Vaccinators with Targets - Penalty/Reward Scheme for Irish Hospitals includes Infant Vaccination 'Metric'.
Justin Healy, ComeLook.Org, 
17 March 2011

HSE Principal Medical Official boasts of 99.4% uptake rate for BCG shot - says less parents refuse BCG shot “as they become more informed”.
Meanwhile, unexplained 60% increase in infant mortality during period after Swine Flu vaccination (Q2/2010).

€18m in ‘Inefficiency’ fines
Figures released last month show that 20 Irish hospitals were fined nearly €18m  for failing an efficiency test last year. The fines are part of a 'penalty and reward' system operated by the Health Service Executive (HSE) to incentivise hospitals to become more efficient. This €18m will now be redistributed among 19 other hospitals as a reward for a good performance.  One of the key areas measured is ‘immunisation rates’ with hospitals being expected to match a target uptake rate of 95% for infants aged under 12 months .

One hospital was given a 'commendation' at the 2010 Irish Health Care awards (in the ‘Best Public Health Initiative’ category) for recently adding an extra vaccine to the existing schedule for newborn infants.  In Oct 2008, Cork University Maternity Hospital re-introduced a Neonatal BCG vaccination programme  (a TB shot originally canceled in 1972) to all eligible newborn infants.  Dr Catherine Murphy, Principal Medical Officer HSE South said," Of the 15,376 newborns eligible for vaccination only 93 have refused the vaccine  outright (an uptake rate of 99.4%).   The number of parents who refuse has consistently decreased over time as they become more aware and more informed about the benefits of BCG vaccination”.
Ironically, a top respiratory consultant in this same Cork hospital, Dr Charles Bredin, told Irishhealth.com that he believed BCG should be discontinued as a universal vaccine. He said the vaccine had been discontinued in Northern Ireland some years ago because of doubts as to its benefit. This was why the decision was taken to stop its supply in Cork in 1972, by, he said, an 'enlightened' medical director.  With almost a 100% level of ‘informed consent’ achieved, it's unlikely those running the Cork Hospital BCG vaccine programme see fit to inform parents of the expert opinion of the TB specialist sitting on-campus (on the necessity of BCG vaccination).

In fact, it seems difficult to find any Irish respiratory disease experts who thinks vaccinating newborns with the BCG shot it is such a good idea. Dr JJ Gilmartin, president of The Irish Thoracic Society , is not so convinced either, stating " It has been proven ineffective in other countries in the control of TB ."  The Irish Thoracic Society is the official society of healthcare professionals involved in care of people with chronic respiratory disease in Ireland.

Infant Mortality Statistics 2008 
One additional 'metric' the HSE could employ to validate recently increased infant vaccination incidence is the Infant Mortality statistics (which cover the Sudden Infant Death Syndrome numbers). In 2008, the HSE introduced the Hebatitis B and Pneumococcal vaccines for 2 month old infants (in addition to the BCG shot introduced in the south, previously mentioned above). During 2008 the number of deaths of infants aged 'under one year' was 284 compared with 230 in 2007 (despite fewer births in 2008 ) - a rise of 24% over the 2007 figure (Note the Irish Doctors' newspaper 'The Medical Independent' reported this as only a 'slight rise').

60% Increase in Infant Mortality during period after Swine Flu vaccination (Q2/2010).
In addition, during the winter flu season of 2009/10, the HSE advised parents to vaccinate their infants (aged 6 months old plus) against the Swine Flu (using the Squalene/Thimerasol laden vaccine Pandremix).  Full yearly figures for 2010 are not available yet, though latest stats available from the Central Statistics Office  for Q2/10 and show a 60% increase in infant mortality over the corresponding period from the previous year (for the same number of births):
" There were 84 infant deaths registered in quarter 2 of 2010 giving an infant mortality rate of 4.5 deaths per 1,000 live births. The corresponding rate in quarter 2 of 2009 was 2.8 per 1,000 live births. The number of neonatal deaths (deaths of infants at ages under 4 weeks) in quarter 2 of 2010 was 54, 2.9 deaths per 1,000 live births.(There were 18,844 births registered in the second quarter of 2010, the same number of births registered in the corresponding quarter of 2009)".
Remarkably, in Q2 2010, the number of infants who died in the 'less than 4 weeks' age group (excludes stillborn) was higher than that for all infants aged 'under one year' in Q2 2009.  Is this a delayed consequence of the Q4/09 & Q1/10 vaccination campaign targeting pregnant women with a Swine Flu vaccine that had never been tested on pregnant women? (Note that no infants were dieing of Swine Flu itself in Ireland).

Infant mortality and early vaccination
The link between infant mortality and early vaccination is not discussed in Irish Medical circles – it is simply ‘out of scope’.However there are compelling reasons to believe that the two are linked. In 1975, Japan changed the minimum age for initial vaccination from 3 months to two years and immediately their infant mortality rate declined sharply . Japan zoomed from 17th to first place in infant mortality in the world. Also, a three year Australian scientific study monitored babies using a breathing monitor.  Episodes of apnea (cessation of breathing) and hypopnea (abnormally shallow breathing) were measured before and after DPT vaccinations. The data showed that vaccination caused an extraordinary increase in episodes where breathing either nearly ceased or stopped completely. 

Past investigations into unexplained infant mortality in Ireland have never considered infant vaccination as a risk factor worthy of study. Other more obscure, seemingly unlikely causes, such as bedsharing , social deprivation and lack of regular soother use were investigated though.

Vaccinators with Targets
The one uncontrolled variable in the HSE performance model relating to immunisation uptake rates is parental choice. P arents who still have their own minds are something of an enigma to vaccinators with targets - unable to comprehend why they do not always defer to the doctrine of "regulatory body approval".

In the latest published HSE reviews, Cork West & Dublin North West regions (both with infant vaccination rates of 'only' 79%) are currently rated ‘Amber’ ( i.e. ‘average performance, room for improvement’).  Incoming Health Minister Dr James O'Reilly describes how HSE management have dealt with sub-standard performance in the past:  
"Facilities are being closed down, being told that they do not meet standards and they must close, having deliberately been run down. We have seen in the past how they undermine smaller hospitals with a very simple formula - starve them of resources, make them unsafe, commission a report and then use that report to justify closure."

As long as "immunisation rates" remain a measure of hospital 'performance', the drive to pressure parents to comply with inappropriate vaccination programs, regardless or risk or logic, will continue.

Contact
justin@comelook.org

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