Urban Health Training Centre celebrates world immunization week

CHANDIGARH: World Immunization week was successfully celebrated by Urban Health Training Centre (UHTC, Sector-38), Department of Community Medicine, School of Public Health, PGIMER both at health facility level and at community level in Sector-38, Chandigarh from April 24 to April 30, 2014. World Health Organization's (WHO) theme for the year 2014 was "Are you up-to-date?"

The low income group (LIG) areas of the sector-38 were selected for the celebration of world immunization week since these areas recorded lower immunization rates and higher dropout rates compared to the corresponding higher income group of the same sector. The awareness and celebration campaign was done at respective Anganwadi centers of the LIG colony of Sector 38-A, D and C on 24th, 26th and 28th April, 2014 respectively. There were totally 32, 21 and 25 pregnant women and nursing mothers from LIG colony of Sector 38-A, D and C actively participated in this celebration.

Introduction was given by Dr. Kathirvel. S, Senior Resident about the vaccine preventable diseases and its effect, necessity for immunization against the diseases and its benefits and benefits of giving breast milk especially colostrum to children. He also elaborated the complete national immunization schedule under Universal Immunization programme. Dr. Sudip shared information with the gathering like when and where to go for immunization, what to do in case of missing dose and missing immunization card, what to do in case of in and out migration. The session also included the dos and don'ts in case of adverse event following immunization. 

A short movie on immunization was shown to the participants. At the end of the video session, queries raised by the group were addressed by the doctors. Information on optional vaccines to children and other pre and post exposure prophylactic vaccine like anti-rabies vaccine (ARV) was also shared with the gathering. The event was quite interactive in which the doctors cleared doubts of pregnant and nursing mothers regarding immunization. The mothers also expressed their satisfaction after the interactive session.

Source: TimesofIndia

Hilleman Labs to help India improve coverage of routine immunisation programme

Marking the start of the World Immunisation Week, the Hilleman Laboratories, an equal joint-venture partnership formed between Merck & Co. and Wellcome Trust, announced their innovative technological intervention, thermostability, to help improve coverage of the routine immunisation programme in India.

With the vision to achieve 95 per cent coverage of Expanded Programme of Immunisation in India which will merit 70 – 80 million doses annually, Hilleman Laboratories is bringing in innovation to act as a catalyst in bridging the gap between academia and product development by increasing the efficiency of existing vaccines with heat stable, easy to use, affordable and novel packaging features, said a release here.

Commenting on the current immunization scenario, Dr. Davinder Gill, chief executive officer, Hilleman Laboratories said, “With a quarter of the current birth cohort left unimmunised in the country, India severely lags behind even when compared with lesser developed nations as well as its immediate neighbours. We aim to compliment the current ecosystem and help expand the supply chain, adding scale and lowering the manufacturing cost; making the existing vaccines accessible and affordable for the unimmunised in India and other developing nations.”

According to WHO, 70 per cent of the world's 22.6 million unimmunised children live in 12 nations; with India home to the largest chunk of 6.9 million. According to the Immunisation Report by UNICEF and WHO, against the 67 per cent cover in India, our neighbours boasts a much higher coverage with Sri Lanka topping the list at 97 per cent followed by Bangladesh at 95 per cent, Bhutan at 92 per cent , Pakistan at 88 per cent and Nepal at 85 per cent.

“The solution to amplify this figure lies in distributing life-saving vaccines without the requirement for large bulk shipments, expensive warehousing and costly, difficult-to-maintain refrigerated shipping paths from the manufacturing plant to the patient, currently spearheaded by Hilleman Laboratories. One of the key breakthrough results the company presents is about the thermo-stable property of vaccines enabling it to withstand tough temperature conditions of countries in Asia and Africa,” the release said.

According to a recent McKinsey & Company report, one of the key constraints of enabling deeper vaccine penetration in India is attributed to limitations in distribution, public health delivery system and supply. Distribution is hampered by an inadequate cold chain and constraint to last-mile distribution, which has limited penetration of basic vaccines to 60-70 per cent.

Though vaccines have transformed public health throughout the world, for children in particular, the burden of vaccine preventable disease in India is still substantial.  Close to two million Indians died of vaccine preventable diseases in 2012. The grim irony translates from the fact that India is the largest producer of vaccines in the world.

