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Independent Audit of Global Child Immunizations Urged

Survey finds overpayments to some countries where data doesn't match WHO reports

WEDNESDAY, Dec. 17 (HealthDay News) -- About 7 million fewer children are immunized against diphtheria, tetanus and whooping cough (pertussis) than individual nations and World Health Organization/UNICEF estimates report, a new study shows.

Since countries receive international funding for vaccinations based on these estimates, the University of Washington in Seattle researchers calculated that 51 countries may have been overpaid $140 million, or almost twice as much as they should have received, for vaccinations that were never given.

The authors, writing in this week's issue of The Lancet, call for independent monitoring that is open to public scrutiny to avoid abuse of these important health-care initiatives.

"Measurement of immunization coverage must be through more periodic gold-standard surveys that are integrated with improved administrative data if progress towards goals such as universal childhood immunization is to be better measured and understood," they wrote.

The researchers, comparing data on the three-dose diphtheria, tetanus and whooping cough vaccine (DPT3) being given from 1986 to 2006 with surveys of children's caretakers, found that only 7.4 million children in the countries receiving special financial support from the Global Alliance of Vaccines and Immunizations (GAVI) were immunized, although official reports put the number at nearly 14 million. Based on $20 received for each vaccinated child, the authors estimated these countries received $290 million in GAVI money, when the surveys suggest they should only have received $150 million.

"The pattern of results is suggestive, but not conclusive," Dr. David M. Bishai, of Johns Hopkins School of Public Health in Baltimore, wrote in an accompanying commentary in The Lancet. "Ample room for reasonable doubt should forestall an inquisition that diverts country vaccine-staff away from the important job of immunizing children and maintaining accurate data. The real impact of (the) study should be to encourage researchers to finally try to understand why survey reports do not agree with administrative reports."

More information

The Nemours Foundations has more about childhood immunizations.

-- Kevin McKeever

SOURCE: The Lancet, news release, Dec. 11, 2008

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