A single medical discovery has changed the future of children. Vaccination is a powerful and cost-effective weapon against disabling and life-threatening diseases. In India, nearly two million children still die from preventable diseases such as pneumonia, diarrhoea, malnutrition and birth complications.

Haemophilus influenzae type b (Hib) is a major cause of bacterial meningitis while pneumonia caused by Hib and Streptococcus pneumoniae (S. pneumoniae or pneumococcus) is also a threat to children’s health worldwide.

Rotavirus-related diarrhoea sends thousands of children to the hospital and kills a large number too. New vaccines are available to protect against these pathogens and India is now gradually moving towards including these latest vaccines in the immunisation programme.

In fact, 2011-20 has been declared the ‘Decade of Vaccines’ by the global community. Awareness about the benefits of vaccines and advocacy for the introduction of new lifesaving vaccines must increase during this period. The health and well-being of millions of children will improve only when the importance of vaccines is acknowledged.

Vaccines provided under the Universal Immunisation Programme (UIP) in India offer children protection from just a handful of infections — tuberculosis, diphtheria, pertussis (whooping cough), tetanus, polio, measles and Hepatitis B across the country and Japanese encephalitis in some areas.

New vaccines against Hib and rotavirus have gained popularity in many countries. The benefits of these vaccines are yet to be maximised in India.

The three new vaccines that will benefit children the most in the country are the pentavalent vaccine that confers protection against Hib; the rotavirus vaccine and the pneumococcus conjugate vaccine.

Other countries have readily embraced these vaccines, and are deriving their benefits. Hib vaccine has been a part of routine immunisation programmes in several countries after WHO’s Strategic Advisory Group of Experts (SAGE), recommended in 2006 that this be included in national immunisation programmes. Of the 194 WHO Member States, 185 have adopted the pentavalent vaccine that protects against Hib.

And the benefits have been huge, since Hib diseases have almost disappeared in these parts of the world.

India too would derive massive benefits: 72,000 child deaths and nearly three million hospitalisations in India will be prevented each year once the Hib programme is established across the country.

In India, the pentavalent vaccine that contains Hib (and also protects against diphtheria, pertussis, tetanus, hepatitis B) has been popular for a decade in the private sector, and was included in the National Immunisation Programme more recently.

The vaccine was introduced in Tamil Nadu and Kerala in 2011 after endorsement by India’s National Technical Advisory Group on immunisation and a detailed review of vaccine safety coordinated by the Indian Council of Medical Research (ICMR).

Since then, the pentavalent vaccine has also been introduced in six additional states.

PENTAVALENT safety The introduction of the pentavalent vaccine in some Asian countries has been associated with safety concerns.

This included reports of deaths shortly after vaccination in Sri Lanka, Bhutan, India, Pakistan, Nepal and Vietnam.

Because of these concerns, Sri Lanka, Bhutan and Vietnam temporarily suspended pentavalent vaccine use as a precautionary measure. In all countries, investigations by local governments, WHO and international experts have not demonstrated a causal link between vaccination and infant death.

As a result, Sri Lanka, Bhutan and Vietnam have resumed the use of pentavalent vaccine.

Faith in the safety of this vaccine was further reinforced after WHO’s Global Advisory Committee on Vaccine Safety reviewed the pentavalent vaccine safety data from four countries (Sri Lanka, Bhutan, India and Vietnam) and concluded that it was safe.

The Indian Academy of Paediatrics (IAP) has expressed concern about the misinformation being spread about the vaccine, and has denounced attempts to distort facts.

IAP maintains that pentavalent is safe and endorses the government’s decision to introduce the vaccine in six states.

While efforts should continue to ensure the safety of vaccines, the drive to introduce immunisation that reduces childhood illnesses and saves lives should not be compromised.

The WHO remains committed to working with the national government to enhance the benefits of safe and efficacious vaccines to India’s population.

(The author is WHO Representative to India)

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