Five million Indian children were vaccinated with the five-in-one pentavalent shots in just over a year. Jammu and Kashmir became the sixth State to introduce the vaccines as part of the universal immunisation programme.
The vaccine, with one shot, offers protection against diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae B (Hib). “This will bring down child mortality and morbidity drastically,” says Ajay Khera, Deputy Commissioner, Child Health and Immunisation, Ministry of Health.
There are about 27 million children under one year in the country at any given point of time, and the intention is to take the benefits of the pentavalent to all of them, he adds.
The pentavalent vaccine was introduced in Tamil Nadu and Kerala in December of 2011, the two States with high vaccine coverage and solid public health systems.
After an evaluation of the two States in August 2012, the decision to expand was taken.
The pentavalent vaccine was then introduced in phases in Haryana, Puducherry, Goa, and Gujarat, with Jammu and Kashmir being the latest to join the list.
At present, the vaccines are being procured by UNICEF, with funding from GAVI. The operational costs are borne by the government, Dr. Khera points out. “We need to preserve the vaccine in a good cold chain system, use single use auto disable syringes and provide manpower support to the administration of the vaccine,” he explains. The vaccines are provided free of cost under the public health scheme, while in the public sector, between Rs. 400 and Rs. 700 is charged per dose. Infants are given three doses of the pentavalent vaccine at six, ten and 14 weeks of age.
Replying to an RTI application by Kerala-based doctor K.V. Babu, the Ministry indicated that Kerala had a total of 11 deaths in 2012, and Tamil Nadu four, listed under ‘Adverse Effects Following Immunisation’ (AEFI) using the pentavalent vaccine. In 2011, the year of introduction, there was one death in Kerala. “We need to ask whether the vaccine is safe after all, with periodic assessments. The life of every child is precious, and we cannot afford to lose children from vaccination,” Dr. Babu says.
Responding to this, Dr. Khera explains, “The vaccine safety surveillance system enables us to understand whether programmatic errors are happening. That does not mean that whatever AEFIs are reported do not have a direct association with the vaccine administration. Since we are keen on tracking the pentavalent, we allow even deaths occurring a week after the vaccination to be reported.”
He points out that on an average 3,600 children under the age of five years die every day in the country, due to various factors. “The point is that there can be many factors causing the death of children, the vaccine might be incidental. However, we investigate every reported case of death or even other adverse effects.”
In fact, the vaccine has been available in the private sector in India for over a decade now, he said. The vaccine has been demonstrated to be efficacious and effective in numerous studies and is widely supported by global and Indian health communities.