Защита детей от кори в Румынии
Родители из общины рома, проживающей в городе Стрехае на юго-западе Румынии, кивают и с облегчением улыбаются после просмотра короткого видеоролика о пользе иммунизации для их детей, показанного местным врачом. Врач отвечает на вопросы родителей, прежде чем они вместе со своими детьми перейдут в следующий кабинет, где всем детям будет проведена вакцинация. Здесь дети разного возраста: те, кто только начинает ходить, и те, кому уже исполнилось 18 лет. Самые маленькие крепко держат своих мам за руку, а те, кто постарше, улыбаются и просят посмотреть фильм еще раз. Производство и показ данного фильма осуществляется в рамках программы ЮНИСЕФ в Румынии по поддержке усилий министерства здравоохранения страны, направленных на повышение показателей охвата иммунизацией и предотвращение распространения кори. С 2000 года показатели охвата иммунизацией в Румынии значительно снизились. В 2017 году только 75 процентов детей получили две дозы вакцины MMR - комбинированной вакцины против кори, эпидемического паротита и краснухи. Этот показатель намного ниже рекомендованных 95 процентов, необходимых для защиты всех детей. В результате низких показателей охвата иммунизацией в Румынии произошла вспышка кори. В 2016 году ею заболели более 15 000 человек, из которых 59 человек умерли. Большинство из них составили дети. В рамках непрекращающихся усилий по повышению охвата детей иммунизацией, в июле 2018 года стартовала организованная министерством здравоохранения Румынии кампания по вакцинации детей, которые не были привиты. Для информирования населения о важном значении иммунизации участники кампании ходили по домам. В целях поддержки данной кампании ЮНИСЕФ разработал серию информационных материалов, предоставляющих предоставить родителям фактическую информацию о преимуществах и самом процессе иммунизации детей в доступной для понимания взрослых форме. В состав этих информационных материалов входит короткометражный фильм, который посмотрели семьи в Стрехае. Фильм демонстрируется семьям из наиболее уязвимых общин Румынии - родителям, живущим в труднодоступных районах, семьям, пострадавшим от нищеты, и общинам рома. Показатели иммунизации среди детей в этих общинах чаще всего самые низкие по стране. В этом фильме рассказывается о необходимости и преимуществах вакцинации, и одновременно даются ответы на часто задаваемые и волнующие родителей вопросы относительно вакцинации: Безопасно ли делать прививку моему ребёнку? Что делать, если она/он заболеют другой болезнью? Что, если мой ребёнок заболеет после прививки? Эта прививка бесплатна? A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. Девочка получает прививку в общинном центре в Бухуши, в восточной Румынии, в рамках кампании по проведению вакцинации детям, которые её не прошли. Эта кампания проводится при поддержке ЮНИСЕФ и ВОЗ. «Вначале родители не хотели прививать своих детей, но потом они доверились нам. Мы рассказали родителям о пользе прививок и попросили их задавать врачу все вопросы, которые могут возникнуть у них в ходе проведения кампании. Таким образом, родители смогли получить чёткое представление о пользе вакцинации», - сказала Габриэла Стан, медицинский работник в городе Бухуши, в Восточной Румынии. Габриэла была членом группы, ходившей по домам, для того чтобы информировать родителей из уязвимых сообществ о преимуществах вакцинации. И хотя за последние несколько месяцев в Румынии произошли положительные сдвиги в деле вакцинации уязвимых детей спасающей жизни прививкой MMR, дети будут по-прежнему находиться в опасности до тех пор, пока охват иммунизацией не достигнет 95 процентов. ЮНИСЕФ в Румынии будет и впредь помогать в проведении информационно-разъяснительных кампаний о важном значении и необходимости вакцинации и поощрять всех родителей и лиц, обеспечивающих уход за детьми, к своевременному проведению этой профилактической процедуры. Таким путём они смогут защитить своих детей от болезней, предотвратимых с помощью вакцинации.
