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Samoa's vaccine programme gets tick of approval from W.H.O.

The World Health Organisation is confident in Samoa’s ability to safely carry out vaccinations, after two nurses were jailed for negligently preparing vaccines resulting in two deaths.

Dr. Rasul Baghirov, the organisation’s representative for Samoa, has been overseeing training and capacity building in the health sector since last year's death of two infants who had received a negligently prepared vaccine. 

“The W.H.O has been active in this area from the beginning, since the tragic event happened in 2018,” he said.

“We helped in a big way in terms of establishing the cause of death and the aftermath of it by reviewing existing guidelines and by training people who are involved in immunisation.”

Training of front-line health professional continues today, not only in the Moto’otua Hospital but in district hospitals as well, Dr. Baghirov said.

“I think Samoa is definitely prepared to perform this function at a very good level.

“All components, starting with quality of vaccines, cold chain, with storage, with people who train to deliver services, it should function absolutely fine.”

He said Samoa’s immunisation program is of a good standard, especially compared to others in the region, but like healthcare services generally, requires “absolute discipline.”

Dr. Baghirov’s comments come as New Zealand faces its most serious outbreak of measles in two decades, with 812 confirmed cases in Auckland alone this year.

This week, two vaccination experts stated that Samoa is facing  a real threat of contagion, with frequent travel between New Zealand and Samoa, and a startingly low vaccination rate among infants: just 31 per cent, according to national data.

In Samoa, the measles vaccine was suspended while a national inquiry into the infant’s cause of death was carried out. It was resumed in April, leaving at least two cohorts of children unvaccinated, Dr. Baghirov said.

He said the Ministry of Health’s statement that 46 per cent of the children who missed out at Moto’otua Hospital have now been vaccinated is plausible, though the W.H.O is not privy to that data directly.

“That’s very encouraging,” the doctor said. "The very fact that there was no immunisation for nine months doesn’t necessarily tell you that outbreak is imminent.

“What we know from the evidence elsewhere is that the outbreaks are possible but not necessarily in the next month or two. It may happen several years after that event.”

Vaccine coverage rates in Samoa have been falling since 2014, from nearly ideal rates of 90 per cent coverage only the year before. 

Dr. Baghirov said after the tragic deaths of two infants, it could take as much ten years to rebuild confidence in the vaccine program again, nearly twice as long as rates took to decline. But the threat of the outbreak in New Zealand may speed that up, he said.

“Because the threat is real, and it’s just four hours away from Samoa, I think that gives big hope the country will really rebuild that confidence.

“Particularly that the trial [of the nurses] is over, I think there will be more and more people realising that the only way to make safe themselves and their children is to be immunised.

“It’s not that I am celebrating what is happening in New Zealand but this is definitely working as a stick to get parents moving.”

This year has seen a surge in measles cases globally, and in March, the W.H.O’s Western Pacific director Dr. Takeshi Kasai wrote a series of recommendations to the Pacific Health Ministers, including strengthening risk communication, or raising awareness of the symptoms of measles, of how serious it is and what to do if anyone suspects they are infected.

“In our collective efforts to achieve measles elimination in the Pacific, a single case of measles constitutes an outbreak,” Dr. Kasai wrote.

He also recommended countries “achieve and maintain over 95 per cent measles vaccination coverage for both first and second doses,” maintain a reserve of measles vaccines and syringes, and to vaccinate adults without documented vaccination history.

Samoa’s threat to measles is all the more significant because of the rates of Pacific people with measles in New Zealand is particularly high.

In New Zealand, the W.H.O analysed published data on measles from the Institute of Environmental Science and Research. 

They found Pacific people have been predominately affected by the measles outbreak, constituting 40 per cent of hospitalised cases, and 37 percent of the reported cases of measles.

New Zealand Prime Minister Jacinda Ardern is blaming inequality and access to health services for the stark numbers of Maori and Pasifika affected by the outbreak. 

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