After introducing the inactivated polio vaccine (IPV) into the routine immunisation (RI) schedule, the State is preparing to implement yet another step of the Global Polio Endgame Strategic Plan, when along with the nation, it will totally phase out trivalent Oral Polio Vaccine (tOPV ) and replace it with bivalent OPV (bOPV) on April 25, ‘National Switch Day’.
“tOPV (effective against type 1, 2, 3 of polio virus) will not be used for immunisation after April 25 and will be replaced by bOPV (effective against type 1 and 3 virus). tOPV is being completely removed from the cold chain and disposed of as per national guidelines under direct supervision in all district headquarters. May 9 is the national validation day when the entire nation will be certified as a non-user of tOPV,” a senior health official said.
About 1,000 plus vials of tOPV in public sector hospitals in the State will be destroyed, while the withdrawal of tOPV stocks in the private sector is being coordinated by the State Drugs Controller. All health divisions of Railways and the ESI Corporation and military hospitals are cooperating with the Health Department in ensuring that no trivalent vaccine is stored anywhere.
The process has to be very thorough because this withdrawal of the type 2 polio virus component is a globally synchronised move and hence the presence of even a single vial of tOPV anywhere after the national switch day poses a huge risk of even bio terrorism.
Only bOPV will be used for all immunisation activities since April 25, alongside IPV.
IPV shortage worsens
Meanwhile, the global shortage of IPV has worsened as governments of 126 nations have been buying up the stocks and this has hit the private sector hospitals hard.
IPV is not available any more in the open market and only government hospitals are now providing it. Because of the shortage, following the recommendation of the Indian Expert Advisory Group, infants are being given two fractional intra-dermal doses of 0.1 ml of IPV at six weeks and 14 weeks instead of the full 0.5 ml intramuscular dose.
Though IPV has just been introduced in the public sector, most private sector paediatricians had made a total shift to four full doses of IPV for immunising children ages ago. Many of them are now forced to refer their patients to government facilities for IPV and are quite irate that the government has not been able to facilitate separate IPV sessions for them.
Health officials say that it is likely that quite a few children might miss IPV sessions.“All nations follow the government’s RI schedule. But in India, paediatricians follow a separate schedule fixed by IAP, which contains many expensive optional vaccines. They stopped OPV on their own and fully shifted to IPV. A total shift to IPV is good only if the total immunisation coverage of the nation is above 95 per cent. If IAP had followed the national immunisation schedule, the basic immunisation for all children would have been the same,” a senior official said.