Source: pharmabiz.com

The vaccine and its controversy

The MMR vaccine is an immunization vaccine against measles, mumps, and rubella (German measles). It is a mixture of live attenuated viruses of the three diseases, administered via injection. The three vaccines (for mumps, measles, and rubella) were combined in 1971 to become the MMR vaccine.

​The MMR vaccine became the centre of a controversy following claims (which were subsequently established as fraudulent) that the vaccine was responsible for causing Autism-spectrum disorders in children. The controversy was kicked off in 1998 by the publication of a paper by British surgeon Andrew Wakefield in the medical journal The Lancet. Investigations later revealed that Wakefield had multiple undeclared conflicts of interest, had manipulated evidence, and had broken other ethical codes. The Lancet paper was partially retracted in 2004 and fully retracted in 2010, and Wakefield was found guilty by the General Medical Council of serious professional misconduct in May 2010 and was struck off the Medical Register.

ALARMIST NOTION

​Despite overwhelming scientific evidence for the fact that the vaccine's positive effects significantly outweigh any risks it may pose, some anti-vaccine groups in the US and UK have created an alarmist notion that the MMR vaccine is responsible for autism. Many parents have bought into this, so much so that several diseases, including measles, which had previously been controlled to a large degree, have seen serious outbreaks in the recent past. The New England Journal of Medicine has said that anti-vaccine propaganda has resulted in a high cost to society, "including damage to individual and community well-being from outbreaks of previously controlled diseases, withdrawal of vaccine manufacturers from the market, compromising of national security (in the case of anthrax and smallpox vaccines), and lost productivity.

Source: http://timesofindia.indiatimes.com/city/bangalore/The-vaccine-and-its-controversy/articleshow/34130024.cms

Yellow fever vaccination centre to come up in Aundh

PUNE: The Union government's yellow fever vaccination centre, which was supposed to come up in the city two years back, is yet to take off as authorities have now decided to shift the venue of the centre to Aundh Civil Hospital instead of B J Medical College.

The change of location is due to the technical issues related to the procurement of medical equipment. "Earlier, we had decided to set up the centre at B J Medical College attached to Sassoon Hospital, which is under the Maharashtra government's Directorate of Medical Education and Research (DMER). There were some technical issues in terms of procurement of medical paraphernalia. We have now decided to set up the centre at Aundh Civil Hospital which comes under the Maharashtra government's Directorate Public Health Department," said Vasant Gokak, senior regional director (regional office) of the Union ministry of health and family welfare.

"If everything goes as per our plans, the centre will become functional within a month," he said, adding that the Union government has also proposed to set up two more centres in Aurangabad and Nagpur.

Gokak said that the aim is to cater to the large number of people travelling to endemic countries in Africa and South America. Currently, they have to go to Mumbai to get the shot and obtain the mandatory yellow fever vaccination certificate, in the absence of which, they do not get the permission to travel.

Yellow fever is an acute viral haemorrhaegic disease transmitted by infected mosquitoes. 'Yellow' refers to jaundice that affects some patients. There is no cure for yellow fever. Treatment is symptomatic and is aimed at reducing the symptoms. "There will be a one-room facility at the government health centre. It will be manned by a medical officer and a nurse. It will offer vaccination only on fixed days and during fixed hours for those travelling to yellow-fever endemic countries," said a state health official.

Certain countries in South Africa and South America require travelers to get the yellow fever vaccination certificate. Also, people coming to India from these countries need a certificate stating that he or she is vaccinated otherwise they are quarantined at the airport hospitals and kept under observation for 10 days.

A yellow fever vaccination certificate is valid only if it conforms to the model certificate. The validity period of the international certificate is 10 years, beginning 10 days after vaccination.

Foreign nationals residing or who have passed through the yellow fever endemic countries during the preceding six days, are granted visas only after producing the vaccination certificate. After checking the vaccination certificate an entry read as 'Valid Yellow fever Vaccination Certificate Checked' is made in the passport of the passenger.

Fact sheet

Yellow fever is endemic in 33 countries in Africa and 11 countries in South America

The virus is transmitted in two ways - the sylvatic or forest cycle and the urban cycle

Transmission begins when vector mosquitoes feed on non-human primates infected with the virus. The infected mosquitoes then feed on humans

Once contracted, the virus incubates in the body for three to six days. The infection can occur in one or two phases. The first, 'acute', phase causes fever, muscle pain with backache, headache, shivers, loss of appetite, and nausea. In most patients symptoms disappear after three to four days

15% of the patients enter the second and more toxic phase within 24 hours of the initial remission. Along with high fever, the patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates

(Source: World Health Organization)
Article Source: TimesOfIndia

Pentavalent Vaccine – reshaping the conversation

As India celebrates being officially declared polio free, it is critical that the legacy of polio eradication transcends across child health in India. In one of its final acts before the UPA Government wrapped up its term in office, the health ministry announced that eleven additional states are set to include the pentavalent vaccine in their routine immunisation programmes.

