Embracing routine immunization

ZOMBA – For the next two weeks, Edna Jairosi and her infant daughter Yanko (20 months) will camp together along the shores of Lake Chilwa in Malawi. They will join hundreds of other men and women who rely on this huge body of water to put food on the table.

Edna, a fish trader, earns her living from Lake Chilwa. However, the remote location lacks access to essential health and social services, leaving these communities vulnerable and at risk for various diseases and health challenges.

As the first sunlight breaks the horizon at dawn, Edna plunges into the frigid waters to begin her day, purchasing fish and selling wares to the fishermen.

“I have been here for more than five days now. The lake is rough, so we must wait until it is calm. Meanwhile, I get to sell wares to these fishermen who await the lake’s calmness,” she says.    

In Malawi, there is an ongoing measles and rubella immunization catch-up campaign, and Edna’s daughter is among the first to be vaccinated courtesy of the health surveillance assistance who are going door-to-door around the islands of Lake Chilwa.

“My line of work requires that I spend as many days and hours as possible here. I kept postponing visiting the clinic so my daughter could receive her second shot of the measles-rubella vaccine. I was even scared to face the nurses at the clinic as they do not take defaulting lightly,” she says.  

Triggered by sporadic incidences of measles diseases over the last two years, the Government of Malawi through the Ministry of Health embarked on a national immunization campaign, the Periodic Intensification of Routine Immunization (PIRI), with technical and logistical support from WHO and UNICEF and funding from, Gavi, the Vaccine Alliance.

The campaign aims to reach all people that zero-dosed and under-immunized populations across the various districts. A mapping exercise conducted mapped 50,629 zero-dosed and 267,316 under immunized children under 9 years. These have been targeted to be dozed in the ongoing catch- up vaccination as part of the PIRI exercises.

Both measles and rubella are highly contagious diseases which attack the respiratory system and weaken the immune system. Measles in particular affects millions of children throughout Africa, a continent already fraught with other childhood diseases such as malaria and malnutrition – with health facilities that are few and far between.

In 2023, more than 485 suspected cases and 134 laboratory-confirmed cases of measles were recorded in Malawi. Two districts recorded measles outbreaks. As of 9^th November 2024, 1194, suspected cases of Measles had been reported with 244 laboratory confirmed cases notified. 7 districts had also confirmed outbreaks and the provision of catch- up vaccinations were critical counter measures to control the outbreaks.

“Routine immunization is vital to our health delivery system and is yet another commendable milestone in Malawi’s efforts to minimize the risk and consequences arising from vaccine-preventable diseases,” said WHO Representative, Dr. Neema Rusibamayila Kimambo. “Provision of catch- up vaccinations is an integral part of strategies recommended to achieve measles and rubella elimination.”

One effective strategy during the campaign has been to access remote communities such as the fishing communities along Lake Chilwa, whose arduous jobs take them away from basic social services such as health. Health surveillance assistants are therefore posted to these islands, to bring vaccination services closer to the men and women who work there.

As another significant intervention, WHO and UNICEF have also supported the Ministry of Health to raise awareness among vulnerable groups, helping to expand knowledge and acceptance of the value and safety of vaccinations and other health services.

Now that Edna knows that her daughter’s health is well covered, she can fully concentrate on the two weeks of hard work. After eating a hurried meal, she is ready to meet the demands of another day.