First State to include vaccine in immunisation programme

Kerala will become the first State in the country to roll out pentavalent vaccine as part of the Universal Immunisation Programme on December 14.

The Union Health Ministry is rolling out the pentavalent vaccine, which introduces the vaccine against Haemophilus Influenzae Type B (Hib) infection in the national immunisation schedule for infants for the first time, only in Kerala and Tamil Nadu in the first phase.

Tamil Nadu is expected to launch the vaccine on December 17.

The pentavalent vaccine is a conjugate vaccine which combines the antigens against five infections — Diphtheria, Pertussis and Tetanus (DPT), hepatitis B and Hib — in a single shot

The National Technical Advisory Group on Immunisation in 2008 itself had recommended that Hib vaccine be introduced as pentavalent vaccine in the UIP because of the high mortality due to meningitis and pneumonia caused by Hib infection. It suggested that that as two States with excellent immunisation coverage and good vaccine delivery system, the vaccine be introduced in Kerala and Tamil Nadu first.

Safety issues raised

However, the recommendation had come under a cloud with a section of doctors and public health activists questioning the safety of the vaccine and the rationale of recommending universal immunisation against Hib, without adequate surveillance or ground-level data.

In Kerala too, there had been much opposition to the introduction of Hib as pentavalent vaccine with many questioning the piloting of the vaccine in the State without sufficient Hib incidence or surveillance data.

Following this, the Government had appointed an expert committee to look into these issues.

Kerala has now has decided to go ahead with the introduction of pentavalent vaccine, with the expert committee pointing out that the benefits of Hib vaccine far exceeds any possible risks which may be associated with it.

“We decided to go ahead with the pentavalent vaccine as we are fully convinced that it is as safe as any other vaccine and that the introduction of Hib vaccine is a very important intervention that Kerala requires if we are to bring down our current Infant Mortality Rate (12) any further,” the Principal Secretary, Health, Rajeev Sadanandan, said, while addressing the media at an interaction organised jointly by the UNICEF, WHO and the Department of Health here on Tuesday.

At present, Hib as pentavalent vaccine is a luxury available only to the rich parents in Kerala.

With the Centre fully bearing the entire costs, this is an opportunity to provide the protection afforded by this vaccine to all the poor children in the State, Mr. Sadanandan, said.

Approximately 5.5 lakh children in the State under 12 months will be immunised every year.


As in the case of any vaccine, extreme precautions will be taken to maintain all procedures and to monitor any adverse effects which may occur when the pentavalent vaccine is newly introduced, he said.

Free of cost

The Global Alliance for Vaccines and Immunisation (GAVI) is supplying the vaccine free of cost to the Union Health Ministry for the first three years. Six other States apart from Kerala and TN , have also demanded that they be provided Hib vaccination under UIP.

Pneumonia deaths

Health experts from the WHO and UNICEF pointed out that invasive pneumonia and meningitis caused by Hib is responsible for 23 per cent of pneumonia deaths among children under five years of age in the country. This includes seven per cent of neonatal deaths due to pneumonia. The case fatality ratio ranges from 21 to 29 per cent. Approximately, 72,000 deaths due to Hib infection occurs in India annually.

  • Immunity against DPT, hepatitis B and Hib
  • ‘Pentavalent as safe as any other vaccine'