacts. It also helps since people will not need to visit the health centers several times,” Mawlong said.
She, however, noted that many infants are only receiving the first dose of OPV at birth. The Joint DHS (MCH&FW) added that people are hesitant to get the next dose of OPV, especially when injectable vaccines are administered together.
Mawlong emphasised that vaccine hesitancy is not limited to uneducated individuals, as even educated people are resistant to vaccination.
Meanwhile, she informed that the Ministry of Health and Family Welfare is conducting Intensified Pulse Polio Immunisation only once a year, unlike in the past when it was conducted twice a year. The Joint DHS (MCH&FW) mentioned that they had conducted the Intensified Pulse Polio Immunisation from March 4 to 6 this year.
She also stated that they are conducting door-to-door visits on the second day of the immunization drive. Mawlong explained that health workers would mark a “P” on households that have received the OPV, while those that have not yet received the vaccine would be marked with an “X.”
“Our supervisor will randomly visit households that refuse the vaccine to provide some form of counseling.
However, it is really difficult to convince such households since they are firm in their decision not to immunize their infant or child,” the Joint DHS (MCH&FW) said.
She reiterated that vaccine hesitancy affects all types of vaccines, not just the polio vaccine.
State Surveillance Officer (SSO), Valerie J Laloo, added that outbreaks of vaccine-preventable diseases mostly occur in clusters or villages with low immunization coverage. Laloo noted that the first disease likely to break out in areas with low immunization is measles.
“Measles is the most sensitive indicator of low coverage. The measles vaccine also prevents pneumonia,” she said.
The Joint DHS (MCH&FW) mentioned that the recent suspected polio case of a two-and-a-half-year-old infant in Jengrip village, Tikrikilla, West Garo Hills, is due to low immunisation coverage, which is currently only around 50 to 60 percent.
“Herd immunity develops only if 90 to 95 per cent of the area is vaccinated. People who are not vaccinated are also protected once herd immunity develops,” Mawlong said.
According to her, herd immunity will not develop if vaccination coverage is only 70 per cent. She said that areas with very low vaccine coverage are prone to outbreaks of vaccine-preventable diseases.
“Children and infants with low immunisation are also prone to vaccine-preventable diseases,” the Joint DHS (MCH&FW) said.
Laloo added that villages with low immunisation coverage include South West Khasi Hills, Ri-Bhoi, East Garo Hills, and North Garo Hills. She also mentioned pockets in East Khasi Hills, such as Mawkynrew, where they have witnessed measles outbreaks.
The State Surveillance Officer said that they are conducting awareness programmes in these villages and reaching out to every household to stress the importance of vaccination. “I have personally experienced that people will patiently listen to us. But in the end, they will say, ‘Sorry, we will not accept the vaccine.’ It is difficult to change people’s minds since they are adamant,” she said.
Laloo stated that the main issue lies with routine immunization, whether for polio or measles.
Meanwhile, the State Surveillance Officer has ruled out that the recent suspected case from Tikrikilla in West Garo Hills is wild polio. She observed that if it were wild polio, it would have spread within the community by now.
“We can confidently say it is not a case of wild polio. We are continuing with surveillance, both on the people and the environment, to closely monitor the situation,” Laloo, who is also a Public Health Specialist, said. She added that they are now waiting for the test results from NIV, Pune, to confirm whether it is truly a polio case.
“Even if it is positive, it is likely an isolated case,” Dr. Laloo said.
Earlier, the Union Health Ministry confirmed that the case of the two-year-old child from Tikrikilla is not wild polio but rather an infection that occurs in some people with low immunity.