FREE: More Newborns In Jamaica Have Died This Year for Unknown Reasons, Raising Fresh Questions About Hospital Cleanliness and a Newly-Introduced Vaccine Regimen
This story was originally published by 18º North behind our paywall on February 14.
Because of the public health component of this story, it is now being re-published for free having first fulfilled our commitment to our paid subscribers.
It’s also updated to reflect the cause of death in one case, which is why it took over a month to republish. The causes of death have not been ascertained in other cases because the Ministry of Health & Wellness and the relevant hospitals named in the article have not responded to further questions.
At least two hospitals in Jamaica are experiencing more deaths among newborns as compared to last year, 18º North has learned.
Three babies died at the public Black River Hospital in St. Elizabeth in January alone, when, for each of the past three full years, there were between five and seven such deaths.
Upon hearing about these deaths, 18º North then called around to the other public hospitals and found that three babies had also died at the Savanna-la-Mar Hospital in Westmoreland compared to this time last year when there was only one such death.
The news follows last year's revelation that twelve babies had died after a bacterial outbreak at the Victoria Jubilee Hospital in Kingston without any initial revelation or warning to the public by the health ministry. It also follows the ministry's introduction in January of an additional dose of a vaccine now being administered at the time of birth, with limited to no public education.
The Deaths As They Occurred
The CEO of Black River Hospital, Diana Brown-Miller, confirmed the three newborn deaths to 18º North, saying two of the babies died on the same day, which is “very unusual.”
Though not independently verified, she said her hospital late last year was awarded best perinatal mortality rate in the country from the Ministry of Health & Wellness, so “It is indeed coincidental and unfortunate to have 3 deaths in the same month and so early in the year.”
Mrs. Brown-Miller said the first baby was born with hypoxia or a lack of oxygen to the brain, and so there was end-organ damage. The baby ended up dying in the fourth week of January, three days after being born. It’s not clear if the baby died in hospital.
The other two babies were born over the weekend and discharged, and “usually, if the baby doesn’t have a clean bill of health, I don’t see them sending home the baby.”
However, she said, by Tuesday, which would have been the 31st, one baby was dead on arrival at hospital and will need a post-mortem to determine cause of death. The other had been admitted and died within twelve hours after experiencing “a massive bleed in the lungs.” Both were born within hours of each other and both died at three days old.
Shakera Morgan, who carried her newborn back to the hospital after the baby had stopped breathing, told 18º North that the hospital wasn’t able to save her child. “They told me sorry for the loss.”
“I heard about another death,” she said. “It was the same problem.” (It’s not confirmed it was the same problem.)
The CEO of the Savanna-la-Mar Hospital, Camile Lewin, also confirmed that two of the babies that died at her facility were in the age group of 0-6 days and one was in the age range of 7-27 days. She added that one was born extremely premature having been birthed after only 25 weeks of pregnancy. A post-mortem will have to be done on the other two, she said, in order to determine the cause of death.
Swabbing For Dangerous Bacteria At Both Hospitals
Because of last year’s bacterial outbreak at Victoria Jubilee Hospital, 18º North asked Ms. Lewin in a follow-up email whether her pediatric ward had been swabbed, but she didn’t respond.
Black River’s CEO Mrs. Brown-Miller confirmed to 18º North that her hospital was not recently swabbed. But because there was “an unusually high admission” of newborns around November and December of last year, there was a request made for a regional audit. It’s not clear whether the audit was done, what it would have entailed or what the results were of the audit.
She said the last set of swabs were done in August and “did not demonstrate any germs similar to the one found at the Victoria Jubilee Hospital.” However, her hospital missed the next scheduled quarterly swab because of “a shortage of swabs at our facility” and because “Mandeville Regional Hospital indicated that they were out of disc to process the swabs.”
This lack of swabbing supplies would seem to run counter to the recommendations from the Pan American Health Organization (PAHO) report released only in October 2022 following the baby deaths at Victoria Jubilee Hospital earlier in the year.
Those recommendations for the national level include, “ensure adequate supplies for collecting culture specimens” and “ensure periodic reporting on antimicrobial susceptibility patterns for relevant aetiologic agents of HAI [Healthcare Associated Infections].”
“That’s unacceptable,” said Dr. Carolyn Gomes when she heard about the failure of the hospital to swab. As a pediatrician in Jamaica and Vice Chair of the Strategy Committee of the board of the Global Fund, whose mission is to eliminate infectious diseases like HIV, tuberculosis and malaria around the world, she added, “Infection control is a priority…Babies are very vulnerable to infection.”
