Vaccination in India includes the use of vaccines in Indian public health and the place of vaccines in Indian society, policy, and research.
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Vaccination policy
India's Universal Immunization Programme (UIP) began in 1985. The UIP covers:[1][2][3]
- BCG vaccine for Tuberculosis
- DPT vaccine for Diphtheria, Pertussis and Tetanus
- OPV vaccine for Poliomyelitis
- Measles vaccine/ Measles and Rubella vaccine
- Hepatitis B vaccine
- TT vaccine
- Pentavalent vaccine for Hib, DPT, Hep B
- JE vaccine (localised)
- Rotavirus vaccine
- PCV for Streptococcus pneumoniae
Available vaccines
Coronavirus
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India has been vaccinating against coronavirus since 16 January 2021.
Rotavirus
India's implementation of the rotavirus vaccine in its Universal Immunisation Programme has saved many children's lives.[4]
Nearly every child in every country globally experiences at least one rotavirus infection in early childhood.[5] However, in India, children are more likely to get this infection multiple times, and children in India are more likely to die from it.[5]
A rotavirus vaccine is available.[5] This vaccine is highly effective and has been preventing half of the severe rotovirus diarrhea cases which would occur in India otherwise.[5] Scientists in India produce vaccines for this disease which are special for India only.[5]
HPV
As of 2019 the Indian government is scaling up efforts to promote the HPV vaccine for girls to prevent cervical cancer.[6] This effort began in 2008 with the introduction of one sort of vaccine and in 2018 the government began providing a newer version of the vaccine.[6]
Respiratory syncytial virus
Cases of respiratory syncytial virus (RSV) in India mainly occur in North India in the winter.[7] This virus causes lower respiratory tract infection.[7]
Safety
India, like many other countries, uses the World Health Organization system for reporting and classifying "Adverse Events following Immunization".[8] The government agency which manages this program is responsible for both increasing safety and giving an explanation if a problem occurs.[9] Between 2012 and 2016, the system identified about 1000 cases.[10] Researchers responded by examining these cases to improve safety.[10]
History
In 1802 a 3-year-old girl in Mumbai received a smallpox vaccine, making her the first person to take a vaccine in India.[11] The British government claimed success and began to block use of the previous technology variolation to only recommend vaccination instead.[11] In hindsight, the situation was complicated because vaccines were the long-term solution but way that the British Raj introduced them was disruptive to how people accessed traditional health services, and to government operations, and in religion.[12]
Society and culture
The pharmaceutical industry in India is strong and has a reputation for producing good vaccines for sale and export.[13] Typically when a country makes vaccines, that means that local people have good access to them.[13] For various reasons, India has both a strong vaccine manufacturing sector and also people in India, especially children, have higher rates of missing vaccines than in comparable countries.[13]
Various commentators have given different reasons for why India has less vaccination.[13] One historic reason is that India has contributed intensely to encouraging vaccines for smallpox and polio at the expense of being able to promote other vaccines.[13] Another explanation could be that the Indian government underspends on vaccines in general.[13] Somehow India's population does not demand vaccines, which could be a result of lack of public health education.[13] India also has pseudoscience activists promoting vaccine hesitancy.[13]
Some research has suggested that community engagement (CE) may be especially important to consider in supporting vaccination in India. This may include "[efforts that are] focused on upstream relationships (bidirectional), fostering trust, transparent communication, capacity building, and political will to ensure such approaches."[14] There appears to be overarching support for vaccination CE among decisionmakers in India, but there remain many structural and social barriers to moving forward on this front.[15]
Vaccines in research
Dengue
There has been a dengue vaccine available since 2015.[16] However, this vaccine is not effective in many cases.[16] The Indian government participates in the global research to develop an effective general use dengue vaccine.[16]
Kala azar
There is research for a kala azar (Leishmaniasis) vaccine in India, but none exists.
Special populations
Foreign tourists visiting India contribute significantly to India's economy.[17] People who visit India from countries with different diseases may not have vaccines to protect against infections in India.[17] When tourists do get an infection in India, often that infection could have been prevented with a vaccine.[17][18]
The World Health Organization recommends different vaccines for tourists in different circumstances.[17] Those vaccines include diphtheria vaccine, tetanus vaccine, hepatitis A vaccine, hepatitis B vaccine, oral polio vaccine, typhoid vaccine, varicella vaccine, Japanese encephalitis, meningococcal vaccine, rabies vaccine, and yellow fever vaccine.[17]
References
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