Letters to the Editor

Indian Pediatrics 2002; 39:982-983

Reply

On behalf of the "IAP Committee on Immunization" I thank Dr. Alexander Mathew for his very valid observation and comments. We had received similar clarifiction from many of our members and agree that the HB vaccination schedule given on page 29 and the IAP Immunization Time Table given on page 47 in the Guide Book has caused ambiguity and subsequent confusion.

I would like to reiterate here that IAP way back in 1996 recommended HB vaccine as 3rd antigen at birth and IAP’s policy has not changed since then. As indicated by Dr. Alexander himself, the IAP’s primary recommendation of 3 primary doses of HB vaccine at birth, 6 and 14 weeks has since been shadowed due to various factors as 6,10,14 weeks. Through the columns of Indian Pediatrics we would like to rectify that IAP’s recommendation for universal HB vaccination has only one option viz. birth, 6 and 14 week. There is no second option for this universal approach.

However it should be clearly understood that 6,10,14 weeks schedule also works and is intended only for babies born to known HBsAg negative mothers (where prior antental screening has been done which is not a routine in India). Perinatal transmission accounts for 30-40% of new cases of HBV infection and therefore first dose at birth is indicated.

Though these facts have been clarified through the columns of Academy Today and Indian Pediatrics, the issue needs further clarification. As suggested by Dr. Alexander we are deleting the 6,10,14 weeks sehedule from pages 29 and 47 of the Guide Book 2001 retaining only the birth, 6 and 14 weeks schedule. Hope this will clear the existing ambiguity. Necessary modifications, including addition of WHO options for HB vaccine 2001, the exact dosage at different age groups and under special circumstances etc. and the retention of 0,1,6 schedule for infants beyond one year, adolescent and adults are also being explained in greater detail in the revised edition of the Guide Book which will be available on IAP website shortly.

E-mail: [email protected]

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