Neither Health Minister Dr. Christopher Tufton nor Chief Medical Officer Dr. Jacquiline Bisasor McKenzie responded when asked about the lack of supplies or whether they were investigating the deaths of the babies.
The Newly-Introduced Vaccine Regimen
The deaths of the newborns have also come at a time when the Ministry of Health introduced at the beginning of the year an additional dose of a vaccine.
The vaccine has long been around to ward off Hepatitis B, with the series usually beginning at six weeks. But according to what appears to be correspondence to healthcare facilities generated by the health ministry in December 2022, the Hepatitis B birth dose (HepB-BD) should now be given “as soon as possible after birth, within 24 hours.”
The health ministry told 18º North that Hepatitis B can easily be spread from mother to child during childbirth. And newborns, if exposed, have a 90% risk of chronic infection, which can lead to liver failure, liver cancer and death.
The ministry noted that the Hepatitis B birth dose could be given with the Bacillus Calmette–Guérin (BCG), currently given to newborns in Jamaica to prevent tuberculosis, and that it would complement the three other doses already being administered for Hepatitis B at six weeks, three months and six months.
The ministry outlined to doctors that the birth dose was already being used in 31 other Latin American and Caribbean countries. Based on research, 18º North also learned that the Hepatitis B vaccine has been recommended for use at birth in the United States since 1991. However, BCG is not generally recommended for use in the U.S. because of the low risk of infection.
The rollout of the birth dose was to have occurred in Jamaica in April 2020 but got derailed because of the Covid-19 pandemic. The new rollout date then became January 1, 2023, but there was no widespread public education campaign or even a press release to journalists.
Dr. Gomes chided the health ministry and said, “It’s very poor practice to introduce something without sensitizing the public first.”
Dr. Gomes added that the ministry should have said, “This is what I’m introducing to you, these are the reasons and these are the side effects.”
The ministry didn’t respond when asked why there was no press release or widespread public education campaign.
Did The Newly-Introduced Vaccine Regimen Cause Injury or Death?
According to the website of the U.S. Centers for Disease Control and Prevention, the listed side effects of the Hepatitis B vaccine include low fever and sore arm, and, at the extreme, it says “as with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.”
However, attorney Anne Carrión Toale of Maglio Christopher & Toale in Sarasota, Florida that advertises on its website that it’s gotten more clients vaccine compensation in the past five years than any other law firm in the U.S. told 18º North that in 20 years, she may have reviewed a Hepatitis B birth dose case once in an infant, but “don’t think I brought a claim.” (Under the U.S.’s no-fault program, she says she’s had a couple of cases where her clients claimed that the adult Hepatitis B caused various autoimmune disorders, and she was able to secure compensation for those clients.)
The CEO of the Savanna-la-Mar Hospital, Ms. Lewin, confirmed the Hepatitis B birth dose was rolled out at her hospital, but she didn’t answer questions emailed as to whether the three babies that died had received the shots.
Mrs. Brown Miller, on the other hand, emailed that all three babies that died at Black River Hospital were given the Hepatitis B birth dose along with the BCG vaccine. Initially, she had said she wasn’t sure if the first newborn with the organ damage would have been given the shots.
When asked how come the baby with the end-organ damage was given the shots, she backtracked and said that she would have to check the docket of the first baby that died, but she never responded in time for publication. It’s not known if the baby was considered sick or medically unstable.
Dr. Eve Palomino-Lue, who’s been a pediatrician for the last 50 years in Jamaica, says she doesn’t disagree with giving the two vaccines at birth. She says having damaged organs would make babies less able to survive an infection and so, if they’re not sick, it’s medically okay to administer the vaccine to increase the baby’s protection.
The ministry’s guidance to healthcare facilities also states that, “There are no true contraindications to the birth dose,” or reasons that should stop the vaccine from being administered. Therefore, it stated, prematurity, low birth weight, small for gestational age, HIV infection of mother or infant, or jaundice shouldn’t prevent newborns from being administered the vaccine.
Mrs. Brown-Miller said based on conversation, she felt at least one mother whose baby died was blaming the vaccine, and she was alerted by her staff that a gentleman had walked onto the maternity ward asking who gave the baby the injection.
Ms. Morgan, who said she’d had one child previously with only one vaccine administered at birth told 18º North she still had so many questions. “I don’t know what to say about whether it’s the vaccine.”
Mrs. Brown-Miller remains unconvinced that the problem was the vaccine, however. She said a total of twelve babies were born within the same period as the two later ones that died and they all got both shots.
“The Paediatrician has subsequently reviewed all of the remaining babies and found them well. This implies that something else could have been happening with the two babies that passed,” she said.
