Private clinics can increase immunisation coverage, Govt. urged

The President of the Society of Private Nurses and Midwives (S.P.N.M.), June Scanlan-Lui, has pleaded with the Government to allow private clinics to deliver childhood vaccines again.

More than six months into the new year, and the measles crisis last year, Mrs. Scanlan-Lui and others like her who run private clinics, are waiting patiently for the authorities to decide in the private healthcare worker’s favour.

“We need to increase the immunisation coverage and use the private nurses,” the registered nurse said. “They [the Ministry of Health] can’t do it by themselves alone.”

Despite a major national effort during the measles epidemic, Samoa’s vaccination coverage for childhood vaccines remains lower than the 95 per cent target, according to national data compiled by the World Health Organisation (W.H.O.) and the United Nations Children’s Fund (U.N.I.C.E.F.).

In 2019, 87 per cent of the of-age children received their first dose of measles-containing-vaccine (measles, mumps and rubella or measles and rubella) but only 44 per cent had their second. A child needs two in order to be fully immune.

The rates are slightly slower than the official Government figures (96 and 59 per cent, respectively) due to the data having no directly supporting sources. 

However, the rates are significant improvements on the year before. 

In 2018 just 31 per cent of children got their first dose while a mere 13 per cent had their second. Typically children have their first dose aged 12 to 15 months and their second as they start school, or between four and six years of age.

Speaking ahead of the S.P.N.M. launch on Friday evening, Ms. Scanlan-Lui said primary care in private practice should be utilised to keep vaccination rates high, because nurses are qualified to deliver vaccinations and that is should be part of their role in delivering primary care.

“We are still waiting for them to sort out a lot of issues with the leadership of the Ministry of Health,” Ms. Scanlan-Lui said of the Ministry.

“We already undertook the refresher course of immunisation but it’s up to them. We told them to come and visit our clinic for the things they want us to implement in the clinic and we await their call.”

Private practice clinics should be able to deliver vaccinations because a lot of their clients are working-class people who do not want to use the hospital services, she said, and it is important they still get the services they need. 

Coverage rates for all the childhood vaccines have risen too. All 11 of the vaccines delivered in Samoa had increased coverage in 2019 from the year before, with some more than doubling coverage.

Rates for diphtheria, tetanus, pertussis, hepatitis and Haemophilus influenzae type b grew between 50 and 670 per cent between 2018 and 2019.  

Polio vaccine rates reached 76 per cent coverage in 2019, while rubella went from a decade low of 31 per cent to 87 per cent. 

Despite this improvement, there remain five out of 11 vaccines that only reach 60 per cent of children, a far cry from the intended 95 per cent.

Until late November last year, several private clinics run by either doctors or nurses were running their regular vaccination services alongside the dozens of Government-run emergency vaccination booths around the country. 

After M.O.H. launched an investigation into a clinic for allegedly improperly acquiring and storing the measles, mumps and rubella vaccination, as well as charging for the service during the epidemic, all private practices had to stop delivering vaccines. 

It was later revealed that the clinic was Agape Jal Nurse-Led Primary Healthcare Services, run by Ms. Scanlan-Lui and two colleagues Latama Asovale Peteru and Alamoeaia Taaseu, all registered nurses previously employed by the National Health Services. 

M.O.H. Director General Leausa Dr. Take Naseri said at the time that private clinics was not meant be administering the MMR vaccine in the middle of the epidemic, rather only the M.O.H. nurses.

M.O.H. destroyed the doses, and suspended vaccine services at all private clinics, not only Agape Jal.

In response, Agape-Jal released a statement, saying their vaccination standards were of utmost quality.

“We assure the public and our clients we have administered vaccinations to in the past three weeks that the vaccinations we provided meets the current standards and protocols of both the Ministry of Health and U.N.I.C.E.F. (the United Nations Children’s Fund),” the statement reads.

“Our clinic met and will continue to meet the universal standards and protocols for storage and administering vaccinations.

“With respect to providing vaccinations, this is one of the basic duties that a registered nurse in Samoa can administer and this is a professional nursing service that is internationally recognised that nurses are qualified to provide.”

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