Vaccination of children hampered by conflict in Ethiopia’s Tigray region

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Doctors and regional health officials says deadly diseases such as measles, tetanus and whooping cough are on the rise in Ethiopia’s Tigray region after vaccination rates plunged during the civil war that broke out nearly two years ago.

The percentage of children in Tigray receiving routine vaccines has fallen below 10% this year, data from the Tigray Health Bureau shows, undoing years of government efforts to boost immunisation rates.

“The hopes of the children in the region to grow healthier and happier were snatched away in a blink of an eye,” says the bureau in a letter this month to the global vaccine alliance Gavi.

The letter blames the decline in vaccination on supply shortages caused by what it called a “siege” of Tigray by Ethiopian federal forces power, out ages that have disrupted vaccine cold chains, and the inability of people in rural areas to reach health facilities.

UN commission of human rights experts says a ceasefire between March and late August between Tigray and federal forces allowed in a trickle of medical aid but humanitarian access has been suspended since fighting resumed. They had reasonable grounds to believe that the denial of access to healthcare and other aid by federal authorities amounts to a crime against humanity.

Ethiopian government spokesperson Legesse Tulu, military spokesperson Colonel Getnet Adane and the prime minister’s spokesperson Billene Seyoum did not immediately respond to requests for comment about the UN report. The government has repeatedly denied blocking aid and says the Tigray People’s Liberation Front (TPLF), the party leading regional government, is responsible for the conflict which has killed thousands of civilians.

Health Minister Lia Tadesse said vaccines had been provided to Tigray this year and that more were ready to be delivered once conditions allowed. The Tigray Health Bureau said the percentage of children receiving the full three doses of the Pentavalent vaccine against diphtheria, whooping cough, tetanus, hepatitis and haemophilus influenzae type b (Hib) dropped from 99.3% in 2020 to 36% in 2021 and 7% this year.

The rate across Ethiopia was 65% in 2021 according to data from the UN children’s agency UNICEF. The letter said the percentages of children being vaccinated against tuberculosis and measles have also plummeted from over 90% in 2020 to less than 10% this year.

There have been measles outbreaks in 10 of the region’s 35 districts since the war began and 25 cases of neonatal tetanus this year compared to just two in each of the previous three years.

“Vaccines that treated children for measles and whooping cough are given for free across Ethiopia but they are not coming to Tigrayan children,” says Fasika Amdeslasie, surgeon at Ayder Referral Hospital.

Gavi, which buys and distributes vaccines for developing countries, had provided measles and COVID-19 vaccines during the ceasefire but some activities had been suspended since fighting resumed.

Ethiopia’s health minister Lia says 860 000 doses of measles vaccines were delivered to Tigray last December and additional doses were delivered on April 2. Another planned delivery is on hold at the instruction of the UN World Food Programme (WFP) which coordinates humanitarian deliveries into Tigray.

WFP spokesperson Claire Nevill says the agency was waiting on clearances from Ethiopia’s government, in the absence of these clearances the delivery of lifesaving humanitarian supplies, including food, nutrition and medical items will have to be on hold.