CHILDREN have been dying and resources wasted because for decades the World
Health Organization has accepted information about vaccination coverage that’s
often unreliable and sometimes wildly wrong.
Occasionally vaccinations are recorded more than once, says Anthony Burton of
the vaccines division of the WHO in Geneva. “If your data are over-reported, you
may not be paying attention to a problem area and kids who normally would have
got vaccinated will get a disease and die,” he says.
Burton and his colleagues at WHO and UNICEF analysed vaccination data for the
past 20 years. “We discovered that 25 per cent of data were simply missing and
19 per cent were ‘outliers’,” Burton says. Outliers have “something funny about
them”, such as unusual jumps or inconsistencies.
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For example, they found that 106 per cent of children in Bangladesh were
given the third dose of diphtheria, tetanus and pertussis vaccine (DTP3) in one
year. In Sierra Leone, take-up supposedly jumped from 28 per cent to 68 per cent
between 1997 and 1998, despite a civil war.
And the problem isn’t limited to developing countries. Curiously, the review
found that there was no data from Norway.
“National level immunisation coverage values are a myth,” says virologist T.
Jacob John, advisor to the Indian state of Kerala. He says that for “year after
year”, India reported vaccinating hundreds of thousands more children against
polio than the number of doses the country purchased.
What’s more, independent experts say this has been going on since the 1970s.
“Everybody knows about it,” says Pierre Claquin, an epidemiologist working in
Bangladesh. There the reported figure for measles immunisation in 1999 was 96
per cent, as compared with 61 per cent from an independent survey, he says. “Too
often in the past health workers were threatened by punishment if they did not
meet targets.”
The WHO and UNICEF are now preparing revised estimates after re-analysing and
comparing the data with independent surveys. “As of now, we are reserving the
right to disagree with the country submitting the data,” Burton says.
