Key vaccines expire, red tape at ministry to blame

The consignment of the vaccine that arrived at JKIA Swissport storage in 2017 wasted away due to bureaucracy and failure to pay clearance token fees.

The red tape could have denied many Kenyans immunisation against haemophilus influenza type B (the bacteria that causes meningitis, pneumonia and otitis media – ear infection), diptheria, whooping cough, hepatitis B, tetanus and other ailments.

Pentavalent, also known as Five-in-One, is a combination with of five vaccines.

The Nation obtained a copy of a confidential letter to Health Director-General Patrick Amoth late last month by the Pharmacy and Poisons Board (PPB), revealing the mess.

Headlined “Collection and Disposal of Expired Vaccines at JKIA Swiss Port Storage”, the letter says the storing firm wants the expired vaccines destroyed since as they are occupying valuable space.

“These are lifesaving vaccines that should be treated with urgency once they get into the country but because of bureaucracy by the clearing agency, we have to dispose of 6.1 tonnes of vaccines. Very unfortunate,” Drug Crime and Investigations head at PPB Dennis Otieno says in the letter.

Tetanus

Even as the vaccine donated by the Serum Institute India expired in July last year, many children and women went without their dosage because it was in short supply in public hospitals.

The tetanus vaccine is given to babies who are six, 10 and 14 weeks old. 

The disease in newborns is prevented if the mother has been immunised.

The mother is immune if she has been vaccinated before getting pregnant or during pregnancy. 

An expectant mother whose tetanus immunisation status is uncertain or whose last immunisation was more than 10 years ago should be vaccinated against the disease.

The tetanus toxoid vaccine has reduced incidence rates world wide. 

Neonatal tetanus continues to be a major killer and can be prevented by providing the vaccine to women of childbearing age.

During childhood, five doses are recommended, with a sixth given at adolescence. 

After three doses, almost everyone is immune, but an additional dose every 10 years is recommended.

Tetanus/diphtheria/pertussis (Tdap) is recommended during pregnancy, preferably between 27 and 36 weeks gestation. It protect babies from whooping cough. 

If not administered during pregnancy, Tdap should be given immediately the baby is born. According to the World Health Organization, there were 15,103 tetanus cases in 2018.

Had the government agencies cleared the consignment, more cases would have been avoided. Given that three years have lapsed, there is a likelihood of lives having been lost.

No communication

Swissport said it wrote to the Ministry of Health about the vaccines many times but did not received a response.

“The management of Swissport requested for products to be cleared and disposed of since they were occupying space, with no commitment of any action by the consignee,” the letter goes on.

The board states in the letter that it was notified of the expired vaccines at Swissport.

Through the cargo services head, the board was informed that fee for the consignment had been waived due to lack of payment and prolonged stay at Swissport.

The board then requested the ministry to clear and organise the disposal of the vaccine.

“The purpose of this letter is to consider expediting the collection of the consignment and facilitating safe disposal of the same in line with the PPB for safe management pharmaceutical wastes,” the letter says.

“The board is apprehensive that improper disposal of these vaccines will occasion negative public health outcomes.”

Through the Global Alliance for Vaccines and Immunisation (Gavi), such drugs are donated to the world’s poorest countries to protect children from diseases.

With support from Gavi, pentavalent vaccine is available in the world’s 73 poorest countries and had saved more than 467 million lives by the end of 2018.

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