The Consensus Recommendation and the Immunization Time Table 2012
was released by the Indian Academy of Pediatrics Committee on
Immunization (IAPCOI) in the July issue of Indian Pediatrics
[1]. The process involved review of recent published literature
including standard text books, vaccine trials, recommendations of
reputed international bodies like ACIP of CDC, World Health
Organization (WHO) etc, post-marketing surveillance reports from
industry, cost-effective analysis, etc. More reliance was given to
studies emanating from India, especially on disease epidemiology,
and vaccine immunogenicity, efficacy, and safety. Expert opinion was
sought to fill the gaps. The existing national immunization schedule
and government policies were also taken in to account while drafting
recommendations.
The recommendations of IAPCOI are primarily for
pediatricians in office practice. IAPCOI has replaced the earlier
categorization of vaccines from 4 to 2 categories: first, the
vaccines recommended by IAP for routine use; and second, vaccines to
be used in special circumstances only. The recommendations have also
reviewed and issued recommendations on the recent contentious issues
pertaining to rotavirus, Hib, and pneumococcal conjugate vaccines.
We hope to revise immunization timetable every year rather than
every two years as has been practiced so far. Also, in future,
IAPCOI will adopt a new evidence based methodology, e.g. GRADE
(Grades of Recommendation Assessment, Development and Evaluation),
for issuing not only the future recommendations but to apply to
existing recommendations also, especially on newer vaccines. A
subcommittee has been constituted that will devise a new model based
entirely on evidence to grade the available evidences and on its
basis decide the strength of recommendations in 2-3 different
categories. The main focus will be on scientific evidence and
transparency so that the system can be reproducible and can also be
reviewed by other experts.
IAPCOI also plans to prepare position papers on
important vaccines and vaccine preventable diseases highlighting
committee’s stand on various issues. Hib diseases and vaccines have
been chosen for the inaugural papers. As another important step, the
IAPCOI has taken a stand to generate systematic reviews on important
issues; the first review on rotavirus vaccine is already underway.
It is thus appropriate that immunization related
continuing education activities come to be in the forefront of IAP
programs. The Academy is now gearing up to organize another meet on
Vaccinology "National Vaccicon TOT" in the last week of August at
Mumbai. The event is planned as a national TOT where 300 IAP members
will be trained in the advances in the science of vaccinology. The
trainees are expected to further percolate this science through
their branches to other members. We are also planning to distribute
the surplus from this national TOT to some 50 branches to conduct
such activities further down the line. It also gives me immense
pleasure to inform you that an advance vaccinology course on the
lines of ADVAC of France is going to be held at Bangalore on 22