Polio eradication in India has rightly been hailed as one of the greatest global public health achievements. However, the pentavalent scale up announcement went largely unnoticed despite being a tremendous step towards ensuring that all Indian children are protected against vaccine preventable diseases. The pentavalent vaccine, includes protection against Haemophilus influenza type b (Hib) to the existing diphtheria-pertussis-tetanus (DPT) and hepatitis B. Hib is a serious threat to India’s children, causing an estimated 2.3 million cases of pneumonia and more than 35,000 cases of meningitis in 2000.

India currently has the highest number of children under 5 dying every year. According to Unicef, 1.4 million children every year die from largely preventable diseases like pneumonia, diarrhoea, malnutrition and newborn complication like sepsis.  The pentavalent vaccine is a preventive tool in a comprehensive approach to child health. Early and exclusive breastfeeding, vaccines, hand-washing, zinc supplementation and oral rehydration salts could significantly reduce child deaths in India. Last month a special article published by India’s Ministry of Health in the Indian Journal of Pediatrics analysed all available evidence and found a significant burden of Hib disease in India to warrant the use of the Hib vaccine. The paper reasserted that the national introduction of a Hib-vaccine could prevent up to 72,000 child deaths every year.

In 2009, India’s National Technical Advisory Group on Immunisation advised the government to incorporate Hib via pentavalent into its national immunization program. Since then, around 8.2 million doses have been administered to children in nine Indian states and the government’s new scale up of the vaccine is a major step forward to ensuring that all children have an equal start in life. Over 100 countries use the pentavalent vaccine in their national immunisation systems. . Eighty-two of these countries use vaccines made by Indian manufactures. Despite providing pentavalent vaccines for the world, India is one of the last countries to protect its own children against Hib-disease. It’s time we ensure all of children have access to this protection, regardless of their families’ ability to pay. 

The pentavalent vaccine has long been available in the private market and is already in use in nine states. The Indian Academy of Paediatrics an umbrella body of 22,500 paediatricians, the World Health Organisation and many others have long supported the use of the pentavalent vaccine. A recent survey of over 1,000 paediatricians showed that over 80 percent have been using the pentavalent vaccine in their clinical practices for the last 5-15 years. Another crucial issue for vaccine introduction is the safety profile of a vaccine. All medical interventions carry some risk and public health programmes have to weigh the benefits and risks. The pentavalent vaccine has been tested in 23 clinical trials with more than 12,000 infants given the vaccine. After careful monitoring the results have shown the vaccine to be effective and have an excellent safety profile.  (Read: )

When new vaccines are introduced, it is critical that they are monitored closely in case of reports of adverse events from immunisation (AEFIs). For example, in Bhutan, Vietnam and Sri Lanka there were several cases of suspected adverse events reported. Each country suspended use of the vaccine and subsequently reinstated it following investigations by local governments and the World Health Organisation, which found no causal link between pentavalent vaccinations and reported infant deaths. India’s health ministry also set-up a mechanism to thoroughly investigate and evaluate all infant deaths and other adverse events reported around vaccinations by an expert committee. This was the case in Kerala and Tamil Nadu, the first two states to receive the vaccine. All AEFI’s have been investigated and none have been reported as being connected with the vaccine.That doesn’t mean there are no risks or side effect to vaccines but the pentavalent benefits far outweigh the risks.

It’s not just the pentavalent vaccine, which is helping to save lives. Training health workers to wipe the umbilical cord with a disinfectant has been shown to reduce neonatal deaths by half. And the development of a new low cost indigenous rotavirus vaccine could save tens of thousands from diarrhoeal death or hospitalisation. Learning the lessons of polio eradication, the government has not been swayed by unfounded criticisms and is moving forward to ensure all children are protected against deadly disease. No child should suffer from Hib-pneumonia, meningitis or any other preventable disease when the power of prevention is already in our hands. 

Source: health.india.com

By: Dr CP Bansal April 1, 2014