Thoroughly baffled, Mrs. Chioma Alozie narrated the ordeal her child suffered at about 11 months old. Despite having immunised him against measles at age nine, little Chigozie went down with measles that almost snuffed life out of him.
The boy suddenly started showing signs of measles infection all over his body but that was not known to his mum. Alozie, a secondary school teacher, didn’t realise early enough that she was in for a battle for his soul. She became perturbed as he regularly had high temperature, itched in most parts of his body and became very irritable.
After applying first aid helps at home, she decided to take him to the doctor. There she was told that her son had measles and needed urgent medical intervention to save the situation.
The question on her lips since then has been, “Why measles infection despite immunisation?”
She recalled having tried hard to get him immunised at a public health centre in Lagos, but she was denied because the nurse on duty insisted that she could not open the injection except she had at least six babies to attend to.
She said it would be a waste for her to open it and use it for just the three babies that were around that fateful day. So, Alozie angrily left the health centre and went to a private hospital where she paid a token sum to have her child immunised.
The doctor that attended to the sick child said her baby possibly got immunised with a non-viable vaccine.
“I got irritated by the attitude of the workers at the government health centre that I had to go and pay at a private hospital. I took him for the immunisation on the scheduled date, just when he clocked nine months old and he was immunised with the vaccine that was meant to aid her body in fighting against measles. He only survived the measles attack by chance, we almost lost him to measles,” said Alozie.
Saturday PUNCH found that most immunisation vaccines are not viable six hours after they are opened. It was found that although the routine immunisation vaccines are now available, there are still a number of impediments created along the distribution chain and by the dispensing officers at the public health centres.
Apart from mothers, who do not patronise the health centres because they cannot stand the crowd on scheduled immunisation days, there are others, who say that cannot bear the attitude of public health workers because they cash in on the fact that the vaccines are free to insult mothers.
Some mothers say they would rather pay for the service at private hospitals and keep their dignity than have some public servants erode it. Yet another group of mothers said that although some private hospitals may not have the facility to store the vaccines as appropriate, there are many who can vouch for their source of supply.
“Come to think of it, the immunisation in some of the public health centres is not entirely free. They capitalise on everything to make you part with some change. Mothers give this money because it is insignificant, but the idea is that the money becomes worthwhile because of the crowd,” said Mrs. Toun Alayo, a mother of three, who lives in Ikeja, Lagos.
She said that most times, the public health centres require you to come with your own syringe and gloves, or your baby will not be immunised.
Going by samples of prices for routine immunisation in some private hospitals people believe that it could gradually slip away from the reach of the average Nigerian mother. Whereas, Nigeria’s immunisation programme states that routine vaccines should be free and accessible to all mothers.
In most small to medium-category private hospitals, immunisation from birth to six months costs less than N1,000. Same is true at Bee Hess Hospital on Akowonjo Road in Lagos.
But for yellow fever and measles the hospital charges N2,500.
Meanwhile, at Reddington Hospital on Victoria Island, immunisation from birth to nine months costs from N4,000 to N15,000. At birth, a child gets BGC vaccination for N10,000; the child needs N6,000 for each of the three mandatory doses of the Oral Polio Vaccination before he or she is nine months. For measles vaccination, the hospital charges N10,500, while yellow fever vaccination costs N20,000.
The Medical Director, Bee Hess Hospital, Dr. Bakare Olabode, a gynecologist tried to explain the reason why private hospitals charge clients for routine immunisation vaccines, describing them as handling charges.
And on the allegation of poor handling and loss of viability, he said, “I hear those stories a lot of the time, the public health centres only use that to discredit the private hospitals. We run a 24-hour service here and we cannot afford to have lights out. Our facility is either powered by electricity from Power Holding Company of Nigeria, generator or inverter.
“We have special fridges given to us by our private suppliers like GSK, for preservation of the vaccines. Some public health centres don’t operate at weekends while others don’t work at night, but we do. So how are they able to preserve vaccines better than us? Anyway, I only speak for my hospital.”
Olabode said that not only are the vaccines bought from the certified private suppliers, they now come in single dose packaging for individuals; leaving no room for waste or leftovers. He said his hospital is a government registered vaccination centre so it also gets supply from the government to serve people that are not even clients of his hospital.
“We also serve the less privileged through the vaccines we get from the local government immunisation centres. Private hospitals have a vital role to play in ensuring that all babies are duly immunised,” he added.
But a Paediatrician and public health worker in Agbor, Delta State, Mr. Abidemi Shabi, wonders how any private hospital can afford the demand of keeping vaccines viable.
Giving the situation report in Delta, he said vaccines are available and easily accessible in the state, and that mothers are not required to pay. He also said that it was not common for people to patronise private hospitals for immunisation in Delta State.
On viability, he said government agencies have Cold Chain Officers, who maintain the viability of the drugs for immunisation. He said when the required temperature is not maintained, the vaccines become de-majored and they are no longer capable of fighting infections.
“If a child gets immunised with a de-majored vaccine, his mother may have it on paper that he has been immunised but his body will not be able to fight the infection when the time comes. That is why even the general anti-polio vaccines are carried about in special coolers with ice blocks. On the vaccine bottle, there is a vaccine monitor that can tell you whether the content is still okay or not. It is a colour code.
“I must say that it is not easy to maintain the quality of the vaccines. For private hospitals, it could mean leaving their source of electricity on always. Hospitals that keep the leftover beyond six hours after opening it should watch it. Private hospitals have a duty of ensuring they get vaccines from trustworthy sources. The government should know that when a vacuum is allowed in any area of its responsibilities some people will rise up to fill it. You can’t blame private hospitals for charging a fee, but immunisation is free at government hospitals,” Shabi said.
Meanwhile, at a National Programme on Immunisation Centre in Lagos, the officer in charge of immunisation, Mrs. Aderemi Akinwale, said routine vaccines were available in Lagos State.
“The vaccines are available and we use solar electricity to store them. I doubt if anybody has come here in recent time and complained that we have a short fall of vaccine,” she said.
Akinwale said the NPI office supplies, vaccines to all registered vaccination centres and hospitals (public and private) free of charge.
“Vaccines come in a bundle with the syringes and needles and the safety boxes. We simply hand them over to the private hospitals and we even train their members of staff on how to immunise the children.
“For people that come here for immunisation, we only ask them to bring their gloves. We don’t charge anybody money for gloves. But we cannot use our bare hands to immunise their children. That is why we ask them to bring gloves,” she said.
A paediatrician at the University of Nigeria Teaching Hospital, Enugu, Mrs. Chioma Onuh, told Saturday PUNCH that an infant should be okay with the regular vaccines.
“I am aware some private hospitals do charge patients for the other vaccines that are not the routine ones. You don’t have to blame them. They are expensive. But i think a child should be okay with the regular vaccines and not bother about others,” she said.
Corroborating her view, Akinwale explained that such vaccines are not the routine ones given to infants.
“We don’t even have such vaccines here. The government doesn’t have it. But we are aware that some private hospitals have them. It is the choice of parents. It is not mandatory.
“Those vaccines are expensive. You don’t really have to blame the private hospitals who charge exorbitant fees for the vaccines. Patients who require them are probably rich and can afford them. But I always tell mothers that such vaccines are not really necessary. The government has approved the vaccines that babies need,” Akande said.
Another health worker in a public health centre in Lagos, who doesn’t want her name in print, said it is not compulsory to immunise a child with vaccines other than the regular ones.