Protecting children against measles in Romania
Parents living in Strehaia, a Roma community in South-West Romania, nod and smile in relief after watching a short video shown by their local physician on the benefits of immunizing their children. The physician answers questions from the parents before they gather their children and move to the next room where all of the children are vaccinated. The children range in age from young toddlers to 18 years old. The young ones hold their mothers’ hands tightly, but the older ones laugh and ask to watch the film again. The film is part of UNICEF Romania’s ongoing support to the Ministry of Health’s efforts to increase immunization coverage and prevent the spread of measles. Vaccination coverage in Romania has declined since 2000. In 2017, only 75 per cent of children had received two doses of Measles, Mumps and Rubella (MMR) vaccine – a coverage rate far below the recommended 95 per cent needed to protect all children. As a result of low immunization coverage, Romania has experienced a measles outbreak, with over 15,000 people affected since 2016. This includes 59 deaths, the majority being children. As part of ongoing efforts to increase immunization coverage, in July 2018 Romania’s Ministry of Health launched a door-to-door catch up campaign to vaccinate children who missed their vaccinations. In support, UNICEF developed a series of materials to provide parents with easy to understand, factual information about the benefits and process of children being immunized. These materials include the short film watched by families in Strehaia. The film is shown to parents and families in the most vulnerable communities in Romania - people living in hard to reach areas, those affected by poverty, and Roma communities. These communities often have children with the lowest rates of immunization. The film talks about the necessity and benefits of vaccination and, at the same time, addresses the most common vaccine-related questions from parents: Is it safe to vaccinate my child? What if she/he catches another disease? What if my child gets sick after the vaccination? Is the vaccine free of charge? A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. “In the beginning parents did not want to vaccinate their children, but then they put their trust in us. We told them vaccines are good and we encouraged them to ask the doctor all the questions they have during the campaign. So they were able to have a clear picture on the benefit of vaccination,” said Gabriela Stan, a health mediator in the town of Buhuși, in Eastern Romania. Gabriela was part of the team that went door-to-door to inform parents from vulnerable communities about the benefits of vaccination. Although there have been positive developments in reaching vulnerable children with lifesaving MMR immunizations over the past few months in Romania, until the coverage rate reaches 95 per cent, children will remain at risk.
Vaccination drive ongoing to protect children from deadly measles outbreak in Ukraine
Uliana Dziuba, 36, is holding the hands of her two young children as they wait to receive their vaccination against measles, mumps and rubella (MMR). Unlike her brother Volodia, nine-year-old Maryana is anxious, but Uliana knows how important today is. “I used to refuse to vaccinate the children against measles,” she says. “Once, I refused because they were sick at the time. Another time, there was a very powerful anti-vaccination campaign on social media. But Maryana got measles at age three and now I’m very worried that my son will get sick. I am vaccinating both of them for the first time today.” The pair are among thousands of children now being vaccinated in Lviv region, Ukraine, after the Ministry of Health with support from UNICEF launched an immunization drive. It is using a combined approach: teams of mobile doctors are working to reach school-age children while local clinics are increasing their ability to vaccinate more children. The drive is happening as UNICEF warns that global cases of measles have surged to alarmingly high levels – including in countries that had previously been declared measles free – eroding progress against this highly preventable, but potentially deadly disease. Maryana Dzuba, 9, receives her first dose of MMR vaccine on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, Ukraine, as part of a three-week long catch-up vaccination campaign to increase MMR coverage among school aged children in the region. Maryana Dzuba, 9, receives her first dose of MMR vaccine on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, Ukraine, as part of a three-week long catch-up vaccination campaign to increase MMR coverage among school aged children in the region. In Ukraine alone, according to Government data, there were more than 53,000 cases of measles in 2018. Another 24,000 people were infected just in the first two months of this year. The situation in Lviv region is particularly dangerous, with approximately 11,000 measles cases in 2018, and up to 50,000 unvaccinated children in the region. Of the 634 children attending Volodia and Maryana’s school in Lviv, only 13 remain unvaccinated due to the ongoing immunization drive. During the first two days, a total of 2,030 children were vaccinated. For many it was the first time. The vaccination drive also helps combat negative attitudes towards vaccination, as well as shortages in vaccine supply through 2009-2015. “Teachers and medical professionals have been campaigning for vaccinations,” says school headteacher Tetiana Malieryk. “We held all-school meetings and parent-teacher conferences, where the danger of measles was explained. Now fewer parents are refusing vaccinations and those children who did not receive vaccinations because of their parents’ beliefs are being vaccinated.” Next in line for vaccinations at the school in Lviv are six-year-old twins Vitalina and Yuliana. The girls and their mother Olesia Kechur, 37, are dressed in traditional embroidered clothing. This will be their second vaccination against measles. Twins Vitalina and Yuliana Kechur, 6, are given a check-up by the doctor before receiving MMR vaccination on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, western Ukraine. Twins Vitalina and Yuliana Kechur, 6, are given a check-up by the doctor before receiving MMR vaccination on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, western Ukraine. “The mother is very responsible about vaccinations,” reports Halyna Narolska, their doctor. “They get all of them and don’t miss anything.” Narolska has been a doctor for over 30 years. During this time, she says, she has not seen a single complication from an MMR vaccine. “Temperature may increase and there may be rash on day four, but neither has happened to a single child that we have vaccinated,” she says. “The only way to stop the outbreak is to vaccinate all children.” “There is a measles outbreak all over the world,” remarked Ukraine’s Deputy Minister for Healthcare Olha Stefanyshyna, during a recent visit to Lviv. “However, Ukraine is sadly a leader among the European countries. This is why we need to take extraordinary measures. I would like to say that this campaign is aimed primarily at children who missed their vaccination against measles, mumps, and rubella in the past. Today, we have better coverage of children who are born now.” UNICEF and its partners are supporting governments to reach millions of children in countries around the globe with life-saving immunization. However, stronger commitment and actions to vaccinate more children and protect them from preventable diseases is critical – including in Ukraine.
