The new national vaccine policy, finalised by the Health Ministry but yet to be announced, has called for introduction of new vaccines under the Universal Immunisation Programme (UIP) and pushing of research in developing vaccines specific for the prevailing diseases in the country.
“For almost 2 decades since the beginning of UIP, India had same 6 antigens in the UIP and recently hepatitis B and measles second dose has been incorporated in UIP. There are a number of diseases, for which vaccines exists for long (typhoid, rubella), which may further be considered for the introduction in India. Similarly, a number of new vaccines have become available in last few years. They are Haemophilus influenzae type b (Hib) vaccines, pneumococcal conjugate vaccines, rotavirus vaccines, HPV vaccines, which have estimated high burden and possible role in reducing child mortality in India,” according to the policy document.
One of the major hurdles in the decision-making process for the introduction of new vaccine has been the lack of indigenous surveillance data to assess the disease burden. The country needs to build upon the available investigator initiated research, modelling data, and systematic reviews to assess the disease burden. Nonetheless, the efforts should be made to strengthen Vaccine Preventable Diseases (VPD) surveillance system. The institutional capacity building should be done for conducting demonstration projects and impact studies in the country, it said.
It has listed several challenges in implementation of immunization programme.
Weak VPD surveillance system, lack of data on disease, lack of diagnostic tools for certain vaccine preventable diseases, lack of baseline surveillance data, limited economic evaluations to show cost effectiveness of vaccines over other interventions to support decision-making, lack of a financial sustainability plan for the introduction of new vaccines in the UIP also affects decision making in this area, shortage of trained manpower to manage the UIP at the Centre as well as State levels, and effective vaccine management are cited as present barriers.
“The authorities should use innovative financing, funding and assured supply mechanisms to overcome these challenges. Furthermore, there is need for the institutionalizing and strengthening of decision making process and enhancing confidence of the people in the process besides preparing in-built country mechanism for sustainable production of newer vaccines within country,” it said.
“The diseases which are prevalent in developing countries are often different than the ones in developed countries. However, till last decade majority of the vaccine research was being done in developed countries and the focus was on the vaccines against diseases, which are prevalent in developed country setting. India has a leading vaccine industry; however, there is need for investing more on the research for the vaccines for the priority diseases in the country. Such research can be promoted only when there is conducive environment, funding and subsequent chances of vaccine being introduced in the National programme,” it said.
“India should be able to ensure quality, safety, and efficacy of all vaccines that are either indigenously produced or imported for the use in the country. Achieving this require a robust regulatory mechanism to be in place. Furthermore, the implementation of immunization program should be put in the perspective of broader goals of National Health Policy. The sufficient political will & support, and the necessary sufficient and sustainable financing mechanisms should also be ensured for this purpose,” the policy said.