Posted by Deborah Gimblett
Frequently Asked Questions about the project, UNICEF and Rotary
Q: In recent years, there has been a growing anti-vaccine sentiment in some communities where parents refuse to vaccinate their children. What is UNICEF’s reaction?
A: Immunisation saves lives and gives children the opportunity to live a healthy life and to reach their full potential. Children who are not immunised face illness, disability and death.
Immunisation is extremely safe, with very low risk of serious complications or allergic reactions. Erroneous claims about vaccination (that it causes autism, contains harmful “toxins” or damages fertility) are entirely unscientific and false.
When immunisation rates against highly contagious diseases like measles fall below 95%, “herd immunity” breaks down, creating a higher chance for intense transmission and disease outbreaks – with dire consequences for children. Herd immunity also protects babies who are too young to be vaccinated (less than six months) against measles and anyone who is immunosuppressed.
All children, no matter where they live or their circumstances, have the right to survive and to access the best available healthcare – and we each have the responsibility to help them realize these rights. In the countries where UNICEF operates, we work with communities to raise awareness about the importance of vaccines.
 
Q: Is UNICEF transparent? How do we know the funds raised will be spent in the way promised?
A: UNICEF is a signatory to the international transparency trade initiative.
In 2016, the Aid Transparency Index placed UNICEF in the 'very good' category, rated 3/46 organisations.  In 2015 UNICEF launched a transparency microsite showing exactly where and when funds raised are spent, which can be found here: http://open.unicef.org/
 
UNICEF Australia and New Zealand will produce annual reports showing where the funds raised have been spent and the difference this is making. There will also be opportunities for Rotary Representatives to go to the Pacific to see the project first hand to enable them to report back to fellow Rotarians.
 
Q: Is the Rotary: Give Every Child A Future Program sustainable?
A: One of UNICEF’s key priorities in programme design is sustainability. UNICEF works in partnership with governments to design 5-year country plans, and our programmes fit within this plan. As in this case, UNICEF will set up this program in a way that allows the governments to take over its implementation at the end of the initial funding. Therefore, the impact of setting up the relevant infrastructure, training healthcare workers and working with local communities to encourage them to have their children immunised will have long lasting benefits. The savings to the national healthcare budgets that will arise through lower hospitalisation rates and lower incidence of these diseases will contribute to the ongoing costs of the immunisation program.
 
Q: Will this project eliminate these diseases totally, like the Polio Plus project aims to do for polio?
A: The short answer is no, or at least certainly not in the short to medium term.  These viruses are too prevalent and mutate too easily.  They are more akin to the influenza virus.  It would be very difficult, if not impossible, to eliminate them totally.  So, the aim is to provide everyone with a degree of protection so that if they do get infected then the body’s immune system can easily deal with the virus.
 
Q: Are there any side-effects from these vaccines? If so, what are they and how serious can they be?
A: The answer varies for the three vaccines.
For the rotavirus vaccine recipients may have slightly increased risk of developing mild diarrhoea or vomiting in the week after the vaccine administration. Serious side effects are very rare. There is also a slightly increased risk of intussusception, a rare form of bowel blockage, associated with the rotavirus vaccine. However, the risks of rotavirus gastroenteritis are many times greater than the very small risk of immunisation.  Before rotavirus vaccine became available in Australia, almost every child was infected by rotavirus by the age of 5 years. About 10,000 young children were hospitalised with rotavirus gastroenteritis each year and up to one young child a year died from complications. Since rotavirus vaccination started in 2007 more than 7,000 hospital admissions for rotavirus are prevented each year. Those who do go to see a doctor are less ill. This compares with more than 200 babies being hospitalised for intussusception each year, of which only about an extra 14 may be related to having received rotavirus vaccine.  Based on the established benefits of rotavirus vaccination and the rare occurrence of IS, both the World Health Organization (WHO), the Australian Technical Advisory Group on Immunisation (ATAGI) have recommended the continued use of rotavirus vaccine for infants under the National Immunisation Program (NIP).
The pneumococcal vaccine is very safe, although, like all vaccinations, it has some side effects. It is not possible to catch a pneumococcal infection from the vaccine, as the vaccine doesn't contain any live bacteria. Mild side effects of the pneumococcal conjugate vaccine (PCV), which is the version of the pneumococcal vaccine given to babies under the age of two, include:
  • decreased appetite
  • a slightly raised temperature
  • irritability
  • redness at the site of the injection
  • hardness or swelling at the site of the injection
  • feeling sleepy
  • not sleeping well
 
