The National Technical Advisory Group on Immunization (NTAGI) during its recently held meeting recommended the scale-up of the pentavalent vaccine across the country. The pentavalent vaccine, which was recommended by NTAGI in 2008 to be added to the universal immunisation programme, has so far been introduced in a phased manner since 2011 in Kerala, Tamil Nadu, Karnataka, Puducherry, Goa, Gujarat, Haryana, Jammu & Kashmir and Delhi. The NTAGI has approved the national scale up of the pentavalent vaccine along with activities to monitor for potential adverse events of the vaccine, after the technical sub-committee recommended the expansion.
Welcoming the recommendation for scale-up, Dr NK Ganguly, former Director-General of the Indian Council for Medical Research said, “The national scale-up of the pentavalent vaccine, which simultaneously provides protection against the five life threatening diseases, diphtheria, pertussis, tetanus, Hepatitis B and Hib (Haemophilus influenza type b) will help in reducing the number of shots a child receives from nine to three. It will make vaccinations easier and allow for many economically disadvantaged children access to a vaccine that is already available widely from private doctors. A single auto-disable syringe will be used instead of three per child, thereby substantially reducing the plastic and sharp waste.”
Pneumonia is the leading killer of children under five years of age in India. Globally according to World Health Organisation (WHO), Hib accounts for at least three million cases of serious disease and approximately 386000 deaths every year. It has been estimated that Hib caused 72,000 deaths, 2.3 million cases of pneumonia, and 35,000 cases of meningitis in India in 2000.
Separately, the National AEFI (Adverse Events Following Immunisation) Committee, which investigated the reported deaths in Kerala following pentavalent vaccine administration, has submitted a report to the Ministry of Health and Family Welfare that the deaths reported in Kerala are not causally related to the pentavalent vaccine. The recommendation of the committee to further strengthen the AEFI surveillance systems has been accepted by NTAGI.
“The NTAGI recommendation for national scale up and the report from the national AEFI committee are consistent that the best experts in the country have judged the pentavalent vaccine to be safe and effective. Pneumonia is one of the leading causes for deaths in children below the age of five years. Availability of the pentavalent vaccine through the universal immunisation programme will help not only prevent morbidity associated with pneumonia and meningitis but also avert thousands of deaths due to these diseases annually,” said Dr Jacob John, a leading infectious disease expert and former Professor at Christian Medical College, Vellore.
“GAVI applauds this decision and India’s leadership in the fight to reduce childhood mortality,” said Dr Seth Berkley, Chief Executive Officer, GAVI Alliance. “Expanding access to pentavalent vaccines will play a key role averting the deaths associated with Hib-pneumonia and meningitis, and liver cancer. NTAGI’s recommendation will ultimately strengthen India’s routine immunisation programme and ensure that vaccines reach those most in need. India is one of world’s largest producers of vaccines, we hope this is the beginning of a new era in public health in India where highly cost-effective Indian vaccines are used locally to reduce infant mortality.”
The pentavalent vaccine, which is being used in 188 countries, is an important tool to reduce under-five mortality in India. The pentavalent vaccine rollout in Sri Lanka, Bhutan and Vietnam was briefly suspended to investigate concerns over a few deaths, but has since been re-introduced in all of these countries. Private practitioners in India have vaccinated lakhs of infants of the rich with this vaccine without any reports of adverse effects. With the proposed national scale-up, it is expected that the pentavalent vaccine will reach all children, more so those from the poor families who need it the most and are least able to afford the vaccine.
The Ministry of Health and Family Welfare will work on plans to implement the recommendations from NTAGI with immunisation partners.
EP News Bureau – Mumbai
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