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Measles Vaccination Scandal Results from Misleading Media Reports

November 3, 2008

Nona Suvarian, Tbilisi

210 people were injected with measles vaccine at the policlinics # 26; 180 people were injected on the second day; 22 were injected on the third day and 6 more on the third… the number of people that were being vaccinated had been reduced each day.  The reason for the changes was that TV has carried stories about the children who ended up in hospital after being vaccinated. Consequently, many people became afraid about the measles vaccine and did not trust that it was safe and they would not have complications themselves.

The same coverage was also reported in the printed media, with many articles about the vaccination program being carried out within the framework of an international campaign. Authors of the articles spoke that vaccine was of low quality and it had been illegally imported into Georgia. The vaccination campaign was already underway for several weeks when this news was being reported. The Human Rights Centre interviewed Tamar Manjavidze, the head of the public relation department within the Georgian Ministry of Labor, Healthcare and Social Welfare.

-Mass vaccination starts when a certain region or the world community intends to eradicate a certain virus or bacteria disease.  This campaign is connected with the decision of Europe to eradicate the measles virus. A total of 34 million people were injected with the vaccine.

Azerbaijan, Armenia, the Ukraine, Romania, Italy, Turkey and Cyprus-are those countries who took part in this campaign. Georgia is the last country to participate in this program. Generally, we wanted to carry out vaccination in summer but we postponed it because of the war situation existing back in August 2008.

-Why was it necessary for Georgia to be involved in this campaign?

-Membership of certain international conventions requires us to follow certain rules as laid down by those agreements. If we want to be member of the EU we should then share in their decisions and opinions about public health issues. However, nobody compelled us to carry out vaccination process.

-People spoke about future threat of epidemics. How predictable is a measles epidemic for Georgia?

-Of course, it is predictable enough; epidemiologist and research institutes are work on it. We expect there to be epidemic in 2009. Furthermore, Georgia has high rate for the epidemic because of high number of compactly residing people and this helps in the spread of a disease.  How close humans are in contact is the factor that determines the risk level. The epidemic situation facing the country is studied every year and reports are generated. These consider many factors and these are all taken into considering in drafting and releasing such reports and this allows responsible agencies to reduce the risk levels to society and have response plans.

-That means, our scientists also predicted the threat of the epidemics? 

-The sphere of science does not its limits. We cooperate with international experts and they cannot make decisions without the data that we provide them.

-Why did you choose the vaccine produced in India?

-It is not medicine that decides but it is a business decision. Each successful business owner tries to set up enterprises in those countries where production costs are the lowest. I mean cheap equipment and inexpensive labor costs. As for term “Indian vaccine”, it is not right.  It is the medicine produced by the international producer that manufactures the medicine in India, and this process is based on international standards. Besides that, only this institute produces joint vaccine of the measles. These medicines are tested several times. The World Health Organization, WHO, is actively involved in the process. It has independent European laboratories for testing. The WHO organization does not rely on the quality documents provided by the producer and tests the medicines in European laboratories independently. Furthermore, it does not happen only once, and there are many test and retests. There is data and this is also important, and only based on such information are we able to speak about the quality of medicines. There might be documents on the high quality of the medicines but in fact they might be of low quality. According to the recent events in Georgia we cannot claim that this vaccine was of poor quality.

-But there are a lot of infected children placed in hospitals…

-They spoke about adverse side effects in children following the injection. It is not enough ground to speak about the low quality of the medicine. Each medicine has its introduction which lists its possible side effects. But nobody considers the medicines to be poor because of the possible consequences. Vaccine is also a medicine and it also has various adverse affects. It also has its own estimated percentage of who will be impacted, and between 5-15 percent of the vaccinated people can experience side affects. Children are vaccinated after the age of two months. Side effects of the vaccination process have never been so negatively determined before. We, doctors are not surprised at diverse range of effect. Those people who were injected are not surprised with the outcome of the vaccination. It is dangerous only if vaccination threatens life and health. We received data from the whole Georgia on an hourly basis: how many people were injected and how many people experienced side effects. It was estimated 0.14 percent while the acceptable limit was from 5 to 15 percent. According to the data of 5 working days 330 thousand people were vaccinated. 35 thousand people are vaccinated a year. Thus, we injected people enough for nine years. In usual regime of the vaccination TV items are not prepared about side effects.

Only 380 people had side effects among a total of 330 thousand. Some patients were hospitalized because of the following symptoms: feeling sick, feeling dizzy, pain in abdomen and temperature. Only 6 percent of the vaccinated had rash. 2 percent of them had swollen the place of injection. Somebody felt sick and rushed to hospital. Only 55 people were placed in hospital for further examination.

Nobody was placed in intensive care as it was announced in the media. Generally, doctors should use medical terms. “Emergency room related activities”, which was used by journalists, means to restore the basic life functions of the body. In this case the heart and breathing have stopped, and it is a life or death situation. But children placed in hospital were not in such a critical situation to be able to comment about their conditions before cameras.

This scandal broke out because of incorrect information was spread throughout society. We had to provide correct information to overcome the disinformation. Children who were placed in hospitals because of reactions are not out of the ordinary but most cases are only taken as a precaution.  When we explain the situation with wrong term, moreover, claiming children were placed in the intensive care, of course people will react seriously to such statements. 

-Nevertheless, the society has more questions; how legal was the measles vaccine that was imported to Georgia? Did it have all documents that are necessary for importing medicines in the country?

-As for the registration, there is a law. It is Georgian Law on Medicine and Pharmaceutical Activities that regulates import of medicines. According to the Article 18 part VII of this law envisages particular conditions for importing medicines with simplified rules. Those particular conditions are: “natural disaster, mass injury of the population, epidemics, humanitarian aid or emergency interests of the state.” Currently we have faced one of those particular cases because the state has decided to import medicines and they are humanitarian aid. The procedures on importing the medicines are simplified and products can be imported without custom free. 

Based on the law, the Georgian Minister of healthcare has established a commission that regulates import of medicines. This commission has registered the vaccine. There is a list of documents that must be provided about the vaccine: information about its usage; certificate of the quality, notification of the production procedures, and these are according to international standards. In addition, if the commission is not satisfied with the provided documents, they can demand even more documents. However, the vaccine had all documents.

-That means, the vaccine was not tested in Georgia?

-Recommendation of such an organization like the WHO already serves as a guarantee. As for registration, it is necessary for the medicines that are imported based on another rule. This vaccine did not need to be subjected to complicated vaccine regulations because it was provided free-of-charge and it was imported for single usage and not across the counter.