Discrepancies mar Sindh’s typhoid vaccine drive

Discrepancies and malpractices have been detected in the ongoing typhoid conjugate vaccine (TCV) campaign in Sindh, provincial health authorities conceded on Saturday, vowing to take stern action against offenders after the post-campaign evaluation.

Health authorities also announced an extension of the campaign until June 1 to ensure targets are met.

The vaccination drive, conducted from May 13-25, aimed to vaccinate 9.8 million children aged nine months to 15 years across Karachi and Hyderabad to curb the increasing cases of drug-resistant (XDR) typhoid. Despite ample resources provided by both the provincial government and donor agencies, serious malpractices, financial embezzlements, and discrepancies were noticed from the first day of the campaign.

An inquiry report from the Sindh health department revealed the presence of "fake 1st and 2nd level supervisors" during the campaign's monitoring. Additionally, "relatives" of officials and irrelevant persons were hired as social mobilizers with no experience in convincing people to vaccinate and counter vaccine hesitancy.

Reports of "coercion by the 1st level supervisors for mobility funds”, inadequate supervisory tier monitoring, and non-provision of fuel led to low coverage in several union councils, according to the report. It was also discovered that several schools did not cooperate with the vaccination efforts, yet it was falsely reported that children in those schools were vaccinated.

“Worst of all, vaccinators were not provided any facilities to perform their jobs in extremely hot conditions. They were not given fuel, umbrellas, or water,” the report highlighted.

Health authorities have directed the project director of the Expanded Programme on Immunization (EPI) to closely monitor campaign activities. They warned that strict action would be taken against those submitting false or fabricated vaccination records.

An official of the Sindh health department informed The News that Sindh Health Minister Dr Azra Pechuho has taken serious notice of the irregularities and financial embezzlements during the TCV campaign. The campaign has faced several issues, impacting its effectiveness and coverage. One major issue is the lack of awareness and reluctance among some parents to vaccinate their children. Despite efforts to inform and mobilize communities, misinformation and distrust towards vaccines persist, leading to lower vaccination rates.

“In these circumstances, irrelevant and incompetent persons were hired by the campaign managers, adding fuel to the ongoing vaccine hesitancy,” the official claimed. He added that although it was shown that thousands of vaccinators and support staff were deployed, in reality, hundreds of teams were just present on paper and not in the field.

“Accurate and real-time monitoring of the vaccination campaign is critical. Issues have arisen with the timely collection and reporting of vaccination data, vital for assessing progress and addressing gaps. The use of mobile technology for data collection is a step forward, but its implementation needs to be more widespread and consistent,” he added.