The interesting article on vaccination in the remote mountains of DRC was marred by the illustration of one of the worst immunisation practices, pre-filling syringes especially with measles vaccine. If this is routine MSF practice they should be advised to stop it. Best wishes Anthony

"MSF is fully aware of current best immunization practice. In 2013, 6,7 million doses of vaccines were administered during preventive and reactive mass vaccination campaigns in various countries and in support to routine vaccination activities in projects we run around the world. However, it is unfortunately still the case that very occasionally teams reverts to old practices, and this was the case in this vaccination in August this year in the Democratic Republic of Congo (DRC). We have taken steps over the past years to ensure that these old immunization practices are removed from all MSF projects worldwide, and we acted immediately when we learned that this old practice had been used during the August campaign to ensure that this does not occur again. Quality of vaccination activity conducted in projects is key for us, as it is for the international vaccination community." Florence Fermon (leader of the vaccination working group), Dr Isabella Panunzi (vaccination advisor-MSF Operational centre Brussels)

Very glad to hear it, but am puzzled by the reference to "old practices". Pre-filling has NEVER been an accepted practice. I am also surprised that the author of the article was so unaware that the picture was posted in the first place. Anthony