KARACHI, Nov 20: The Expanded Programme on Immunisation (EPI), Sindh, has decided to introduce a new combination of vaccines to contain pneumonia, meningitis and a few other preventable diseases in children across the province in two phases beginning next month.

Sources privy to the immunisation activities undertaken in the public sector said the introduction of the new combination, known as Pentavalent vaccine, aimed at giving the province’s children protection against diphtheria, tetanus, pertussis, Hepatitis B and Haemophilus Influenza Type-B (Hib) had to be delayed mainly for two reasons -- delay in the additional training of government employed vaccinators and paramedics posted in the districts and non-supply of the vaccine from Islamabad.

The federal health ministry had approved the introduction of the pentavalent vaccines, with the technical and financial support of the Global Alliance for Vaccination and Immunisation, in January last and expressed the resolve to start administering the vaccine free to the Pakistani children on July, 2008.

While the vaccine has recently been introduced in Punjab and some parts of Balochistan, Sindh has not been able to make it for want of training and a requirement of the federal government to first exhaust the stock of Combo vaccines available with it and to be substituted by the pentavalent, the source said, adding that about 2,500 vaccinators were yet to be imparted special training for the administration of the new vaccine.

An estimated 23,000 children die of Hib diseases in the country each year, while thousands others are left with life-long disabilities such as paralysis, deafening and brain damage. About five million children each year will receive their first shot of pentavalent vaccine through the rural health centres, basic health units, EPI centres and government hospitals.

Globally, over 1,000 children under five die from Hib-related diseases each day.

In Sindh, 81 children out of 1,000 still do not survive their first year after birth, while the rate of mortality in children between birth and fifth birthday is 101 per 1,000 births. Most child deaths are caused by acute respiratory infection or pneumonia, diarrhea, and other vaccine-preventable diseases.

The project manager, EPI Sindh, Dr Mazhar A. Khamesani, said that under a new plan the introduction of the pentavalent had been delayed for some time as training of the vaccinators could not be ensured in the stipulated period.

He said a town health officer, a paediatric health personnel and a supervisor from each of the towns in Karachi had recently been imparted training by master-trainers deputed by Islamabad to function as trainers in the case of hundreds of vaccinators in their respective towns.

After the training of vaccinators, which is likely to be completed in the near future, the children of Karachi will start getting the pentavalent vaccines in three doses and preventive measles-vaccine in 11 months on Dec 15, he added.

The administration of the vaccines in the case of children belonging to the rest of the districts of the province will take place in the beginning of 2009, Dr Khamesani said and elaborated that the training of trainers of other districts would be conducted at Hyderabad, Mirpurkhas and Sukkur after the Eid-l-Azha holidays.

He said training of the staff concerned serving the children of the other parts of the province would be completed in December. The pentavalent vaccine would be administered to deserving children in three doses, while an additional vaccine against measles would be given after nine months of birth, he added .