A lack of awareness about Bacillus Calmette–Guérin (BCG) vaccine is depriving newborns of the vaccine during their birth despite 23% of them being born at clinics or hospitals with the vaccination facility in Chakaria upazila of Cox’s Bazar.
Only 2% of neonates have received the vaccine in the first week of their birth in the upazila, where 89% neonatal mortality occurs in the first week of birth.
The International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) came up with the findings in a recent study titled “Bangladeshi neonates miss the potential benefits of early BCG vaccination.”
BCG vaccine, also popularly known as TB vaccine, is primarily used against tuberculosis. In countries where the bacterial disease is common, one dose of BCG vaccine is recommended for newborns as close to the time of their birth as possible.
The research on BCG vaccination was conducted using Health and Demographic Surveillance System (HDSS), which covered 4,584 children aged 12–23 months in the upazila between 2011 and 2015.
The vaccination campaign covered 99% of Chakaria HDSS area where 65% newborns received BCG vaccine along with the first dose of Pentavalent vaccine simultaneously at the age of six weeks.
Another study published in British medical journal Lancet styled “Effect of breastfeeding on immune response to BCG vaccination” found that breastfeeding significantly enhanced cell-mediated immune response to BCG vaccine given at birth, but had no significant effect if the vaccine was administered four weeks after birth.
According to the study, as a reason for not vaccinating their neonates, 70% mothers reported that the first week is unsuitable for vaccination.
When contacted, Researcher and Associate Scientist of Centre for Equity and Health Systems in ICDDR,B SM Manzoor Ahmed Hanifi said: “Our vaccination programme has almost achieved the global standard of the child vaccination coverage in Bangladesh through its monthly outreach sessions along with the fixed facility services.”
“However, only a few children receive BCG vaccine at birth as I discovered at the Maternal and Child Health Training Institute at Azimpur. Only 20% of newborns gets the vaccine administered in the first month,” he said.
Health and Family Welfare Ministry in the Expanded Programme on Immunisation (EPI) guideline clearly mentioned vaccination with a dose of BCG implant at birth, but that is not being followed in the EPI, revealed the ICDDR,B study.
Figuring out a lack of awareness in this regard, health expert Ahmed Hanifi said: “Outreach health workers typically aim to provide BCG along with the first dose of Pentavalent at six weeks of age to minimise workload and to facilitate mothers’ preference of not taking a baby out of home in early days of life due to some traditional beliefs.”
“Low Birth Weight (LBW) and preterm infants are given BCG immunisation late due to lack of directives from WHO. However, as recent studies have shown no negative effects of early BCG vaccination in these children, WHO now recommends early immunisation for LBW and preterm babies,” he added.
Hanifi suggested that doctors be more aware about administering BCG vaccine to the newborns and encourage mothers in this regard by informing them about the benefits of the vaccination during anti-natal period.