The Hindu : Study on feasibility of vaccinations

Online edition of India's National Newspaper
Friday, Jun 20, 2003

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Study on feasibility of vaccinations

By Bindu Shajan Perappadan

NEW DELHI JUNE 19. Ever wondered how much the vaccine you pay for really costs? Unbelievable as it might sound, despite the enormous amount of money spent on vaccinations annually, the details of feasibility and cost effectiveness have never really been worked out.

To rectify this flaw, Plan India along with St. Stephen's Hospital here undertook a study at Sangam Vihar in Delhi covering a population of 65,000. While Hepatitis B vaccine was taken up for the case study, the questions probed included the Hepatitis B carrier rate among pregnant mothers in this area, cost and benefits of selective vaccination, and universal immunisation to control Hepatitis B.

According to figures, 25 million babies are born each year in India and 65 per cent of them are delivered at home. All these babies must be reached and vaccinated within 48 hours of delivery to achieve effective universal immunisation. They must be vaccinated with Hepatitis B vaccine at birth, one month, and at six months of age.

Data was collected from 1,100 women who delivered in the project area during a one-year period (December 2001 and November 2002) and then analysed to arrive at an estimation of incidence of Hepatitis B carriers among pregnant women in the community.

The cost of selective immunisation as against universal immunisation was also studied. Also a cost effectiveness analysis in terms of the lives saved or life years gained was looked at.

``We tested 1,100 pregnant women for their Hepatitis B carrier status and found a true prevalence of 1.4 per cent. We found that the price of vaccinating all babies was 19 times more costly than testing mothers and vaccinating babies of Hepatitis carriers,''explains the head of the Department of Paediatrics and member of the research team, Jacob M. Puliyel. It was found that selective immunisation was more cost- effective. However, considering the per capita GNP in India and the small numbers of lives saved, neither of these strategies seems cost-effective.

The report, meanwhile, also presents a novel calculation, using data available on mortality from Hepatitis. "We calculated the cost of universal immunisation per Quality Adjusted Life (QAL) year gained and then adjusted this figure for the approximate cost of money discounting at 3 per cent. What we found out was that the vaccination price must come down to Rs 5.20 per dose before universal vaccination can be considered a viable programme for the country,'' explains Dr. Puliyel.

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