Ministry of Health Director General Dr Nyane Letsie
Pascalinah Kabi
THE Ministry of Health says it was well within its constitutional rights to vaccinate children without written parental consent during the recent measles and rubella immunisation campaign.
The countrywide campaign, which ran from 13 to 24 February, has ignited an outcry from Basotho after hundreds of children suffered various side-effects from the vaccination.
Four children have reportedly died from effects, with the latest passing on at Queen ‘Mamohato Memorial Hospital (QMMH) over the weekend.
However, the ministry yesterday denied the four deaths had any association with the vaccine, saying that there were only mild reported side-effects and the patients were treated as outpatients.
This was said during yesterday’s key stakeholders’ panel discussion on the ongoing status of the MR vaccination at the Health Ministry’s headquarters in Maseru.
The ministry said that at Queen Elizabeth II Hospital, out of 850 cases seen last week, there were only 24 cases with potential adverse side effects but upon investigation, these were classified as minor side-effects with the children being treated as outpatients.
The ministry said all other districts had reported minor side-effects except a Mafeteng case in which a grandmother reported that her grandchild stopped walking after the vaccination.
“The child was later admitted at Tšepong (as QMMH is popularly known) but it was later suspected that the child had fallen, hence they couldn’t walk. This was just a coincidence,” Mafeteng Public Health Nurse, ‘Mampho Mafereka said during the panel discussion.
Among other complaints from the public was the ministry’s decision to vaccinate children without parental or guardian permission.
Some parents argued that it was malicious to vaccinate children without prior approval or a booklet; saying that immunising children without knowing their medical history put the children’s lives in danger.
This was raised in light of warnings by the Centre for Disease Control and Prevention (CDC) that the MR vaccine should not be administered to a person living with HIV/AIDS, or another disease that affects the immune system.
In a country with high prevalence of HIV like Lesotho, they argued that clinicians ought to have studied the children’s medical backgrounds prior to vaccination.
The CDC also warned that anyone who had been treated for cancer with radiation or drugs should not be vaccinated.
Reacting to those arguments, the ministry’s representative Limpho Maile said the 1970 Public Health Order allowed them to vaccinate children without written parental consent.
“The 1970 Public Health Order states that written consent is not mandatory where the aim is to protect the community. I am a Mosotho and I don’t remember seeing my parents putting in a written consent in my schoolbag when campaigns like this one were undertaken in the past,” Dr Maile said, adding that vaccination had life-long benefits.
She said there were people she grew up with who were not vaccinated and still suffered from diseases such as polio to this day.
For his part, a doctor representing United Nations Children’s Fund (UNICEF) Lesotho, Toni Asiji said the vaccination was procured from India, not Geneva (Switzerland) as Health Minister Dr ‘Molotsi Monyamane had said last week.
Dr Asiji said the Indian firm – Serum Institute of India Ltd – was the only World Health Organisation (WHO) pre-qualified vaccination manufacturer in the world.
He said that UNICEF was a major procurement agency obtaining vaccinations for governments throughout the world.
He said that UNICEF only procured vaccinations from WHO pre-qualified manufacturers; ensuring that the national regulatory authorities such firms operated under were capable of inspecting and verifying that standards of handling vaccination were adhered to by such firms.
“There is only one WHO pre-qualified supplier of vaccine in the world and we procured the vaccine for Lesotho from that company – Serum Institute of India Limited,” Dr Asiji said.
Ministry of Health Director General, ‘Nyane Letsie said yesterday’s meeting was not held to defend the ministry but rather to lay cards on the table as “there was nothing to hide.”
“We are not here to defend anything but here to ensure that every Mosotho knows the status report on how this immunisation campaign was carried out,” Dr Letsie said, adding that there was data available to support their case.
Asked if there was any negligence on the part of the ministry during the campaign, Dr Letsie said there was no tangible evidence to support that the aftermath (reported adverse side effects) was a result of negligence on their part.
She said that they were looking at all avenues to get to the bottom of the problem and that until concrete evidence surfaced, they were not going to speculate on what went wrong.
“We will not admit any wrongdoing until such time. WHO regional and international offices have been made aware of this matter and we will do anything possible to regain the public’s trust,” she said.
She said that they would intensify their public awareness campaign; saying it was important for the public to understand the importance of vaccination against diseases such as measles and rubella.
Asked if it was possible to have the vaccine sample independently tested, Dr Letsie said only WHO accredited personnel on handling the vaccination would be allowed to run the tests.
“But the tests are not really necessary because by all these standards articulated here, all necessary tests were adhered to because for instance, once the vaccine is exposed to a certain temperature it changes colour,” she said.
She added: “Running tests on the vaccine involves a whole lot of things and we just cannot give it to persons not certified by WHO, without involving WHO, for testing.”
For her part, Queen Elizabeth II pediatrician, Thabelo Makhupane said it was important to understand that “only persons with full-blown HIV cannot be vaccinated.”
“As clinicians we are trained on these things and we can tell by the look of an eye that a child has full-blown HIV and is sick; you will not even find such children in schools,” Dr Makhupane said.
Meanwhile, Christian Council of Lesotho (CCL) said the ministry of health had not handled the matter with the sensitivity it deserved.
“CCL received complaints from the public, asking why we were quiet on this national matter. They complained that the ministry didn’t handle the matter well especially last week when you were addressing the public’s outcry on the effects on the vaccine,” CCL representative ‘Masechaba Thorela said.
She said the ministry needed to understand that “this coin of handling the issue was two-sided.”
She said that yesterday’s meeting should have been organised prior to the vaccination campaign to ensure that everyone understood the importance of vaccination campaigns.
Meanwhile, human rights lawyer Lineo Tsikoane said it was “nonsensical” to say that parental consent was not needed to vaccinate children.
Advocate Tsikoane has joined forces with other local lawyers to fight for the rights of the children presenting diseases associated with the vaccine’s after effects.
She said that it was shocking that the ministry could claim they were within their rights to vaccinate children without parental consent; saying this statement compromised progress that had been made to find an amicable solution to this saga.
“It doesn’t make sense on so many levels. We had a breakfast meeting with the minister and he admitted that it was wrong to immunise children without parental consent,” Advocate Tsikoane said.
She said that it was wrong of the ministry to pull this card, saying that the same ministry was failing to show collateral support when children fell sick due to the same vaccination administered without parental consent.
“Whether we sue or not, as lawyers we understand that it is the sole responsibility of the ministry of health to ensure that people are healed and our immediate plan is to find a better way to handle this because whether we sue or not, these children need help now not after the court judgement,” she said.