#VaccinesWork to protect children in Ukraine, amid measles outbreak
As a mother of two young children, Natalia was once told by her doctor that vaccinations were unnecessary. Now – with a measles outbreak gripping Ukraine –Natalia is glad she chose to ignore the doctor’s advice and instead vaccinate her children. This recent national outbreak has affected 16,500 people and killed 13, including nine children. According to a UNICEF poll taken in 2016, 16 percent of parents in Ukraine have refused vaccinations for their children. Natalia with her two children in a park in Kyiv. Natalia, with her two young children in a park in Kyiv. “Many parents I know still refuse to vaccinate their children,” says Natalia, whose children received the MMR vaccine against measles, mumps and rubella. “They say the vaccines are bad, that they have adverse effects. My children are fine and I think their health is more important.” Ukraine’s Ministry of Health has been leading the outbreak response since 2017 with support from UNICEF and other partners. While less than half of all children in the country were vaccinated against measles as part of routine immunization in 2016 (via the MMR vaccine), the number more than doubled in 2017 to over 90 percent, according to the Ministry. Valentyna Ginzburg, a doctor who heads Kyiv’s state healthcare department, says she and her team have been working to combat the measles outbreak since first being alerted to a rise in infections following the New Year and Orthodox Christmas celebrations in 2018. “We received information on the incidence rates of measles in Kyiv,” Dr. Ginzburg says. “We knew we needed to take rapid action to prevent a situation similar to other regions, such as Odesa, where there had already been fatalities amongst both adults and children from the illness.” Measles is one of the most contagious diseases around and we understood that if we were not proactive and did not control it, it would have not been long before we had the same situation as in other regions. Dr. Ginzburg Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. UNICEF/2018/Krepkih Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. In the four days that followed, 11,000 children were vaccinated in Kyiv. Around 48,000 children were immunized from January to March, a tally that would normally take 12 months to reach. Following national recommendations on outbreak response, authorities in Kyiv launched a ‘situation room’ to collect the latest information and coordinate response actions. Being vaccinated was also made a pre-condition for children attending schools and preschools to help stop the spread. The city administration also encouraged medical specialists to visit schools and raise awareness of vaccination among both teachers and parents. Maryna Stefanenko, a pediatrician at a clinic on the left bank of Kyiv, gives more details. “We had a lot of people coming in, even those who normally go to private clinics,” she says. Dr Stefanenko’s clinic usually administers around 80 vaccines per day, but during the outbreak they were immunizing around 1,200 people each day. On the other side of the city, in Obolon district, another clinic rushed to meet demand. A pediatrician there, Dr Natalia Yatsenko, explained that as part of her job, she must sign the paperwork for parents who refuse to vaccinate their children. She says she spends a lot of time explaining the benefits of vaccination, as well as the risks for children who do not receive their shot. Before the measles outbreak, she managed to talk some 10 per cent of objectors into changing their mind. However, during the outbreak, she did not even have to persuade them – many parents who were once against vaccinations were very keen to bring their children to the clinic. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. Another factor in the response? The effects of armed conflict in eastern Ukraine. “We had some internally displaced people from the eastern regions who came to our clinic,” says Yatsenko. “They told us that their children’s vaccination records had been falsified, and now they wanted to vaccinate them for real. So we vaccinated them.” “We also vaccinated some parents,” adds Stefanenko. “The parents bought the vaccines for themselves from the pharmacy then brought them to us and we administered the shots.” Dr. Ginzburg also advocated with the Kyiv authorities to address one of the biggest issues the country is struggling with - access to vaccines for adults and health workers. “All health workers had to be checked and those who required vaccination had to be immunized,” she says. “Then we were sure that, no matter what, the doctors wouldn’t be incapacitated.” The city administration also made sure the municipal pharmacy chain had measles vaccines available for adults. