Liberia's largest immunization campaign ever targets Yellow Fever

By Louis Vigneault

MONTSERRADO COUNTY, Liberia, 21 December 2009 - The largest immunization campaign ever conducted in Liberia took place last month, targeting over three million people, or 90 per cent of the population. The immunization was against Yellow Fever, a potentially lethal infection transmitted by mosquitoes. Everyone - except pregnant women and children under nine months - received an injection by one of 2,275 health teams mobilized in schools, community centres and clinics throughout the country.

The severity of Yellow Fever is such that one single confirmed case in a country constitutes an epidemic. There is no known cure, but one injection provides immunity for ten years. In addition to the vaccine against Yellow Fever, all children between 12 months and five years of age received a deworming tablet.

"The success of such a large scale campaign lies in the flow of the supply chain and the effectiveness of the social mobilization," explained Coordinator for the Montserrado County Health Team Cecilia Gmawghe. "You need to ensure that everyone comes for their injection and that all health teams scattered throughout the area timely receive the right quantity of drugs and the syringes they need. Otherwise, the valuable medicine gets wasted or people have to queue for hours and hours before receiving their dose."

Raising awareness

Community mobilisers were dispatched throughout the country to inform the population about the danger of Yellow Fever and the importance of being immunized. They also informed them about where the nearest vaccination point was and strongly encouraged people to get vaccinated.

In addition, educational messages were broadcast on radio or by megaphone to raise awareness.

This was not without its challenges. Liberia's network of roads never fully recovered from years of civil war and large areas of the country still remain unreachable by car. In response, a complex logistical organization was deployed to ensure that the vaccines could reach virtually everyone. Some supplies were dispatched to strategic locations by boat, helicopter, motorcycle or any means of transportation available.

Prior to the beginning of the campaign, local health authorities made a plan of how many people needed to be vaccinated in any designated area. Every morning, each health team ensured that they received sufficient supplies to cover the day from the nearest health facility.

Three million immunized

There was little room for error in meeting the target of immunizing three million people by 29 November. Each health team of four members needed to perform an average of 25 injections per hour.

The population responded en masse and the coordination team chaired by the Ministry of Health and Social Welfare continued to ensure that operations ran smoothly. The World Health Organisation, UNICEF and the United States Agency for International Development supported the Government of Liberia to plan, implement and monitor this large scale vaccination campaign.