globe and mail article - Ukraine public declines Vaccines

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Vaccine refusals spur outbreak fears

Article Comments (291) MARIA DANILOVA

Associated Press

March 25, 2009 at 7:20 AM EDT

KIEV, Ukraine — A widespread scare about vaccine side effects in Ukraine has led

to a sharp drop in immunizations that could result in disease outbreaks

spreading beyond the former Soviet republic, international and local health

officials say.

Hundreds of thousands of fearful Ukrainians have refused vaccines for diseases

such as diphtheria, mumps, polio, hepatitis B, tuberculosis, whooping cough and

others this year, according to official estimates. Authorities have cancelled a

UN-backed measles and rubella vaccination campaign funded by U.S. philanthropist

Ted , and will have to collect and incinerate nearly nine million unused

doses in coming months.

" I never thought I'd see the day where perfectly good vaccines are being

destroyed, " said Bociurkiw, a spokesman for UNICEF.

Around the world, health officials say they are struggling with the

repercussions of vaccine fears they call unwarranted and dangerous.

Enlarge Image

A medical worker prepares to administer a vaccine to Yaroslav, 16 month old,

being held by his mother Oksana Vasylenko in a outpatient clinic in Kiev,

Ukraine, Friday, March 20, 2009. A widespread scare about vaccine side effects

in Ukraine has led to a sharp drop in immunizations that could result in disease

outbreaks spreading beyond the former Soviet republic, international and local

health officials say. Hundreds of thousands of fearful Ukrainians have refused

vaccines for diseases such as diphtheria, mumps, polio, hepatitis B,

tuberculosis, whooping cough and others this year, according to official

estimates. Authorities have canceled a measles and rubella vaccination campaign

funded by U.S. philanthropist Ted , and will have to collect and

incinerate nearly 9 million unused doses in coming months. (AP Photo/Sergei

Chuzavkov)

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•The vaccine-autism debate should end now In 2003, imams in northern Nigeria

fomented a boycott of polio vaccinations claiming they were a Western plot to

make Muslims infertile or infect them with HIV. Authorities in Indonesia are

discussing a plan to end childhood immunizations against a number of diseases

out of fears that foreign drug companies are using the country as a testing

ground. A budding movement of parents getting exemptions from pre-school

vaccination laws is seen as partly responsible for a spike in U.S. measles

cases.

Experts blame the Ukrainian scare on government mismanagement and irresponsible

media coverage of an anti-vaccination campaign launched after the May death of a

17-year-old boy who had received a combined shot for measles and rubella.

Activists including members of the homeopathic and alternative healing

industries blamed his death on the vaccination. Ukrainian authorities said they

needed to investigate and halted the campaign to revaccinate nine million

Ukrainians aged 16-29 for measles — a leading cause of childhood death — and

rubella, which can cause serious birth defects.

The Ukrainian Health Ministry and World Health Organization concluded that the

boy died of septic shock from a bacterial infection unrelated to the vaccine.

But the ministry decided last month to terminate the revaccination campaign,

saying there was no longer enough time to administer the vaccines before they

expire this summer and that people would refuse the shots.

More than 4.5 million Ukrainians, mostly children, are vaccinated for a wide

variety of diseases each year in the country of 46 million. Health authorities

say spreading fears of immunization were largely responsible for an estimated

10-per-cent drop in the vaccination rate since May. " This threatens to lead to a

spike in the number of infectious diseases, " said Lyudmyla Mukharskaya, the

country's deputy chief public health official. " There will be outbreaks,

especially among children. "

Ukraine has had two major outbreaks of measles since 200. Ukrainians aged 16-29

have proven to be highly susceptible, apparently because of an ineffective

vaccination campaign carried out in the 1990s, when the country was in economic

crisis following the collapse of the Soviet Union. If Ukraine cannot revaccinate

at least 95 per cent of the estimated nine million people who got deficient

vaccines in the `90s, UNICEF says, the next outbreak could be even bigger.

" There are concerns that the measles disease could be exported to other European

countries where Ukrainians travel, " Mr. Bociurkiw said.

Independent health experts say government mistakes were a major factor in the

vaccine scare. Prosecutors briefly detained the country's chief public health

official after the teen's death and claimed that the vaccine, which was

certified by WHO, was imported into the country without proper authorization.

Dr. Fedir Lapiy, an expert in infectious diseases based in Kiev, said

prosecutors appeared to have used the case to promote themselves and discredit

political opponents. " It looked more like a PR campaign than a thorough probe. "

Ukraine has an educated population but rumours and misperceptions spread easily.

Constant political turmoil and a devastating financial crisis — one of the worst

in Europe — has fuelled mistrust of Ukraine's crumbling health care system, and

authorities in general.

" It is sad to see the population of a country in the middle of Europe refusing

to get immunized, " said Andrei Tulisov, an infectious disease and immunization

specialist at WHO.

Ukrainian media outlets are numerous and uncensored but do not widely follow

Western standards of fairness and accuracy. Some print and online reports

alleged after the boy's death that the Indian-made measles and rubella vaccine

would sterilize men as part of a plot by Mr. , whose Washington-based

United Nations Foundation charity paid for the vaccines. " This kind of scare

tactic coupled with the death of the boy struck the fear of God into a lot of

young people and parents, " Mr. Bociurkiw said.

Nina Zaichenko, a 25-year-old interior designer in Kiev, says she has decided

not to immunize her year-old daughter, Dasha, against any diseases until at

least the age of three. She fears the infant's body is still to weak to handle

vaccinations and she does not trust the local health system to acquire and

properly store high-quality vaccines. " The chances of a child getting sick from

a vaccine and from the disease itself are equal, " Ms. Zaichenko said, an

assertion experts say has no basis in the truth. " It's a hard choice for parents

to make. "

UNICEF says it believes only up to 30 per cent of Ukrainians who need

revaccination for measles and rubella would turn up if the campaign were

restarted today. Only 400,000 people received vaccines before the campaign was

stopped.

The Health Ministry says it will work to promote the need for immunizations

among the population, and look for ways to launch a new measles and rubella

vaccination campaign.

Article Comments (291)