Routine immunizations for tuberculosis, diphtheria, tetanus, pertussis, polio, and measles have been "available" in Haiti since 1977, rubella since 2009, and Hib and Hepatitis since June of 2012. In January 2013, pneumococcus and rotavirus are scheduled to be added to the schedule.
The table below shows the differences in the routine immunizations that are offered in Canada compared to Haiti.
A recent paper (Rainey et al, Vaccine 2012;30:1746-51) reported on the results of a survey done in 2009, a year before the earthquake. Only 40% of the children surveyed had received full coverage of the recommended immunizations (similar results in Canada would be at least 80%). The coverage was highest for TB (87%), the first dose of diphtheria-tetanus-pertussis (92%), and the first dose of polio (93%), and was lowest for measles (47%).
Just because a vaccine is recommended and available is not the same as received.
World Health Organization (WHO) data from 2008 in Haiti reveals that pertussis was reported in 696 individuals, diphtheria in 10, and neonatal tetanus in 16. To report a communicable disease requires that the infection be recognized (patient needs to have access to a physician and physician needs to make a correct diagnosis, which often requires precise lab testing) and that the physician takes the time to document the illness and to send this documentation to the proper authorities. This likely does not happen very often in Haiti, so the reports of any infection are likely a gross underestimate.
My clinical eyes will be open for children with diphtheria, polio, tetanus, measles, German measles, H flu, and other infections that have been uncommon in Canada for over two decades.
DISCLAIMER: This blog was originally posted on Helping Children in Haiti and Nicaragua. Please note, Dr Robson is not accepting donations at this time. However, he would greatly appreciate your comments and suggestions in support of his efforts.
