The death of a baby girl and the effects suffered by two other minors after being vaccinated in a polyclinic in Havana, was due to “negligence during the process of conservation, preparation, manipulation and exposure of the bulb used,” says the official report of the island’s Ministry of Public Health (MINSAP).
According to the conclusions of the investigation carried out, released on Friday night, the cause of the “adverse incident associated with the MMR vaccine,” which protects against mumps, measles and rubella, “is not linked to the intrinsic properties and quality of the vaccine,” but “violations of the norms established for vaccination” in the Betancourt Neninger Polyclinic of the municipality of Habana del Este, where the children had been vaccinated on October 7.
For this reason, the nurse “directly involved” in the event was definitively separated from the national health system, disabled from the exercise of her profession and “is in the process of a criminal investigation,” while “administrative measures were to others with responsibility in the control of the identified deficiencies,” the report states.
As a result of the indicated negligent process, one-year-old Paloma Domínguez Caballero died on the night of October 9 “as a consequence of complications.” The other two affected minors “recovered and were discharged from hospital, based on the intensive treatment they underwent,” says the MINSAP, which specifies that the clinical manifestations of “two other minors with symptoms,” “did not correspond to this event, and they evolved favorably from their disease.”
All the children “were hospitalized immediately after the symptoms appeared and received medical attention in the intensive care ward of the Borrás-Marfán and Centro Habana children’s hospitals,” according to the MINSAP.
“The clinical manifestations presented by the three baby girls affected by the adverse incident, correspond to a Toxic Shock Syndrome, caused by a bacterium (Staphylococcus aureus), isolated in the investigations carried out,” explains the investigative commission, which states that “it was found” that the batch and diluent used in the vaccination “is suitable for use, according to laboratory tests carried out in several accredited research centers in the country.”
This vaccine, which is applied in Cuba, “according to an official plan, to children one and six years old,” is imported and “prequalified by the World Health Organization, certified and approved for use by the Center for State Control of Medicines, Equipment and Medical Devices (CECMED).”
Of the batch of the vaccine and diluent involved, says MINSAP, 43,630 doses had been administered this year on the island, “without reports of similar incidents.” Previously, from 1986 to 2018, more than 9 million doses of the MMR vaccine had been applied on the island, “without the occurrence of serious effects.”
In the report, the Cuban health authorities regret what happened and affirm that “the results of the investigation were informed to the relatives of the three affected children” and that they are taking “measures so that events like this are not repeated in our country.”
The disclosure of the official report occurs a few days after the departure to Mexico of Yaima Caballero and Osmany Domínguez, parents of the deceased baby girl and who after this incident have urged the Cuban authorities to give an explanation of what happened and have claimed to have been pressured to abandon their campaign through the social media, which has been denied by the health authorities.