Upon hearing the available details of the baby deaths at Black River Hospital, Dr. Palomino-Lue reasoned, without knowing for sure, that they probably “picked up an infection.”
“I don’t think we could label them as an injection reaction because it’s very unlikely for three people to have the exact same reaction to an injection,” she said.
Dr. Gomes also said she’d more concerned if it is you have three babies dying from similar things. But, “it doesn’t sound like it,” she said.
What Has Been Done Since the Deaths of the Babies?
Mrs. Brown-Miller stated that since the babies’ deaths, her hospital has filed all the necessary forms that would go to the regional office and then on to the central ministry. But she didn’t answer a question specifically on whether an ESAVI form had been filed. ESAVI stands for Events Supposedly Attributed to Vaccination or Immunization and are supposed to be filed if an adverse event takes place post-vaccination so the event can be investigated and studied, regardless of whether it’s felt that the vaccine caused the event.
She also stated that since the death of the three babies, the hospital is on the lookout for similar symptoms like bleeding in the lungs and breathing problems. She says it’s making sure to maintain careful records to be able to compare cases if the need arises and check the babies more carefully before discharging them.
As for the babies that died, Mrs. Brown-Miller told 18º North that one autopsy would be done internally since the baby died in hospital. She said the other that was dead on arrival would be arranged by the police.
Ms. Morgan acknowledged that the body of her baby was being handled by the police but laments that she didn’t get to say a proper goodbye.
She relayed that she was called into a meeting and laid the baby’s body on a bed at the hospital. When she came back, she said, her baby, she had affectionately called Kiki, was gone -- moved to a funeral home in the care of the police.
“How can my baby’s body be in Bent’s?” she recalled asking the security guard.
Ms. Morgan said she had asked about whether she could get a private autopsy but was told that private autopsies aren’t done on babies. Now it’s a waiting game. She said she was told that the government autopsy would take two to three weeks.
“After the autopsy, I will be able to see the body,” she said.
Ms. Morgan relays that after several weeks, she did get to see her baby’s body again at the autopsy, which was done in Kingston. She shared a copy of the burial order showing that her baby, now formally registered as Akira Campbell, had died of “congenital pneumonia,” which is pneumonia that came with the baby out of the mother’s womb.
Dr. Gomes says this means the baby had had a severe infection in the lungs.
An online publication from the U.S.’ National Institutes of Health’s National Library of Medicine states that the greatest risk of death from pneumonia in childhood is in the neonatal period, contributing to as many as 1.2 million neonatal deaths per year and accounting for 10% of global child mortality. It adds that congenital and neonatal pneumonias are often a difficult disease to identify and treat, with clinical manifestations often being non-specific.
Dr. Palomino-Lue concurs and says she doesn’t think that the hospital would have been able to pick up the infection in 24 hours unless the baby was short of breath or looked sick. She says had the infection been spotted by doctors at the time of birth, the baby would needed to have been treated intravenously with an antibiotic.
Ms. Morgan told 18º North that her baby did sound stuffy at birth, but the doctor merely told her to insert nasal drops, which she didn’t do. This was because, she said, she was discharged on a Sunday, and the pharmacy in her area was closed, but also because the stuffiness exhibited by the baby had cleared up.
Dr. Gomes says that stuffiness exhibited by a baby is common in newborns, and even if nasal drops had been administered, it wouldn’t have made a difference in the case of a lung infection. She said signs of infection would have been more about the chest rather than the nasal passage - difficulty drawing breath or rapid breathing, which Ms. Morgan said her baby didn’t exhibit.
Nevertheless, Ms. Morgan insists that the pediatrician did not do a thorough check of her baby before being discharged after only one day. Additionally, she said that at the autopsy she was told by the pathologist that her docket from the Black River Hospital showed that she, as the mother, also had had an infection, but she was never made aware of that by the hospital.
She says she has since been demanding to know why the hospital didn’t give her that information. She said had she known, she could have been treated and perhaps she would have insisted that her baby be more thoroughly checked. She said the hospital was supposed to have a meeting with her after doing its internal checks, but more than four weeks after the autopsy was done, the CEO, Mrs. Brown-Miller, hasn’t met with her to confirm whether she really had an infection and, if yes, what kind of infection and why she wasn’t told.
18º North has reached out to the hospital for answers, but the CEO, Mrs. Brown-Miller hasn’t responded to any of our recent overtures.
Correction: The spelling of Shakera Morgan’s name has been corrected in this version. Her first name had been incorrectly spelled as Shakira in the first version.