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Although vaccines for children were available in 2017, increased demand had depleted stocks in some regions. To help replenish stocks, a new expedited supply of MMR vaccines was delivered by UNICEF at the request of the Ministry of Health at the end of February 2018, and another 800,000 doses are due this month, to ensure sufficient vaccines for both routine immunization of children and those who may have missed their immunizations in previous years. Significant progress has been made in reaching more children with vaccines, yet still an estimated 1.5 million children die globally from vaccine preventable diseases every year and an estimated half a million children in the region are still not immunized. Millions of lives can be saved by extending basic health services like routine immunization to the most vulnerable and disadvantaged, and UNICEF is on the ground immunizing millions of children each year . Vaccines protect children against disease and death, saving up to three million lives every year. In short, #VaccinesWork.
The undeniable power of vaccines
]: Olena Kudryashova and her daughter, Maya, 17 months, walk outside their home in Kyiv. Both caught measles in 2018. Olena was infected first, before spreading the illness to her daughter. Today, Olena supports vaccination as early as possible. “Vaccination, like politics or religion, leaves no one indifferent,” she says. “But… there is no room for discussion in vaccination. It is absurd to deny its effectiveness.” Инна Онищенко, блогер Facebook, популярный среди молодых матерей в Украине. “It is easy to be an anti-vaccinator when you have no children,” admits Inna Onyshchenko, a Facebook blogger popular among mothers of young children in Ukraine. Before she was a mother, Inna spoke out against vaccination. When she became pregnant, she reconsidered. Today, her three-year-old daughter Zoryana has all of her vaccinations and Inna shares her experiences on her blog, dispelling common myths about immunization. Светлана Овдий играет возле своего дома в пригороде Киева со своим трёхлетним сыном Кириллом. Svitlana Ovdiy plays with her son Kyrylo, 3, a tetanus survivor, near their house outside Kyiv. The infection put Kyrylo in a medically-induced coma, and he spent 50 days in the hospital. “When he heard my voice... he started crying, calling for help, but there was nothing more I could do,” Svitlana recalls. “Now vaccination is a top priority issue in our family.” Ханна Прокопышин находится со своим девятилетним внуком Дмитрием в больнице, где он проходит лечение от бронхиальной астмы. Hanna Prokopyshyn sits with her grandson Dmytro, 9, in the hospital where he receives treatment for bronchial asthma. Dmytro’s parents initially were afraid to vaccinate their son due to his condition – a concern doctors dispelled, especially amid Ukraine’s measles outbreak. Dmytro has already successfully received the first dose of the MMR vaccine and his parents plan to follow the National Immunization Schedule. Сергей Олийнык, врач-педиатр, изображён на фото со своей годовалой дочерью Катей. Serhiy Oliynyk, a paediatrician, holds his daughter Katya, age 1, before setting off to work at Kosiv hospital in Western Ukraine. Serhiy promotes vaccines among his patients and recently had Katya inoculated against measles. Children should generally receive their first dose of the MMR vaccine at age 1; babies at high risk of contracting measles, especially during an outbreak, can receive the MMR shot as early as 6 months. Анна Кравчук, студентка медицинского университета, является одной из шести детей в своей семье. Anna Kravchuk, a university student and one of six children, did not get vaccinated until the measles outbreak in Ukraine reached her school. Many of Anna’s fellow students were infected – one died. After Anna got vaccinated, she convinced her mother to vaccinate her younger sisters. “I am sometimes being asked for medical advice,” she says. “And, of course, in the first year of study I am not a reliable adviser. But for immunization I know for sure – it just must be done. It is obligatory.” Марьяна Возница, главный врач Украинской специализированной детской больницы во Львове, изображена на фото в своём кабинете. “The problems with vaccination... result from the poor communication between doctors and and patients,” says Maryana Voznytsya, Head Doctor at the Ukrainian Specialized Children’s Hospital in Lviv. She adds that her hospital deals with the consequences of other doctors’ vaccination failures. In recent years, the hospital has received six tetanus cases, with many doctors facing the disease for the first