What is the reason for this and what such refusals are fraught with, correspondents understood in the Urals together with Gulshat Kulniazova, Doctor of Medical Sciences, professor of the West Kazakhstan State University named after M. Ospanov (Aktobe).

Disturbing statistics

The Health Department of the West Kazakhstan region does not hide the alarming figures: there are almost 900 unvaccinated children in the region, including more than 790 newborns.

Moreover, this is not the worst indicator in the republic, the region is not even among the five disadvantaged regions in terms of the number of refusals from vaccination.

Doctors say that parents refuse to vaccinate children, referring to religious beliefs and information that vaccination can cause the disease itself or various complications in the child instead of forming immunity. In 2016, 563 "refuseniks" were registered in the West Kazakhstan region, and the mothers of 134 newborns refused vaccinations in the maternity hospital.

– Two of the unvaccinated children fell ill with infectious diseases: in 2014, a two-year–old child got tuberculosis, and in 2016 an 8-month-old child suffered whooping cough, - said the head of the department of the regional health department Ainash Gubaidullina. – Last year, as a result of preventive work with parents, 34 children were vaccinated in the region, for the period of this year – 12 children. The main reason for refusing vaccinations was incorrect information that alcohol is in the composition of vaccinations, so many religious citizens refuse to vaccinate their children. There are families in which five or more children grow up, and none of them has received a single vaccination. Of course, we are pleased with the fact that they are healthy and do not suffer from any infectious diseases, but, according to statistics, if 95% of children are vaccinated, they create a kind of protective barrier for the unvaccinated.

by the way

The Committee for Consumer Protection of the Ministry of National Economy of the Republic of Kazakhstan (hereinafter referred to as KZPP) and its territorial bodies monitor the reasons for refusals of vaccination.

In 2016, 9,685 refusals of preventive vaccinations were registered in Kazakhstan, compared to 2015, there is an increase in the number of refusals by 13.4% (8,383). Parents of children under 1 year of age most often refuse mandatory vaccinations – 3982 (41.1%). In the age group from 1 to 2 years, 2,570 (26.5%) refusals were registered, from 2 to 5 years – 2,072 (21.4%), from 6 to 15 years – 617 (6.3%), over 16 years – 444 (4.6%). During the analysis, experts found that a high proportion of failures was registered in Aktobe (19.2%), South Kazakhstan (13.2%), Mangystau (11.5%) regions and Almaty (12.9%).

The main reasons for refusals are personal 45% (4360) and religious 42.9% (4151) beliefs, 6.2% (600) of those who refused vaccination indicated negative information through the media (Internet resources, press, TV), 6.1% (589) expressed distrust of vaccines.

Open conversation

This acute topic for society and especially young parents in Uralsk was discussed at a round table by doctors, representatives of government agencies, religious parents of young children, imams. All district polyclinics of the region took part in the event online. Gulshat Kulniazova, Doctor of Medical Sciences, Professor of the West Kazakhstan State University named after M. Ospanov (Aktobe), told about the organization of work on immunization, the history of fighting infections in the world and deaths as a result of refusal of vaccination. And she explained in detail which vaccines are used for immunization. She believes that parents should know about this.

– Vaccines are antigens of infectious pathogens that contribute to the emergence of artificial active immunity. When they are administered, an immune response is formed in the body, thanks to which a person is immune to this infection. The resulting immunity is different in its persistence for each child. This is due to the peculiarities of the genetic structure, the constitution," the professor informed. – The types of vaccines used are as follows. Live ones are created from weakened microbes that have lost their harmful properties, actually existing in nature (vaccines against smallpox, polio, tularemia, as well as specially bred vaccines – BCG, influenza). The killed ones are made of pathogens with pronounced pathogenic properties, by destroying them by physical or chemical methods (pertussis and hepatitis A). Chemical ones are created from bacterial cells isolated by chemical method. Synthetic – artificially formed vaccines that carry antigenic features of microorganisms. Recombinant – formed with the help of genetic engineering (against viral hepatitis B, influenza and others).

The professor is sure that, first of all, those parents who are insufficiently informed about the safety of immunoprophylaxis and, most importantly, about the need and benefits of vaccinations refuse vaccinations.

