Corrective measures taken; vaccines tested before supply to States

The Centre on Tuesday admitted that 138 children died of Adverse Effects Following Immunisation (AEFI) in 2010 and said major corrective measures were taken.

Of these, 78 deaths had been pronounced as co-incidental by the AEFI committee, one death was due to reaction to the injection, 11 deaths were caused by a programme error, and 10 children died as a result of vaccine reaction. The cause of death was unknown in 34 cases and four deaths could not be classified at all, Health and Family Welfare Minister Ghulam Nabi Azad said, responding to a question in the Rajya Sabha.

The AEFI guidelines had been published in 2005 and revised last year. In addition, training of various categories of officers had been carried out so that deaths due to programmatic errors could be minimised. Importantly, the vaccines procured from the Drugs Controller-General of India were licensed by the government and private manufactures had Comprehensive Good Manufacturing Practice certificates. Further, before the supply to the States, these vaccines were inspected and tested at the Central Drugs Laboratory at Kasauli, Himachal Pradesh.

National policy

Meanwhile, the National Vaccine Policy focusses on changes in the existing immunisation schedule to accommodate new vaccines and for broader utilisation of some vaccines or changing the number of doses, while calling for overcoming the shortage of trained manpower to run the Universal Immunisation Programme (UIP) at the Central and State levels, for disease surveillance and procurement and effective vaccine management.

Stressing the need for maximising the use of vaccines available globally as a public health tool, the policy also calls for creation of a National Immunisation Authority that could be supported by several cells responsible for different functions, and a similar set-up right up to the district level.

On adverse effects following immunisation, the policy spells out monitoring mechanisms at the central, State and district levels.

The policy has advocated that the governments take up the UIP instead of depending on external funds. It calls for creating a corpus (vaccine fund) through an innovative financing mechanism and setting up an inter-agency task force to assess the legal and administrative barriers to making the fund operational. The fund could also be used for introduction of new vaccines and development of vaccines for emergency.

The policy calls for flexible governing and funding mechanisms to support development in public-private partnership mode.

The UIP targets 2.7 crore infants and three crore pregnant women annually. It is one of the largest programmes in the world. The country has a vaccine industry that caters for 43 per cent of the Expanded Programme for Immunisation and some of the new vaccines purchased by the Global Alliance for Vaccines and Immunisation.

Thirty-five per cent of the country's population buys vaccines in the private market.