time. “Everyone should know that doctors and patients are on the same side in the fight against diseases.” Олесь Похраничный, директор частной школы во Львове, изображён на фото с одной из трёх своих дочерей. Oles Pohranychnyi, a private school director in Lviv, once believed the misconceptions surrounding vaccines – he and his wife decided not to vaccinate their three daughters. Increased risk of measles and other illnesses in Ukraine, such as tetanus and diphtheria, made them change their minds. “The National Education System should... give people confidence in vaccination and health services in general,” Oles says, holding his daughter. He now organizes UNICEF-supported vaccination training for parents and arranges inoculations for staff. Медсестра Иванна Кныш на фото после вакцинации троих детей в Западной Украине. “The more openly we talk about vaccination, the more we'll be trusted by parents, because they realize that there's nothing to be afraid of,” says Ivanna Knysh, pictured after vaccinating three children in Western Ukraine. Until recently, Ivanna, a nurse, worked at a healthcare facility in Novoselytsya, a town in which 100 per cent of children were vaccinated thanks to her efforts. Now a UNICEF-certified vaccination trainer, Ivanna actively encourages doctors to help dispel parents’ fears by better explaining the procedure. Игорь Сухомлин, ресторатор, изображён на фото вместе с женой и тремя детьми у своего ресторана в Киеве. After his middle son contracted chickenpox, Igor Sukhomlyn, a restaurateur and thought leader in Kyiv, was not willing to take any chances. He and his wife immediately vaccinated other members of the family from chickenpox, and no one else got sick. “Vaccination is a valuable scientific achievement,” says Igor, pictured with his wife and children in front of his restaurant. This World Immunization Week, UNICEF and the Bill & Melinda Gates Foundation are launching a new global campaign to emphasize the power and safety of vaccines. From 24–31 April, the foundation will contribute US$1 to UNICEF for every like or share of a social media post using the hashtag #VaccinesWork, up to US$1 million. In the meantime, UNICEF will continue to assist Ukraine’s Ministry of Health in monitoring the outbreak, helping the Government procure free vaccines and spreading the message that together, communities can protect everyone through vaccines. Learn more World Immunization Week UNICEF's work on immunization in the region Vaccine FAQs Parents' most frequently asked questions about vaccines Vaccines and the diseases they prevent Vaccines and the diseases they prevent
Turning every “no” into a “yes” to protect children from the current measles outbreak in Romania
Over 19,000 people in Romania have been diagnosed with measles since 2016. To date, 64 people have died – 58 of them children. The outbreak is the result of a drop-in immunization coverage over the past two decades, with many parents fearful of vaccination, due to the spread of misinformation. For example, the proportion of children who have received a second dose of the measles vaccine – which is needed to adequately protect a child form the deadly disease - dropped from 97 per cent in 2000 to 76 per cent in 2016. It was only after UNICEF started re-engaging in the national measles programme that this drop was stopped, and the coverage is currently up 5 percent from 2016 for the second dose. UNICEF focused on improving immunization awareness of the general public via TV, radio and social media, as well as on redesigning the national electronic vaccination registry, on conducting catchup immunization campaigns in areas with extremely low coverage, and on improving behavior and communication skills of local health workers on immunization. Besides these actions, UNICEF supported teams of health and social workers in 45 communities in Bacău county, in eastern Romania. Their interventions focus on providing a minimum package of community-based health services, including access to vaccination, to save and improve children’s lives. Adina and Didina are two mothers who have been reached by these community-based teams, and whose children are now fully immunized against the disease. The initiative relies on the work of health professionals such as Gabi Stan and social workers like Magda Grigoriu to build trust with families. Delia and Mario are the first children to come home from school, followed by Alberto at 2 pm and Petrina at 3 pm. All four children do their homework at this small table with their mother Adina. Delia and Mario are the first children to come home from school, followed by Alberto at 2 pm and Petrina at 3 pm. All four children do their homework at this small table with their mother Adina.