In Pakistan, a vaccinator’s resolve

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With a vaccine carrier and equipment on his motorbike, Farrukh Hussain travels to the remotest areas of Pakistan's Nankana Sahib district to vaccinate children. © UNICEF Pakistan/2015/Zaidi

By A. Sami Malik

Travelling far and wide, a veteran vaccinator dedicates himself to protecting the health of children in Pakistan, where the recent introduction of pneumococcal vaccine has helped save more lives.

NANKANA SAHIB, Punjab Province, Pakistan, 15 April 2015 – “I have been vaccinating children for the last 25 years,” says Farrukh Hussain, a vaccinator at the Basic Health Unit in Budha village, Nankana district. “I have five children of my own, three girls and two boys, and I have vaccinated all of them myself. Vaccination is the first line of defence against vaccine-preventable diseases, and every time I vaccinate a child, it feels as if I have saved a life.”

Farrukh’s profession is also his passion. He has dedicated his life to vaccinating children and works with energy and passion. With a vaccine carrier on the back of his motorbike, he reaches out to the remotest communities of the Nankana Sahib district, in Pakistan’s Punjab province.

Nankana district has a population of around 1.6 million, with nearly 58,000 live births annually, and health authorities work vigorously to vaccinate them against vaccine-preventable diseases. The role of a vaccinator is extremely important, as vaccines are temperature sensitive and need to be stored and administered with great care. With his quarter-century of experience, Farrukh enjoys the reputation of a hardworking professional.

Recalling his early days as a vaccinator, however, Farrukh says, “My hands would shake and my heartbeat increased every time I injected a child. It felt as if I was hurting them.”

Soon, however, he realized how important it is to vaccinate children during the first years of their lives. “It is like saving children and their parents from a lot of pain and worries later on,” he says.

A new vaccine

In 2012, the Government of Pakistan added pneumococcal vaccine for prevention against pneumonia as part of routine immunizations – the first country in South Asia to introduce it, alongside vaccines against diphtheria, hepatitis B, influenza, measles, polio, tetanus, tuberculosis and whooping cough.

The Gavi Alliance, which brings together public and private sectors with the shared goal of creating equal access to vaccines for children living in underdeveloped countries, provides the pneumococcal vaccine and financial support, while UNICEF and WHO provide technical support to health authorities in Pakistan.

Vaccinators working in the public health system were given a two-day training on management and administering of the vaccine. “Our entire vaccination team was trained on handling and injecting pneumococcal vaccine,” says Farrukh.

The addition of pneumococcal vaccine to routine immunization has drastically reduced cases of pneumonia among children. In rural communities of Punjab, households are often large, with an average of four to five children, and hygiene conditions make children susceptible to community-acquired pneumonia, especially in winter.

Since the addition of pneumococcal vaccine to the routine immunization regime, the number of cases has dropped substantially. If a child does catch pneumonia despite being vaccinated, it can be easily controlled with medication, and recovery is quick.

By and large, communities living in Nankana Sahib have a proactive attitude towards getting their children vaccinated. “A complete course of pneumococcal vaccination comprises three shots/injections given when the child is six, ten and fourteen weeks old,” Farrukh says. “Mothers have the ‘yellow card’, on which we make an entry whenever a child is vaccinated. In case our visit to the community is delayed for a day or two, they either bring the child to the BHU or call us on the phone to ask about the team’s visit to their village.”

The challenge Farrukh faces in vaccinating children is in the far-flung areas that are not covered by the lady health worker (LHW). Each LHW is assigned an area with around 200 to 250 households. LHWs support vaccination activities by mobilizing the target children for vaccination on the day when the vaccinator is supposed to visit the community. In the ‘uncovered’ areas not under an LHW, the vaccinator has to go alone and vaccinate children.

“Sometimes women in those areas prefer a female vaccinator,” Farrukh says. “But when I tell them that vaccination is a facility provided by the government free of charge which would otherwise cost them thousands of rupees, they understand.”


“Pakistan is the world’s sixth largest population, with the biggest birth cohort,” says Dr. Saadia Farrukh, UNICEF Health Specialist. “Each year, more than 350,000 children do not live to celebrate their fifth birthday; one of the major causes of these deaths is vaccine-preventable diseases – 18 per cent attributed to pneumonia. In 2012, with the financial support of Gavi, Pakistan introduced PCV-10, realizing that this is an opportunity for strengthening routine immunization, thereby leading to reduction in the disease burden due to pneumonia in children under 5 years of age.”

It is the dedication and resolve of health providers such as Farrukh that make a difference in protecting children and women against vaccine-preventable diseases. Vaccination is the most equitable and cost-effective health intervention, and healthy children grow up to be healthy adults and become productive members of a society. Timely vaccination protects children from disease and help them grow to their full potential – one of their basic rights.