BCG vaccine shortage in Sindh feared to increase TB cases

LARKANA:There is no BCG (Bacillus Calmette-Guerin) vaccine in the entire Larkana district since the end of November due which newborns could not be vaccinated for prevention of TB, credible sources at Chandka Children Hospital (CCH) disclosed to this scribe on Saturday.

These sources further said that all the 12 vaccination centers across Larkana district being managed by the District Health Officer (DHO), are also without BCG.

DHO Dr Syed Amjad Shah also confirmed the news. Shah said that BCG shortage was not only being faced by Larkana district but also across Sindh. He said: “Over 100 vials are monthly required for the entire district but independent sources said that monthly requirement of Chandka Children Hospital Center is 100 vials and this center is without BCG vaccine since end of November.”

Shah said that he had also written a letter to higher health department authorities in this connection and their monitors were also informed about the BCG shortage during their recent visit to Larkana. He said a meeting was also scheduled with the Sindh health minister next week in which this issue would be raised.

He claimed that 20 newborns could be vaccinated from a vial. Since pregnant women arrive at Shaikh Zayed Hospital for Women (SZHW) here for delivery purposes from more than 12 districts of rural Sindh and many districts of Balochistan while newborns are also vaccinated under EPI at the CCH which is located opposite the SZHW.

Experts who do not want to be identified said that if BCG was not given to the newborns timely as per EPI program, then more TB cases could emerge in the future in the province which was already facing massive outbreak of HIV among children in Ratodero.

The BCG vaccine is one of the vaccines included in Expanded Programme on Immunisation (EPI) being run in Pakistan and other such countries where TB infection is rampant. Serious side effects are rare. Often there is redness, swelling, and mild pain at the site of injection. A small ulcer may also form with some scarring after healing, the scar is often taken as confirmatory sign that the child is vaccinated with BCG. It is not safe for use during pregnancy. The BCG vaccine was first used medically in 1921. It is on the World Health Organization’s “List of Essential Medicines”, the safest and most effective medicines needed in a health system.

Retired DHO Dr Khalilullah Shaikh said that shortage of BCG Vaccine is not uncommon. Its main causes include disparity between demand and supply, supply short of its demand, it comes in multi-dose ampules, each ampule contains 20 doses and loses its potency within 1-3 hours of opening the vial, therefore, to be discarded even it contains for example 19 doses of vaccine. He added that wastage is also one of the causes behind its shortage despite 50% wastage is allowed while calculating the supply consisting of rough estimates of demand, actual and authentic birth rates are not known and the demand therefore surpasses the supply, he added.

Dr. Shaikh said that EPI Centers of Larkana (mainly CCH), which also cater to adjacent districts of Sindh and Baluchistan, the shortage often became acute. He said the government must ensure its proper and regular supply across Sindh or else those newborns would be left behind who arrive from other districts’ far flung areas or provinces.