Acting on the recommendations of the Technical Advisory Committee on Immunisation in the State, the government has approved a proposal to allow village health nurses to take the vaccine into the community, conditionally.
The committee had made the recommendation after surveys found that the State's revised policy of conducting immunisations only at the Health Sub Centre level (adopted in 2008 after children died following vaccination for measles in Tiruvallur district) was not entirely inclusive.
As per the recommendations, Immunisation Day would be conducted as usual at the HSCs on Wednesday. This would be followed up by Village Health Nurses going out to the villages, conducting a mop-up round, administering the vaccine to children who had missed their dose on Wednesday, according to officials of the Directorate of Public Health. The system would be implemented from September.
The VHNs will check, against a list of the children of a particular age group in their area of operation, the children who have received their shots. They will then be required to prepare a list of children who have not been vaccinated and take sufficient vials as they go from door-to-door on Friday. All the villages in a particular HSC will be covered within a month.
The government's approval, however, is conditional. It has specified that intensive training be conducted for the VHNs before they are reassigned the task. They should receive full-fledged training in vaccine administering methods, likely adverse effects following immunisation, and how to effectively handle such cases.
In December last year, the State decided to test out sending VHNs on trial basis to remote and hilly areas, even as they conducted their own study to assess vaccination coverage in Tamil Nadu.
In 2008, four children died following administration of measles vaccine. The government then decided that vaccines could only be given when parents bring the children to the hospitals, taking it entirely out of the hands of the village health nurses, who were the primary agents of immunisation earlier.
Fierce debates have raged since the change in 2008, with allegations that some children are invariably left un-immunised because parents do not bring them to the HSC. A UNICEF study, conducted six months into the commencement of this scheme, indicated a drop in coverage.
Advocates of the community model of immunisation charged that any lapse in immunisation would be deleterious, as it would reduce herd immunity. This would in turn result in epidemics of communicable diseases.
Keywords: communicable diseases