Vaccine care rules issued to clinics

Dubai's new regulations are based on those outlined by the World Health Organisation

DUBAI // Hospitals and clinics offering immunisations in the emirate have to follow new guidelines, including rules for the way they store vaccines and maintain records.

The move aims to iron out discrepancies, some of which include where medicines are stored and at what temperature, said Laila Al Jassmi, the CEO of health policy and strategy at Dubai Health Authority (DHA).

The new rules, which follow guidelines issued by the World Health Organisation, require vaccines to be kept in refrigerators with temperatures between 2°C and 8°C.

Facilities have to ensure they record vaccination cards and carry the full range of immunisations required by the Ministry of Health.

"Clinics will have to maintain accurate recordings of immunisation schedules and they will have to maintain complete records of adverse reactions [as well as a] reporting system," said Ms Al Jassmi. "All clinics who wish to function as a VQC [vaccination qualified clinic] will have to adhere ... in terms of their set-up, staffing structure, storage criteria for vaccines and medicines, and emergency supplies."

A 2009 study by DHA found that clinics were not storing their vaccines properly, which could render them useless.

Correct storage is one of the main aims of standardising the current system, said Dr Marwan Mohd Akhund, the assistant director of the health regulation department, which is charged with assessing all facilities to make sure they stick to the guidelines.

Other guidelines for storing vaccines include the way in which they are placed on the fridge's shelves - so as to not cram in as many vials as possible - and to make sure no food or drink is kept in the same area.

The survey also found that more than a quarter of hospitals and clinics - 28 per cent - did not offer the full range of jabs set out in the Ministry of Health's National Immunisation Programme (Nip).

The programme, followed by government clinics and hospitals, includes vaccines for all ages, including those against diphtheria, tetanus, measles, tuberculosis and the combined measles, mumps and rubella jab.

Nearly half, 48 per cent, had no means of tracking people who did not bring in their children to get vaccines, while 41 per cent had no system to remind them to follow up with patients.

With the system in place, facilities can prevent children from missing out on vaccines, said Dr Hisham Al Khalib, a senior specialist registrar for the public health department.

"Part of the guidelines will include tracing defaulters," said Dr Al Khalib.

The study also highlighted further gaps in the current system, said Dr Aizeldin Abdelrahman Ibrahim, the acting director of public health and safety at DHA.

"Sixty four per cent of private healthcare facilities were not reporting adverse events ... [and] periodic reporting to the concerned authorities, the MoH and DHA, was found to be inadequate in 48 per cent of the private facilities," said Dr Ibrahim.

The discovery also brought up strengths in the current system, he added, with 88 per cent of private facilities maintaining an up-to-standard cold chain - the process by which materials are stored and distributed without a change in the temperature.

With the new system in place, the health authority can ensure that government-run and private facilities operate on the same level.

"For private [facilities] they have certain vaccinations available and some which are not."

The prevalence of private facilities in Dubai - accounting for more than two thirds of all health care - meant a watchful eye had to be kept over how they operate, he added.

Other emirates, such as Abu Dhabi, follow the ministry's guidelines but Dubai is the first to standardise its system for all hospitals and clinics. A Dubai Health Authority official hoped the other emirates would follow Dubai's lead.

Once the first step is taken, said Dr Al Khalib, the authority would look at other gaps in the system, including which new vaccines, if any, had to be added to the Nip. The programme would be reviewed and modified every two to three years.

There is no deadline yet for facilities to comply, said Ms Al Jassmi, but those who do not update their methods could lose their licence to deliver vaccines.

"We will not allow any who do not fill all the criteria to provide the service," said Dr Al Khalib.