PAHO says tetanus shot is not linked to the death of Sabrina Almendarez

Belize maintains one of the most highly regarded vaccination programs in the entire region, providing thirty-thousand immunizations yearly. The Ministry of Health vaccinates against ten general diseases, including polio, mumps, measles, whooping cough, tuberculosis, hepatitis, tetanus and diphtheria. The program has won awards and recognition in the Caribbean and the work is critically important. And so is the need for the program to continue. That’s why the Ministry of Health and its partner, the Pan-American Health Organization, PAHO, are treating with great seriousness the case of twelve year old Sabrina Almendarez. Today the organizations held a press briefing in Belize City and Mike Rudon has the story.

Mike Rudon, Reporting

Sabrina Almendarez died suddenly on Friday, November 29^th, one week after receiving a booster shot for diphtheria and tetanus. Preliminary reports from a post-mortem examination have found no evidence of a connection between the vaccination and the death. The family is still searching for answers, even as the Ministry of Health and PAHO stand behind the vaccination program.

Gerardo de Cosio, PAHO/WHO Representative, Belize

Gerardo de Cosio

“Belize really procures every vaccine, every single vaccine that is used and given in Belize comes from the revolving fund from the organization. And every vaccine that the organization buys comes from pre-qualified and certified producers. So we are very sure that the quality of the vaccines are very, very high and meets the highest standards that can be found everywhere in the world.”

Peter Allen

Peter Allen, C.E.O., Ministry of Health

“We are terribly sorry for the death of this child. It’s a tragic incident but it has absolutely nothing to do with immunizations and we need to emphasize to the general public that the immunization program is the bedrock of public health…it’s the bedrock of primary health and please, you must believe us…you must have utmost confidence…this is a safe and effective program.”

And according to Allen, it’s a program which Sabrina Almendarez had been a part of before.

Peter Allen

“In this particular instance, the young girl had received this same vaccine three times already. There is no history of any allergies, there’s no record of any allergies, there’s no record of any reactions and that is where this would show up.”

Gerardo de Cosio

“If there is a severe reaction to the vaccine normally, and this is what has been reported worldwide, it usually occurs within the first few minutes and hours of when the vaccine has been administered and that’s it. That’s when you would see severe reactions. After that no cases have been reported in the world of severe reactions to the vaccines after a few days like in this case. So basically I would say that we can say that the vaccine was not really associated to this problem at all.”

When the doctors refer to an adverse reaction, they’re referring to a slight rash, fever or a slight swelling at the injection site…nothing more than that.

Nurse Shalima Kelly is one of the coordinators of the vaccination program, and ran us through the process for administering a diphtheria/tetanus immunization booster – which Sabrina Almendarez received one week before she died.

Nurse Shalima Kelly, Vaccination Program

Shalima Kelly

“We start with our hand-washing, we open our vials, we check to see if that vaccine, the expiry date, if it’s maintained cold temperature, because it has to be maintained between a plus two to a plus eight. Once it’s maintained between that, we have a needle, it’s opened, it’s sterile…it’s a single dose. Once we open it and give it to the child that needle is re-taped and discarded. After that what we do is we discuss with the principal or teacher and ask them to advise the parents that the child will be having a temperature so they need to continue getting Tylenol for twenty-four to forty-eight hours. Once a fever persists over three days, it’s not the vaccine. You need to take that child in to see a doctor because they may be some underlying matter that is causing the child to have a fever.”

Peter Allen

“There have never, ever, ever been any fatalities. There have never been any significant adverse reactions to any immunization in Belize as far as I am aware. In the case of this tragic incident, there was absolutely no evidence of allergy in the previous doses of the exact same vaccine. Over a hundred children received the vaccine on the same day. There is no adverse reaction in any of those children.”

According to Doctor Allen, eight other children received their immunization from the same vial as Sabrina, and none of them has exhibited any reaction whatsoever.

PAHO conducts regular assessments of Belize’s vaccination program, and according to the last assessment, found that it is still meeting the highest standards. Sabrina Almendarez was laid to rest in Independence today, the cause of her death still largely a mystery.