Vaccines Shortage Amid Kenya’s Cholera Outbreak Leads To Two-dose Strategy Suspension
The International Coordinating Group (ICG) has decided to temporarily halt emergency supplies of the standard two-dose cholera vaccination regimen.
A single-dose approach will be used instead. The decision was made in response to cholera outbreak campaigns.
The new strategy will allow the doses to be used in more countries, at a time when cholera outbreaks are on the rise globally.
The Ministry of Health in Kenya has issued a multi-county cholera outbreak alert, confirming cholera outbreaks in six counties: Kiambu, Nairobi, Murang’a, Kajiado Nakuru, and Uasin Gishu.
Dr. Patrick Amoth, Acting Director General for Health, stated that departments of health in the affected counties have begun response activities such as field investigations, enhanced surveillance, laboratory testing, case management, risk communication, community engagement, and environmental sanitation to prevent the disease from spreading further.
According to WHO, fewer than 20 countries reported outbreaks on average in the previous five years, and the global trend is moving toward more numerous, more widespread, and more severe outbreaks due to floods, droughts, conflict, population movements, and other factors that limit access to clean water and raise the risk of cholera outbreaks.
“The one-dose strategy has proven to be effective to respond to outbreaks, even though evidence on the exact duration of protection is limited, and protection appears to be much lower in children,” the statement from WHO says.
When the second dose is administered within six months of the first, immunity against infection lasts for three years, according to the study.
Although the temporary interruption of the two-dose strategy will result in a reduction and shortening of immunity, the WHO adds that this decision will allow more people to be vaccinated and provide them with protection in the near term, should the global cholera situation continue to deteriorate.
Ministry of Health has directed County Directors of Health to immediately notify all health workers of the Cholera outbreak and to keep an eye out for patients experiencing acute watery diarrhea.
According to Dr. Patrick Amoth, Acting Director of Health, the county health management should conduct an active search for acute watery diarrhea in health facilities and communities for missed/unreported cases, as well as strengthen surveillance activities up to the village level.
“They should ensure 100% case-based reporting, strengthen the involvement of laboratory personnel in disease surveillance for timely confirmation, as well as ensure that all health workers are conversant with the case definition and are sensitized on the potential Cholera outbreak,” he said.
Dr. Amoth also stated that sub-county health management teams will be expected to increase weekly IDSR reporting to ensure that more than 90% of facilities are reporting, improve information sharing between sub-counties, and conduct support supervision on a more regular basis.
The Sub-county health management teams were asked to reactivate the outbreak management teams at all levels, improve lab capacity for specimen collection and shipment, and increase participation of other stakeholders, such as county and sub-county commissioners, communities, water agencies, and partners.
Other measures include developing an appropriate preparedness and response plan for sub-counties to prevent the spread of any potential outbreak and planning for long-term contact tracing, isolating cholera cases in wards, and increasing community awareness.
Cholera transmission, according to the Ministry, is closely linked to poor environmental management.
Peri-urban slums, where basic infrastructure is lacking, and camps for IDPs or refugees, where basic requirements such as clean water and sanitation are not met, are examples of at-risk areas.
He stated that cholera is a highly contagious disease that affects both children and adults and can kill within hours.
People with low immunity, such as malnourished children or HIV patients, are more likely to die if infected.
This comes as President William Ruto’s promise to expedite reforms at the National Health Insurance Fund (NHIF) in order to fully realize the Universal Health Coverage (UHC) agenda.
The President stated on Thursday during the Mashujaa Day celebrations at Uhuru Gardens that contributions to the NHIF will be restructured to a household contribution model rather than the current individual contributory model.
“In the past 10 years, 12 million Kenyans have joined the fund. The challenge, however, is that the NHIF is an occupational scheme for salaried people on the payroll in the public and private sectors and not the social insurance scheme it ought to be,” said Ruto
As the country moves to promote preventive and promotive strategies in the sector, the President emphasized the importance of community health workers in improving access to primary health care among Kenyans.
“In partnership with county governments, we will mainstream community health workers and make them the foundation of our healthcare system,”
“Many critical health illnesses, including cancer, heart complications, kidney failure, and hypertension, can be detected and addressed at this level without the need for a hospital visit or admission.
Ruto reaffirmed the government’s commitment to addressing healthcare challenges such as a lack of human resources and poor labor relations between health professionals and county governments.
