Mishandled Measles Vaccine Kills 15 Children in South Sudan

(The New York Times)- Contaminated vaccines in a rural village in South Sudan killed 15 children last month and endangered dozens more, according to a statement from the World Health Organization, Unicef and the health ministry of South Sudan.

In the remote village of Nachodokopele in southeastern South Sudan, the same syringe was used on multiple people for four days straight. The vaccines were not stored in a cool place, as they should have been, the statement said.

And children were recruited to help organize the efforts; one even administered injections, the W.H.O. representative to South Sudan, Dr. Abdulmumini Usman, said in a phone interview.

The vaccination campaign, which was officially run by South Sudan’s government and supported by the W.H.O. and Unicef, lasted for four days, and about 300 people in the village were inoculated. The children who died were all injected on the same day and from the same vial, Dr. Usman said.

The fatalities, he added, resulted mostly from the mistakes of a single vaccine administrator working in the village. The statement said the children died of severe sepsis or toxicity.

In addition to the 15 children who died, 32 more became ill with symptoms including fever, diarrhea and vomiting.

“This tragic event could have been prevented by adhering to W.H.O. immunization safety standards,” said the statement, adding that “the team that vaccinated the children in this tragic event were neither qualified nor trained for the immunization campaign.”

People who administer vaccines in villages are trained by county-level health departments, which in turn report to South Sudan’s national health ministry. The W.H.O. and other aid organizations support the county departments but do not always interact with the people administering the injections at the village level, according to Dr. Usman.

A government spokesman referred questions about the deaths to the health ministry, where a representative did not respond to multiple phone calls seeking comment on Friday.

Amid a brutal civil war that has steered resources toward the war effort, South Sudan has had little capacity to carry out basic health initiatives like vaccination campaigns.

The war began in December 2013, when a clash between political leaders, followed by the targeted ethnic killings in the capital city of Juba, led to deadly conflicts across the country, especially in the north and east.

The war has killed tens of thousands of people and displaced millions. A peace deal to set up a transitional government last year fell apart within months, and since then, the conflict has intensified in the southern region of Equatoria, which includes Nachodokopele, though the village itself is remote and has not seen armed conflict.

The upheaval has worsened a backlog of unvaccinated children across the country, and the risk of measles and other preventable diseases remains extremely high. Immunization coverage has been around 44 percent during the conflict, down from 77 percent before, according to the W.H.O.

A report this week from the U.N. said that “South Sudan’s humanitarian crisis continued to deepen and spread” through the end of last year, adding that communicable diseases including measles and cholera were spreading across the country. Impediments to humanitarian efforts in recent years have included the destruction of health facilities, denials of access for aid workers, deportations and the killings of aid workers. The country is also facing famine, which was officially declared in some northern areas earlier this year.

The overlapping crises have stretched resources increasingly thin, even as the conflict continues with no end in sight. The contaminated vaccine fatalities could add one more layer of difficulty for health workers if it makes people suspicious of vaccination campaigns.

“The message we are reinforcing in the country is that this isolated incident happened because somebody did not do what he was supposed to do,” Dr. Usman said. “Not because the vaccines are not safe.”