Rising panic over the diphtheria situation in districts has resulted in a huge demand for Td (Tetanus diphtheria) vaccine across the State from health personnel as well as the general public, resulting in the shortage of the vaccine in the open market.
“There is a sudden scare now; even many private hospitals are asking us for the Td vaccine. Even from a district such as Pathanamthitta with good immunisation coverage, there have been demands from health workers for the vaccine. The current situation does not warrant this kind of panic and apart from doctors and health workers, who may be exposed to risky situations on a daily basis, not everyone needs this vaccine right now,” a health official said.
On the positive side, the current diphtheria outbreak has brought the focus back on immunisation, generating a new demand for completing the vaccinations that many may have missed.
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Vaccine-derived immunity to diphtheria wanes over time and thus it is important that the children are provided the two booster doses of DPT vaccine at 16-24 months and five-six years. But, often, parents forget to give these booster shots.
The coverage of first DPT booster in the State is only about 75 per cent and that of the second booster, less than 65 per cent. Following the age shift observed in the diphtheria outbreak in Malappuram this year – about 74 per cent of the cases were reported in those above 15 years of age – one of the precautionary measures recommended by the Health Department is that all 10-16 year olds, adults, and health personnel in outbreak areas be given Td vaccine.
However, reports of suspected diphtheria cases from many districts, including Palakkad and Thiruvananthapuram, have suddenly spiked the demand for Td vaccine across the State.
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“Because of the scare, all cases of membranous tonsillitis are being chalked up as suspected diphtheria cases and throat swabs sent for testing. But the first line of management for diphtheria is antibiotics and not Td vaccine,” says Amar Fettle, State Nodal Officer for public health emergencies.
Supply situation
The sudden demand for the vaccine from all quarters is threatening to upset the supply situation. The government has placed orders for 4.5 lakh doses of Td vaccine but the supply will be on a staggered basis.
“There has never been much demand for Td vaccine till now and, hence, its supply in the open market is erratic. With sudden increased demand, it is but natural that there will be a shortage. The State Technical Advisory Group on Immunisation has recommended that in future, the TT vaccine at 10 years be replaced with the Td vaccine. But for now, Td vaccine has to be prioritised solely for the population at risk in diphtheria-affected districts,” Dr. Fettle says.