The Tamil Nadu government has ordered closure of all immunization camps in the rural areas of the state and asked the state health department to conduct the immunization programmes only at its Public Health Centres (PHCs). The new immunization protocol includes the close supervision of doctors also, said Dr. Padmanaban, director of public health.

This decision follows the death of four ten-month-old infants in Thiruvalluvar and Dindigul districts on April 23, after being administered anti-measles vaccine at two immunization camps. The director told Pharmabiz that the department was gearing up to combine vaccination with health check ups and parental counselling.

The new drive that started last Wednesday, however, showed only a mixed response with good turnout in the hospitals at Chennai but very low response in other parts of the sate. However, the health officials claimed the overall response was good.

"Under the new scheme, both the mother and the child will be examined, and their medical history will be uploaded in the computer. In the vaccination programmes, private paediatricians will also be hired on all Wednesdays for administering vaccines," he said.

The immunization programme has been continuing in the state on every Wednesday for the last four decades against six diseases such as diphtheria, pertussis, tetanus, measles, polio and tuberculosis. Recently vaccinations were also being given against Hepatitis B and Japanese encephalitis.

"Previously the immunization was being held in as much as 38,000 camp sites, set up by the department, in the rural areas. But the alleged vaccine related deaths have spurred us to shift the programme to the PHCs with close supervision of doctors and focus on maternal and infant care," the director pointed out.

The vaccination, which was suspended following the death of four children, was resumed in all the districts last Wednesday. Meanwhile the decision of the government to shift the programme from the rural camps to the health centres was widely welcomed by a medical practitioners' association called Doctors' Association for Social Equality (DASE). However, the general secretary of the association demanded an independent inquiry into the incident.

"The central investigation team's investigation is not satisfactory. So, a neutral team should be allowed to investigate the cause of death and it should be on a free and fair manner. The true cause of death should be found out and the report should be made available for the public", he said.

The association secretary also wanted the government to take suitable steps to avoid contamination in the vaccines at all level and said vaccines should be kept safely in cold storage at stipulated temperature.

The new move of the department has sparked a dissent among the village health nurses and other health workers. Nirmala, president of the village health nurses association told Pharmabiz, "This move has brought so many difficulties for the villagers, especially women and children. They have to travel long distances to reach the health centres from their places lacking proper means of conveyance".

According to the health workers, the number of babies getting vaccinated in the 1420 public health centres in the state on a day will be very less compared to the number of babies that were getting vaccinated in the 38000 immunization camps set up through out the state previously.

The Union health ministry is yet to announce the cause of the death. Earlier the ministry had sent a set of experts to the spots where the tragedy had occurred and collected samples from various batches of the vaccine allocated to the state. The samples were sent to the Central Research Institute, Kasauli for testing.