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Immunization Committee of IAP
Preamble
Many States in
India are endemic for Japanese Encephalitis (JE). Annual seasonal
outbreaks occur is some districts of Tamil Nadu, Karnataka and Andhra
Pradesh. In other districts of these States and in others in
Maharashtra, West Bengal, Assam, North Eastern States, Uttar Pradesh,
Orissa, Bihar and Haryana, JE occurs as periodic outbreaks at varying
intervals. The Central Research Institute (CRI) at Kasauli has
the know-how to manufacture the inactivated JE vaccine. Earlier, CRI
had been manufacturing about 2 million doses annually, and
distributing it to the JE affected States. However, some States have
defaulted in reimbursing the cost. In the public sector health care
and public health system, there is poor demand, or none at all, for
the vaccine. For these and other reasons, the production had been
discontinued for a few years, but happily resumed in the current year.
At present the production volume is about half a million doses.
Under these
circumstances, the Immuniza-tion Committee of the Indian Academy of
Pediatrics recommends to the Government of India, the following steps.
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The Government may
make the JE vaccine available to the private sector health care
agencies through appropriate mechanisms on payment basis.
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The Government may
call together, at an early date, a meeting of the State Health
leadership of the JE affected States, experts from Indian Council
of Medical Research (ICMR), IAP and other relevant agencies in
order to design an immunization strategy in the districts with
outbreaks of JE.
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The State
Governments may develop District maps of JE infection burden using
both clinical and laboratory criteria, using the help of other
relevant and other interested agencies including local medical
colleges. Such maps may be revised at intervals of 3-5 years.
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The recommended
immunization schedule is to give, intramuscularly, 2 doses one
month apart and a third dose 6-12 months after the second,
provided the last dose precedes the anticipated seasonal increase
in incidence. Immunization may com-mence from 24 months of age to
5 years. Children from rural areas and urban slums where humans
and amplifier hosts (e.g., pigs) live in close contact are
at a higher risk and may be given priority for vaccination.
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Wherever
vaccination is planned or initiated, vector control measures must
also be undertaken, especially by way of the control of breeding.
These recommendations are
provisional and to be revised by the proposed strategy planning meeting.
No recommendation for booster dose is being made now, pending the
outcome of the meeting.
| Members
of the IAP Committee on Immunization: |
Chairperson:
T. Jacob John
Convener:
Anand P. Dubey
Members: Thomas Cherian, Tapan
Kumar Ghosh, Indrashekhar Rao, H.P.S. Sachdev and Navin Thacker.
Ex-officio Members: Swati Y.
Bhave, A. Parthasarathy, G.S. Hathi and Raju C. Shah.
Correspondence to: Dr. A.P. Dubey,
Convener, IAP Committee on Immunization, Professor of Pediatrics,
Maulana Azad Medical College, New Delhi 110 002.
E-mail:
[email protected]
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