Severe shortage of anti-rabies vaccine

C. Maya

THIRUVANANTHAPURAM: Heavy demand for anti-rabies vaccine has made vaccine shortage a perpetual feature in most Government hospitals in the district, including the General Hospital, which is the referral centre for dog-bite victims across South Kerala.

The procedural delays in procuring the vaccine by authorities have only compounded the woes of patients. Health officials point out that with increased demand, stocks are depleted no sooner than these are procured.

"We are now spending over Rs.5 crores on the annual purchase of anti-rabies vaccine for the State and still it does not seem to be enough," points out B. Mahilamani, Director of Health Services. It is time that something was done to control the stray dog population rather than deal with perennial vaccine shortages, she said.

About one-third of cases in both GH and MCH are class III bites (severe wounds on fingers or nearer to the head, which makes transmission of the virus to the nervous system easier). Class III bites have to be treated with anti-rabies serum. However, till last year the serum was not included in the list of drugs prepared by the Central Purchase Committee (CPC) and hence it is not stocked in any Government hospitals.

Two types of serum are available in the market, equine (horse-derived) serum and human immunoglobulin, which costs Rs.5,000 per vial. According to sources, 3.5 lakh vials of anti-rabies vaccine were sold across the State last year, out of which, 2.5 lakh vials were purchased by the Government. About 12,000 vials of serum were also sold, out of which about 20 per cent was the expensive human immunoglobulin.

"Last week, shortage of equine serum forced us to purchase human immunoglobulin worth Rs.10,000 for a patient using hospital funds," a doctor at the GH said. For the first time, equine serum has been included in the CPC list this year, in consideration of the increased demand. The Government has been purchasing the costly human deploid cell vaccine (Rs.300/dose) in place of inexpensive anti-rabies vaccines like `Abhayarab' and `Rabipur' (approximately Rs.150), quoting safety issues. At present there is only one company manufacturing human deploid vaccine in the country.

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