– It is necessary to conduct preventive conversations with parents, to form the level of trust that will create the knowledge base necessary for our children to grow up healthy and vaccinated against many deadly infectious diseases, – Professor Gulshat Kulniazova believes.

After the round table, the delegation from Uralsk together with the professor went to the districts of the region, where they held a number of meetings with the population. Doctors, imams and theologians listened to the arguments of parents, grandparents, and gave examples of the undeniable benefits of immunoprophylaxis.

The religious aspect

The religious parents who attended the round table in Uralsk also agreed with the necessity and usefulness of vaccinations. But they do not agree when the refusal of vaccination is called religiosity. Moms and dads say: "Our religious views have nothing to do with it, we rely on information about how immunization is carried out. There is often information about a low-quality vaccine in the media, the Internet, and cases of vaccination with contraindications are not uncommon."

– In Kazakhstan, from the birth of a child to the age of 16, 20 different vaccines are vaccinated against various diseases. There are different opinions in society about this. Many argue that the main reason for refusing vaccinations is a religious motive. But during individual meetings with refuseniks, we found out that most of them are simply afraid of new drugs and consider them dangerous for the health of their children. Therefore, we need to strengthen explanatory work from a medical point of view, actively and intelligibly tell and show through the media and social networks what the refusal of vaccination leads to," says Nauryz Ubayev, the theologian of the Center for Religious Studies of the Department of Religious Affairs of the West Kazakhstan Region. – From the point of view of Islam, everything that benefits a person is by no means rejected. Many scientists of the Islamic world agree on the need for vaccination aimed at protecting people from such terrible diseases as hepatitis B, whooping cough, diphtheria, tuberculosis, measles and others.

The theologian also assured that among the pro-Islamist non-traditional religious associations of the West Kazakhstan region there are none in which refusal of vaccination is cultivated. Moreover, in one of the pro-Christian non-traditional religious associations, widespread in Kazakhstan, blood transfusion is prohibited, but vaccination is not denied by adherents.

The representative of the Spiritual Administration of Muslims of Kazakhstan for the West Kazakhstan region, Imam Ruslan Sultanov, noted that it is a personal matter of each parent to vaccinate or not to vaccinate their children. But at the same time, they should think about the health of the future generation, the spiritual mentor believes.

– I have three children, all of them received vaccinations according to the plan, they did not refuse immunization, since there is nothing illegal in this according to Sharia. On the contrary, this way we protect our children from various infections, including those with a fatal outcome. It is right that explanatory work with the population is carried out by specialists who are accessible and convincingly giving arguments about the need for vaccinations in childhood," the imam believes.

During his visit to the West Kazakhstan region, Minister of Health of the Republic of Kazakhstan Yelzhan Birtanov said that from July 1, 2017, the country begins to introduce a system of compulsory medical insurance. Within the framework of the health insurance system, citizens will be provided with two types of medical service packages. The first – basic – includes preventive vaccinations and will be available to all citizens of the Republic of Kazakhstan. The Minister also believes that access to information has increased dramatically thanks to the Internet, and some parents believe information from the World Wide Web more than doctors. But the Internet will not replace family and district doctors, and will not conduct an examination.

Other opinion

The topic of immunization was recently raised by the deputies of the Senate of the Parliament of the Republic of Kazakhstan. They proposed to introduce responsibility for parents who refuse to vaccinate children. Deputy Sarsenbai Yensegenov said that in the United States, unvaccinated children are not allowed to study in kindergartens and schools. The Chief State Sanitary Doctor of the Republic of Kazakhstan, Zhandarbek Bekshin, said that this issue has not yet been discussed in Kazakhstan.

In turn, Kazakh expert of the World Health Organization Oleg Benesh informs that there are many cases of measles infection in a number of countries among older children. There are known fatal cases in connection with this disease, including in Western European countries. And the only way to prevent measles morbidity and mortality is vaccination. Cases of deviations in the health of children after vaccination should be dealt with individually, according to the WHO.

Oksana DEMENTIEVSKAYA, Uralsk

https://liter.kz/ru/articles/show/31730-privivochnaya_diskussiya