Vaccination against measles in Kazakhstan puts teenagers into hospital beds

Kazakhstan has suspended immunization against measles after a series of hospitalizations following the injections, Tengrinews reports.

At first, 18 students of a medical college in Temirtau, a town in central Kazakhstan, were hospitalized with high temperature. Then, a similar situation happened in Zhanaozen, where 30 high-school and college students were hospitalized. The condition of the first six was so severe that they were transferred to an intensive care unit. Then, a single case happened in Taraz: a 16-year old student lost consciousness after the immunization and was taken to a psychiatric clinic.

"In connection with the registration of adverse events following the immunization in Temirtau and Zhanaozen, by the resolution of the Chief State Sanitary Doctor of the Republic of Kazakhstan Zhandarbek Bekshin, the immunization campaign has been suspended," the statement of the Ministry of National Economy of Kazakhstan said.

Measles, also known as morbilli, rubeola, or red measles, is a highly contagious infection caused by the measles virus. Initial signs and symptoms typically include fever, often greater than 40 °C (104.0 °F), cough, runny nose, and red eyes. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Complications occur in about 30% and may include diarrhea, blindness, inflammation of the brain, and pneumonia among others. The risk of death among those infected is usually 0.2%, but may be up to 10% in those who have malnutrition.

The measles vaccine is effective at preventing the disease. Vaccination has resulted in a 75% decrease in deaths from measles between 2000 and 2013 with about 85% of children globally being currently vaccinated. Measles affects about 20 million people a year, primarily in the developing areas of Africa and Asia. 

This year's campaign of additional vaccination against measles in Kazakhstan went terribly wrong when dozens of teenagers were hospitalized in fever and unconscious to local hospitals.

It all started in Temirtau. 18 students of a medical college have been hospitalized with high temperature after a vaccination against measles they received on February 10.

As the head of health department of Karaganda Oblast Yerzhan Nurlybayev told, post-vaccination syndrome was identified as the preliminary cause of the condition. "These 18 students of Temirtau medical college were given measles vaccination as part of a large-scale campaign to vaccinate the population. This is an Indian vaccine tested in a medical laboratory and found to be safe for mass vaccination. We are looking into these causes. But the preliminary cause of their condition is post-vaccination syndrome," Nurlybayev said.

In all, 178 students of the medical college received the vaccine. According to Nurlybayev, of the 18 hospitalized students, 17 got better in two days and were discharged from the hospital on February 12. He added that no sanitary or other types of violations were found in the actions of the doctors who administered the vaccines.

Police of the Starogorodsky Division of the Department of Internal Affairs of Temirtau initiated a criminal investigation under the Article 317 of the Criminal Code of Kazakhstan - "Improper performance of professional duties of medical or pharmaceutical worker." The police said they had no suspects, but the doctors were being questioned.

Next came Zhanaozen in Mangistau Oblast in Kazakhstan's west. On February 20, 30 high-school pupils and college students aged between 15 and 19 were brought to Zhanaozen's infectious diseases hospital after receiving the measles vaccine.

It was noted that the vast majority of them were girls. So, according to the deputy head of the Department of Consumer Protection Valery Neyzer, this fact may curiously point to that the reaction could be caused by a psychological reaction to the puncture and not by the vaccine itself, Lada reported. He also said that there vaccinations carried out in Aktau but nothing of the sort happened there.

Later, the number of people in Mangistau Oblast who were taken to hospitals after measles vaccination has grown to almost 60. It is the second week teenagers were complaining about nausea, dizziness and cramps.

Some of the patients were sent to the Mangistau Oblast Hospital. One of the teenagers is still in the ICU. "The total number of teenagers admitted to hospital after vaccination is 59 people. Of these, 53 in Zhanaozen and six in Beineu," said the deputy head of the Oblast Health Administration Almabek Biesen.

The exact causes of poor health of adolescents have not yet been identified. Some presume that complications can be caused by poor-quality vaccines or improper storage of the medicines. The investigation in this regard has been undertaken by epidemiologists from Astana.

A separate case occurred in Zhambyl Oblast. A 16-year old college student in Taraz, a city in Kazakhstan's south, lost consciousness after being vaccinated, KTK reported on February 20. 

“My girl was healthy. She was never seriously ill. Now she is in bed unconsciousness, not reacting to anything. She got vaccinated against measles last Thursday. She was feeling bad for two days and then dropped on the third day. She hasn’t come back to her senses still,” the daughter’s mother said.

Meanwhile, the doctors were conducting their own investigation and determined that the cause of the incident was most likely grounded in troubles at home or an argument with a boyfriend. The mother’s statement that her daughter had no boyfriend did not convince the doctors, who sent the girl to a psychiatric hospital for further treatment.

Several teenagers in Atyrau Oblast in Kazakhstan's west were also hospitalized after the vaccination, Ak Zhayik reports. The incidents became known on 23 February from the parents of students. According to them, after the children were vaccinated against measles, they were brought to hospitals with various symptoms: loss of consciousness, suffocation, some of them could not walk on their own.

Chief pediatrician of Atyrau Oblast Gulfara Umirbayeva said that six cases of hospitalization after the vaccination were registered in the Oblast. "But they are not associated with the vaccination. Rather, they have to do with weakened immunity and exacerbation of chronic diseases," she said.

3012 people were vaccinated in the last three days in Atyrau Oblast. Another 285 refused to receive the injection.

According to the authorities, the need for the additional immunisation arose from the increase in the number of cases of measles in Europe, CIS and Kazakhstan. In January this year an 11-time increase of measles was recorded. The majority of those who ended up in hospitals after the injection were older than 15.

As of February 19, the total number of vaccinated persons aged 15-19 in Kazakhstan made 500,000.

"Post-vaccination complications have not been registered in other regions. According to preliminary results of the investigation, it was established that they are not related to immunization and are being regarded as a consequence of individual sensitivity in combination with psychological and emotional instability common for many adolescents," the Ministry of National Economy said.

Immunization against measles in Kazakhstan has been suspended until 2 March 2015. By this date the National Center for Drug Expertise will complete the investigation and make an examination of the Indian vaccine that has been used in the country to date.

By Dinara Urazova