Immunisation of children in Uzbekistan: pros and cons

A family in Tashkent
On 27 November, the talk show Open Dialogue shot in Hotel Uzbekistan showed medical experts speaking about the “need for and security of immunisation of children in the country”.

The programme, initiated by the Uzbek Health Ministry and the United Nations Children’s Fund (UNICEF) to raise people’s awareness of the planned and additional immunisation of the young generation, has become part of the UN Information Office’s project Open House Show.

Strengthening immunity from birth

Uzbek and foreign experts told journalists about the national calendar for the immunisation of children from their birth up to the age of 16 against 10 controlled infectious diseases, including: diphtheria, tetanus, whooping cough, measles, German measles, mumps, viral hepatitis B, haemophilia infections (causative agents of over 20 various clinical forms of infections, including meningitis), tuberculosis and poliomyelitis.

In addition, vaccinations against epidemiological diseases today include vaccines against flu, rabies and anthrax and against other diseases if need be.

This year Uzbekistan has earmarked 5.4 billion sum (about $2.8m at the official exchange rate) from the national budget to buy vaccines.

In line with the national immunisation calendar, Uzbek citizens must receive all vaccines free of charge at vaccination posts of obstetric centres, rural medical posts and urban hospitals.

Young mothers get the first information about immunisation in maternity hospitals where they are given their child’s immunisation passport.

Then, vaccination consultations can be received at vaccination posts and from local doctors.

“Vaccination does not kill”

Experts shared the latest immunisation trends in Central Europe and CIS countries, global statistics reports, and discussed issues relating to the safety of vaccines and the latest achievements in cooperation between UNICEF and the World Health Organisation (WHO) in Uzbekistan.

“Though vaccines are made by various producers, they are thoroughly controlled. And no vaccine can be brought to the country without WHO certification,” said the head of the healthcare department of UNICEF Uzbekistan, Svetlana Shtefanets, who has recently come from Moldova.

In response to a remark that parents do not know what syringes are used and what is injected in their children during mass vaccination of children in kindergartens and schools, Shtefanets said that parents have the right to check this, but they also need to trust medical workers because a vaccine distributed through the healthcare system “is 100% safe for vaccination”.

Speaking about the existing opinion that a general vaccination is allegedly harmful and dangerous for health, Shtefanets said there were various viewpoints regarding this.

At the same time, widespread online “anti-vaccination campaigns” by various initiative groups often express arguments which she said “had not been proven scientifically”.

One of the main arguments of these groups alleges that vaccination causes autism in children, which experts said had not been proven scientifically.

Vaccines are contra-indicated in separate cases, for example, when a child is allergic to one or another preparation, which is established by doctors.

Asked whether vaccines give rise to complications, Shtefanets said that, as a rule, according to official WHO statistics, this may happen to one person in 100,000 (measles, whooping cough).

Death from vaccination, she said, is virtually impossible, and a child’s death is often caused by complications of concomitant diseases as a result.

Objective is to cover the population fully

Refusal from vaccination is a common problem for Uzbekistan and Moldova, where, Shtefanets said, they often have to prove the need to conduct planned vaccination of children with a view to keeping them healthy.

“Moldova has another problem. This is the separatist region of Dniester where the percentage of vaccinated children is less than in the country’s other regions and stands at about 76-80%,” Shtefanets said. “But the lowest level of vaccination is among Gypsies.”

There is a similar situation with nomadic Central Asian Gypsies in Uzbekistan, with whom medical workers try to hold meetings and explain them the need for immunisation.

However, the manager of the Health Ministry’s extended immunisation programme, Doctor Dilorom Tursunova, said that vaccination covers up to 98% of the population.

Vaccination is free of charge in our country and we want our population to know this

Doctor Dilorom Tursunova

“Because the country conducts immunisation effectively, diphtheria has not been registered in our country since 2002 and poliomyelitis since 1995 though there was an outbreak of this disease in Tajikistan in 2010. And in order to prevent this in our country, wide-scale immunisation measures have been taken against poliomyelitis in border areas, which is planned for 2013 too,” Tursunova said.

This concerns measles and German measles, which are not registered in Uzbekistan any more thanks to large-scale immunisation of children in previous years.

“But we only rely on a mass immunisation and regularly conduct planned ones, looking for children, especially in remote areas, who have not received vaccines against the diseases that cause serious complications,” Tursunova stressed.

She said Uzbekistan was a leading nation where the funding of immunisation programmes makes it possible to buy all necessary vaccines.

“Vaccination is free of charge in our country and we want our population to know this. However, immunisation has to be conducted when a child is completely healthy and, if a child has some health problem, first we consult them individually and treat them in our hospitals, only after this we perform vaccination,” Tursunova concluded.