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Paidamoyo Chipunza Senior Health Reporter
While uptake of the mass rubella vaccinations rolled out by the Health and Childcare Ministry last week was overwhelming, a worrying trend of those living in low density areas ignoring the call has emerged. Harare city’s nursing manager sister Philomina Chitando said although the turnout in high density suburbs was overwhelming, in low density areas it was average.

Earlier, there had been unconfirmed reports of resistance by some elite schools dotted across the country refusing to allow ministry staff to immunise children in schools without the consent of parents.

Government, in a statement, reiterated that while parents or guardians had a right to make decisions on behalf of their children, it was also a right for the children to access basic services such as health.

“The Ministry of Health and Child Care would like to inform the public that in terms of the Constitution of Zimbabwe section 60 (4), which states that while parents and guardians have the right to determine, in accordance with their beliefs, the moral and religious upbringing of their children, they should not prejudice the rights to which their children are entitled under this constitution, including their rights to education, health, safety and welfare.

“In addition Section 81 (3) on the rights of children states that children are entitled to adequate protection by the courts in particular the High Court as their upper guardian,” reads the statement.

Harare was targeting to immunise about one million children between the ages of six months and less than 15 years but by end of day Thursday, they had already surpassed the target with some children still not vaccinated.

“We have already vaccinated 100 percent of our target but we still have children visiting our facilities such that we will extend the immunisation programme to today (Saturday). We also have a few schools which asked to have their children immunised next week Monday as they had other activities involving the targeted children during the week,” said sister Chitando.

There have been negative public perception about mass immunisation programmes backdated to 2009 when three children were reported to have died after such an exercise and many others fell ill. The responsible ministry later issued a statement saying that of the three reported deaths one was due to electrocution while the other two children had had other medical conditions unrelated to the immunisation process.

Unconfirmed reports from Matabeleland North province indicate that following last week’s exercise there was a death of a three-year-old boy from Jotsholo who developed complications soon after immunisation and later died.

Health officials are still waiting postmortem results to ascertain the cause of death with the ministry announcing that the mother of the dead child has since been admitted into hospital with same signs and symptoms as the deceased.

Diseases epidemiology and prevent director in the Ministry of Health and Child Care Dr Portia Manangazira described the turnout from the campaign as pleasing with some districts surpassing their targets with a few mild to moderate reactions following immunisation.
She said rashes and fever characterised the majority side effects are recorded during the mass vaccinations.

“Some bodies react a little bit to the vaccines but to us in the health sector that is a good sign. They may develop a rash, a bit of discomfort, fever, vomiting and diarrhoea,” she said.

Health and Child Welfare Minister Dr Parirenyatwa said the World Health Organisation position paper on rubella recommends countries to take advantage of the combined vaccine of rubella and measles.

He said Zimbabwe has therefore adopted the rubella and CRS elimination strategy targeting both boys and girls culminating in the just ended national rubella and measles vaccination campaign.

The rubella and measles vaccination campaign targeted about five million children between nine months and 15 years from throughout the country, a figure that translates to about 95 percent of all children in the country.

“Congenital Rubella Syndrome (CRS) is characterised by major birth defects such as heart defects, hearing loss, blindness, growth failure and mental retardation. Ninety percent of infants with CRS are born to mothers who were infected with rubella in the first 10 weeks of pregnancy,” where the words of Dr David Parirenyatwa at the beginning of a five-day mass measles and rubella vaccination completed last Friday.

Dr Parirenyatwa said while last measles cases were recorded during the 2010 outbreak, they were recording increased cases of rubella with 1 024 cases recorded in 2014.

“Our concern about rubella is because of the teratogenic effect of the virus,” said Dr Parirenyatwa.
He said ensuring that children were vaccinated was the only way to avoid rubella because most of the defects were not amenable to treatment especially in the Zimbabwean setting.

While measles vaccination had been catered for during routine immunisations, this was the first time the country was vaccinating children against rubella.
The measles vaccine was administered at nine months.

“We therefore envisage at introducing the measles second dose, being given at 18 months into the routine program of immunisation together with rubella vaccine,” said Dr Parirenyatwa.

“We will also take opportunity to administer Vitamin A supplementation to all children aged six to 59 months and allow those who may have missed any of their routine vaccination doses to catch up,” he said.

World Health Organisation country representative Dr David Okello commended Government for its effort to introduce the new rubella and measles vaccine its routine immunisation services.

“Both the campaign and introduction of the vaccine into routine services will help to work towards better control and final elimination of measles, rubella and congenital rubella syndrome,” said Dr Okello.

He said to ensure that immunisation efforts were making an impact, and to minimize the effects of future outbreaks, the WHO supported Zimbabwe to set up a case based surveillance system for measles, supported by a national measles and rubella laboratory service since 2000.“Generally we are happy with the performance of routine immunisation coverage in Zimbabwe,” he said.

Statistics from the national command centre for the campaign showed that by day three, about 59 percent of the targeted children had been vaccinated while 60 percent had received Vitamin A supplement.

Speaking to journalists during a field visit to Concession on Thursday, the district’s medical officer Dr Christine Magadza said by day two of the campaign, her district had already immunised 40 percent of their target.

“We are targeting to immunise about 99 900 children between the ages of nine years and 15 years but as of Tuesday, we had immunised nearly 38 000 children,” said Dr Magadza.

Dr Magadza said 39 percent of targeted children had also received Vitamin A supplementation by the second day of the campaign.
She said prior to the immunisation campaign, the district used village health workers to sensitise communities about the national immunisation programme, hence the overwhelming response.

“We have very few objectors and we are optimistic that we will meet our target,” she said.
In a separate interview, Tsungubvi clinic in Glendale sister in charge Mr Fanuel Runganga echoed Dr Magadza’s sentiments that response was overwhelming.

“First day we immunised 520 children, second day we immunised 830 and on day three we immunized 770 children,” he said.
Mr Runganga said so far the programme was running smoothly with a few and mild reactions. Some of the parents interviewed expressed gratitude in Government’s efforts in promoting the health of their children.

“We really appreciate what our Government is doing in an effort to curb prevalence of preventable diseases,” said Mrs Tatenda Kanyemba from Ramahori Farm in Concession.

“Even though there are long queues, they are moving very fast- a situation that is quiet encouraging because you do not want to spend the whole day waiting for a service,” she added. (Immunisation FAQs answered on R4).