I would like to draw attention of the experts to some issues related to
the recent guidelines by the Advisory Committee on Vaccines and
Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP)
People belonging to low socio-economic groups are
more prone to get infections because of overcrowding and poor sanitary
conditions. Many of these people work as domestic helps, and carry the
risk of spreading their infections to the people where they work. Thus,
these are the people who should be immunized in their own and others’
interest. There are two vaccine preventable diseases which need
Pertussis: In year 2008, IAP Consensus
Recommendations on Immunization stated that "there is no reason to
believe that the disease burden of pertussis is low in adolescents in
India" and thus Tdap vaccine instead of Td/TT vaccine was recommended in
all children/adolescents who could afford to use the vaccine .
Presently there is a huge difference in the cost
between Tdap and Td/TT vaccines. People belonging to low socio-economic
group cannot afford the costly Tdap vaccine. There is thus a need to
develop a combination vaccine of tetanus with reduced quantities of
diphtheria and whole cell pertussis components.
Typhoid: IAP-ACVIP guidelines (2018-19) recommend
Typhoid Conjugate Vaccine (TCV) because it has improved immunological
propertis, and can be used in younger children (
1. Balasubramanian S, Shah A, Pemde HK, Chatterjee P,
Shivananda S, Guduru VK, et al. Indian Academy of Pediatrics
(IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP)
Recommended Immunization Schedule (2018-19) and Update on Immunization
for Children Aged 0 through 18 years. Indian Pediatr. 2018;55:1066-74.
2. Indian Academy of Pediatrics Committee on Immunization (IAPCOI).
Consensus Recommendations on Immunization, 2008. Indian Pediatr.