More serious side effects of the PCV vaccine are rare, and include:
  • high temperature, possibly leading to convulsions (febrile seizures)
  • allergic itchy skin rash
 
With the HPV vaccine, some people might experience mild adverse effects typical of other injected vaccines: soreness, swelling, redness at the injection site, mild temperature or feeling faint.  The World Health Organization’s Global Advisory Committee on Vaccine Safety continues to review the accumulating data on HPV vaccine safety and finds that the vaccine is safe, with over 10 years of data and over 200 million doses given worldwide.
 
Q: HPV is spread primarily through sexual activity. How do we overcome the taboos in some societies to discussing such matters, particularly when we are planning to vaccinate the girls in their early teenage years?  Will vaccinating the girls somehow be seen as giving them permission to become sexually active?
A: The first point that can be made is that the HPV vaccine is not a contraceptive.  What it is doing is providing them with protection again various cancers, particularly the most common forms of cervical cancer.  It is true that they are unlikely to become infected unless and until they become sexually active.  However, it is also true that the protection is much more effective if given before the person becomes infected.  So, the target group is the 12-15 year old girls but this should not be seen as in any way encouraging them to become sexually active, indeed quite the opposite.  Of course, this conversation has to be handled appropriately in each country in the context of the social attitudes of that society. To help address this issue, the program includes social mobilisation activities before the introduction of HPV vaccine in each country. These activities help communities, local leaders and religious groups to gain a healthy understanding of the HPV vaccine and what immunisation means.
 
Q: In Australia and New Zealand, the boys are also given the HPV vaccine. Why are boys not included in this program?
A: It is essentially a question of available resources and setting priorities. The recommendation from WHO and others is that we should give priority to the girls. Vaccinating the boys will give them protection against some relatively rare cancers and, perhaps more importantly, it can also restrict transmission of the virus.  However, the HPV vaccine is the most expensive of the three vaccines that we will be distributing and therefore it would add substantially to the cost of the project to extend the program to include the boys. There is also a question of sustainability as not all counties may be able to afford the continuing cost if the boys were included. Of course, it would be great to be able to vaccinate the boys as well, but the girls are the priority.
 
Q: As a Rotarian how can I help and will there be an opportunity to visit some of the islands?
A: Firstly, we need to be clear that this is not a project where we need to mobilise a large group of people from Australia, New Zealand or elsewhere to go into the Pacific to vaccinate the children. For this program to be sustainable it is critical that the implementation be left in the hands of the local people.  This project is all about increasing the capabilities of these countries to look after themselves.  However, there will be opportunities for some Rotarians to visit and see first-hand what is happening.  There will likely be a need to provide people who can assist in the training of healthcare and community workers – a train-the-trainer type program.  The people required for this may need to have particular skills and qualifications.  For the majority of Rotarians, the best way that they can help is by playing a part in raising the necessary money to fund the project, raising awareness of the issues and by using the project to promote Rotary and the work that we do.
 
Q: Why does Rotary need to raise money for this, surely it is the responsibility of government?
A: Rotarians see a problem and work to find a solution.  Yes, governments and others could, and maybe should, take the responsibility. In the case of many Pacific Island governments they simply do not have the resources. Like so many things in the past Rotary needs to be the catalyst.
 
Q: In your promotion material you say $45 will contribute to immunise 1 child, $450 for 10 children, $4,500 for 100 etc. How do you arrive at these figures?
A: These figures are approximations and an average to let individuals, clubs, districts and other organisations know the scale to which they can help.   Rotary is trying to raise $4.5 – 5 million Australian/New Zealand dollars and this will benefit 100,000 children over the 3-4 year life of this project – thus approximately $45 per child. Every dollar collected goes to the programme. Whether you think in New Zealand Dollars or Australian Dollars, please help. 
 
To see a slide presentation on Give Every Child a Future, click here.
 
If you have any other questions please direct to: everychildafuture@gmail.com
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