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Vaccine safety

Measles vaccine suspected of adulteration linked to the deaths of 15 children in Syria

A court in Syria is to investigate whether the deaths of children under two years of age was a case of inadvertent error or a criminal act.

Muscle relaxant Atracurium is thought to cause of deaths link to polio vaccination programme in Syria

Source: AP / Press Association Images

Muscle relaxant atracurium is linked to deaths in measles vaccination programme in Syria

At least 15 children have died in Syria during a measles vaccination programme after a muscle relaxant, atracurium, was believed to have been added to the vaccine instead of diluents. 

The World Health Organisation (WHO) is helping confirm the exact cause of the deaths but a spokesperson said that it doesn’t seem as though there was anything wrong with the vaccine batch itself but it was “mishandled on the ground”. The vaccine must be diluted prior to use. 

The matter has been passed on to a local court in Syria to establish whether the incident was a case of inadvertent error or a criminal act. The local nongovernmental organisation Measles Control Task Force (MCTF), which was leading the vaccination programme, says it will continue to pursue an inquiry into the matter and prosecute any individuals if they are found to have been negligent. MCTF’s programme had been aided by WHO and Unicef. 

Some 20,000 children were vaccinated in the northern province of Idlib when the campaign began on 15 September 2014, but it was cancelled the following day when the first deaths were reported. 

Vaccination is performed by local health facilities in the area and the MCTF has visited the hospital at the centre of the deaths. In a statement, it says that there was a “great resemblance” between a vial of vaccine solvent and atracurium. 

Atracurium is often used prior to surgery with its dose determined by weight. Younger children are more severely affected by the medicine due to their small size. All of the children who died were less than two years old, while the 50 older children who were affected have recovered, a WHO spokesperson said. 

In a joint statement with Unicef, WHO says it is vital that immunisation efforts in Syria resume as quickly as possible. But before this can occur, the exact cause of the deaths will need to be confirmed and families and communities reassured that the vaccine is safe, WHO adds. 

Measles is a particular threat to children who have been displaced from their homes and who are living in refugee camps or insanitary conditions, says WHO. More than 5 million children have been left in need of basic humanitarian support after four years of fighting in Syria.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20066521

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