Vaccine delays in poorer nations raise health risks for infants

Many infants in poor and middle-income countries get their vaccines weeks later than doctors recommend and therefore face increased risks of sickness and death, according to a new study in the Lancet.

Globally, vaccination rates have risen sharply over the last 20 years, and child mortality has dropped below 10 million a year for the first time, thanks largely to measles shots. But things aren't so good in Africa and Latin America. Researchers at the London School of Hygiene and Tropical Medicine studied health surveys from 45 countries in those regions, and found that:

  • In the slowest countries, at least a quarter of all children got shots between two months and five months late.

  • For vaccinated children, the median delay in the 45 countries was 2.3 weeks for tuberculosis, 2.4 weeks diphtheria, tetanus and pertussis (DTP1), 2.7 weeks for measles-containing vaccine (MCV1) and 6.2 weeks for DTP3.

  • However, in the 12 countries with the longest delays for each vaccination, at least 25 per cent of the children vaccinated were more than 10 weeks late for tuberculosis, 8 weeks for DTP1, 11 weeks for MCV1 and 19 weeks for DTP3.

    Besides the obvious risk that a child will die during the delay, there are some theoretical risks with vaccines being newly introduced. The Hepatitis B vaccine under consideration can protect against infection from the mother only if given within seven days of birth, and the tuberculosis vaccine, which should be introduced in the first week, is often delayed. And a new vaccine against rotavirus has a recommended cut-off date of 12 weeks, meaning it might be denied to many children, say researchers.

    Source: Donald G. McNeil, Jr., Vaccination: Vaccine Delays in Poorer Nations Raise Health Risks for Infants, New York Times, March 24, 2009; based upon: Andrew Clark and Dr. Colin Sanderson, Timing of children's vaccinations in 45 low-income and middle-income countries: an analysis of survey data, The Lancet, March 2009.

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    FMF Policy Bulletin/ 31 March 2009
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