Panel approves 5-in-1 Pentavalent vaccine

A high level government panel has suggested nation-wide introduction of a five-in-one vaccine, hoping to prevent deaths of lakhs of children from two killer diseases -  Hepatitis-B and H influenza-b.

The National Technical Advisory Group on Immunisation (NTAGI) recommended the scale up after the Supreme Court asked the Union Health Ministry to inform the court on safety and efficacy of the vaccine. The apex court is hearing a public interest litigation filed by a section of paediatricians and health activists who demanded withdrawal of the vaccine from the public health programme claiming it is unsafe and can cause death.

The pentavalent vaccine combines the Diphtheria, Pertusis, Tetanus or DPT vaccine - used in national immunisation programme - with Hepatitis-B and H influenzae-b (Hib) vaccine.Hib causes severe pneumonia, meningitis and other life-threatening conditions in children less than five years of age. The vaccine was introduced in Kerala and Tamil Nadu in 2011 and later extended to Karnataka, Puducherry, Goa, Gujarat, Haryana, Jammu and Kashmir and Delhi in a phased manner.

The NTAGI in its last meeting on September 23, recommended the scale-up of the vaccine across the country along with activities to monitor potential adverse effects of the vaccine, sources said.

“The NTAGI recommendation for national scale up is consistent with experts opinion that the vaccine is safe and effective. Pneumonia is one of the leading causes of deaths in children below five years. The vaccine will help not only prevent morbidity associated with pneumonia and meningitis but also avert thousands of deaths annually,” said Jacob John, a former professor at Christian Medical College, Vellore.

But the critics claim the vaccine has poor safety record. They accuse the government and World Health Organisation of promoting it by falsely claiming no adverse effect post-immunisation (AEFI) has been reported with the vaccine.

In a recent issue of the Indian Journal of Medical Ethics (IJME), Jacob Puliyel, head of paediatrics at St. Stephen's Hospital in New Delhi, wrote his own investigation found deaths of children in Bhutan, Sri Lanka, India and Vietnam following the use of pentavalent vaccine.
In India, according to IJME, 21 children so far died in a limited experiment with the vaccine in Tamil Nadu and Kerala. "The common factor has been that the children had received the pentavalent vaccine and in most of them, this was followed by high fever, excessive crying and in some, there were convulsions before the child died," the editorial said. But the National AEFI Committee, which investigated the deaths said in its report the deaths were not causally related to the pentavalent vaccine. “While the decision on pentavalent vaccine will certainly fill the coffers of manufacturers, several babies who took the jab have died in Haryana, Kerala and Tamil Nadu,” said C M Gulhati.

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