On February 19, 2003, 206 children were administered insulin instead of Hepatitis B Vaccine at the Government Primary Health Centre, Kalliyoor, in Thiruvananthapuram district, Kerala. The authorities at the centre realised the error only after the “vaccine” was administered to all the children. Many of the children, aged between 1 and half months to 14 years, who complained of giddiness were rushed to government hospitals by the PHC staff. The then District Medical Officer K. Shylaja, had quickly and sternly ordered disciplinary action against the doctor in charge and five junior nurses for dereliction of duty. 14 years later, on May 2, 2017, in a bizarre twist of events, the former director of Health Services V. K. Rajan and K. Shylaja, the very DMO who had ordered the disciplinary action, have been sentenced to five years of rigorous imprisonment and slapped a penalty of Rs 52 lakhs each by the vigilance special court for procuring excessive amounts of Hepatitis B vaccines vials causing a loss of Rs 1.49 crores to the state exchequer.
The events that followed in February 2003 happened in quick succession. The used vials were seized from the Primary Health Centre by the Rapid Response Team and there was a hue and cry in the media to dismiss the negligent staff. Then the Chief Minister, A.K. Antony ordered a vigilance probe and the story that unfolded shocked Kerala. The case was investigated by vigilance SPs R. Sukesan and C.P. Gopakumar. They found that an unusual amount of Hepatitis B vaccine had been ordered for Thiruvananthapuram when there was no requirement. Hepatitis B vials worth Rs 1.49 crores were procured from three private pharma companies; Serum Institute of India , Shanta Biotechnic and V. H. Bhagat and Co between 2002-2003. The order was placed on the grounds that there were not enough available vaccines. V. K. Rajan was the director of DHS from 1999 to 2004 and Shylaja was DMO but was dismissed from service in 2009 after the vigilance commission filed a case against her. Says Sukesan, “This incident in Kalliyoor PHC blew the lid off the vaccine corruption. What we found, in the course of our investigation, was that there was no vaccination schedule. There was no proper storage facility to store the vials so the Hepatitis B vaccine was stored along with insulin, and much of it was left outside. In Kallliyoor PHC, they assumed the insulin was Hepatitis B Vaccine and administered it to the children.” The investigation team found that the excessive vaccine was procured for only Thiruvananthapuram and no other districts and was disbursed to 40 government health centres. “There was then a rush to finish the vaccines so that the corruption could be suppressed. So they encouraged adults to take the Hepatitis B vaccine which is ineffective for adults. And even in the cover-up the 3 dose schedules for adults were not followed.” Says Sukesan, “If it was curative medicine it would have been difficult to find evidence of corruption but since it was preventive medicine we found a lot anomalies: like there was no schedule in place.”
Rajan and Shylaja had also coerced their subordinates to aid them. In 2010, besides the former directors, store verification officer Sadasivan Nair, pharmacist K. Mohammed and store superintendent Augustine Thomas were also accused in the chargesheet. Thomas passed away before the trial concluded and the other two were let off by the Special Vigilanc Court. Though the Vigilance investigation team tried to establish the closeness of the director and DMO with the pharma companies, they were unable to do so.
To streamline medical procurement and prevent corruption in the government health services, Kerala Medical Services Corporation was started on 28 December, 2007when V.S. Achuthanandan’s was Chief Minister. Says B. Ekbal, public health activist and neurosurgeon, “This is only an isolated case of corruption. As a doctor, I am afraid that this will be used by the anti-vaccine lobby. There is a sustained campaign by the media against vaccines which is being used by religious groups to stop the administration of vaccines as in Malappuram. Media has started a sustained campaign against vaccines and all I can say is that you are killing people.”
A time-line of events:
February 19, 2003: 206 children injected insulin instead of Hepatitis B Vaccine in the Kalliyoor PHC, Thiruvananthapuram
- 2003: A Vigilance probe initiated by Kerala chief minister A K Anthony
- 2004: Case registered
- 2008 November: Investigation completed
- 2010: Former director of District Health Services V K Rajan and District Medical Officer K Shylaja accused in the chargesheet for corruption for buying excessive amounts of Hepatitis B vaccine
- 2017: Rajan and Shylaja sentenced to five years rigorous imprisonment and fined of Rs 52 lakhs each for causing loss of Rs 1.49 crore to government