The National Technical Advisory Group on Immunization (NTAGI) has recommended the scale-up of the pentavalent vaccine across the country, notwithstanding the controversies and intervention by the Supreme Court in the matter.

The pentavalent vaccine, which was recommended by NTAGI in 2008 to be added to the universal immunization 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.

Separately, the National AEFI (Adverse Events Following Immunization) 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  at its meeting on September 23 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.

The Ministry of Health and Family Welfare will work on plans to implement the recommendations from NTAGI with immunization partners.

Very recently, the Supreme Court had issued notice to the Centre on a petition filed by Dr Yogesh Jain alleging that the vaccine had serious adverse effects on children. Besides, there was also mounting resistance from different groups against the use of vaccine.

Welcoming the recommendation for scale-up, Dr N K 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,” he said in a statement.

Pneumonia is the leading killer of children under five years of age in India. Globally according to WHO, Hib accounts for at least 3 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 20001.

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, said the release.

The pentavalent vaccine aims at providing protection against the five life threatening diseases - diphtheria, pertussis, tetanus, hepatitis B and Hib (haemophilus influenza type b). The DPT (diphtheria, pertussis, tetanus) and Hepatitis B are already part of the national routine immunization programme. Protection against haemophilus influenza type B (Hib), which causes severe pneumonia, meningitis and other life-threatening conditions in children less than five years of age, is a new addition.