Rethinking Vaccine Policy: The Case for Hepatitis A Inclusion

Rethinking Vaccine Policy: The Case for Hepatitis A Inclusion

As India debates adding the Typhoid Conjugate Vaccine (TCV) to the Universal Immunisation Programme (UIP), experts argue that Hepatitis A vaccination may warrant even higher priority, given changing epidemiological patterns and rising outbreaks.

Universal Immunisation Program:-

  • 1985: Introduced as the Universal Immunisation Program (UIP).
  • 1992: Integrated into the Child Survival and Safe Motherhood Program.
  • 1997: Became part of the National Reproductive and Child Health Programme.
  • 2005: Remained a crucial component of the National Rural Health Mission.

Vaccines provided under Universal Immunization Program

Under UIP, immunization is provided free of cost against 12 vaccine-preventable diseases.

  • Nationally (9 diseases): Diphtheria, Pertussis, Tetanus, Polio, Measles, Rubella, severe Childhood Tuberculosis, Hepatitis B, and Meningitis/Pneumonia (caused by H. Influenzae type B).
  • Sub-nationally (3 diseases): Rotavirus diarrhoea, Pneumococcal Pneumonia, and Japanese Encephalitis.

Mission Indradhanush

  • Launch: Announced in December 2014 to accelerate and re-energize the UIP.
  • Objective: To ensure full immunization coverage for all children under two years of age and all pregnant women.
  • Focus: Initially targeted 201 high-priority districts with the highest numbers of partially vaccinated or unvaccinated children.
  • Impact: Increased the rate of full immunization coverage from 1% per year to 6.7% per year (prior to August 2017).

Intensified Mission Indradhanush

  • Launch: Introduced on October 8, 2017.
  • Objective: To further enhance the immunization drive by targeting every child under two and all pregnant women who were missed by the routine immunization program.

India’s golden innings in Vaccination

  • Coverage: Achieved 76% full immunization for children, according to the National Family Health Survey (NFHS), showing steady progress over 20 years.
  • Technology Integration:
  • eVIN (Electronic Vaccine Intelligence Network): Digitizes vaccine stock management, logistics, and temperature monitoring.
  • NCCMIS (National Cold Chain Management Information System): Monitors the inventory, availability, and performance of cold chain equipment.

What is PCV, or the Pneumococcal Conjugate Vaccine?

  • Definition: A conjugate vaccine that protects against multiple strains of pneumococci bacteria, a primary cause of pneumonia.
  • Significance: Pneumonia and diarrhoea are leading causes of infant mortality in India. Pneumonia is linked to 20% of under-5 child deaths, with pneumococcal bacteria responsible for half of those fatalities.

Hepatitis: Overview

  • Definition: An inflammation of the liver that can be self-limiting or progress to chronic disease, cirrhosis, or liver cancer.
  • Causes: Primarily caused by hepatitis viruses; also by toxins (e.g., alcohol) and autoimmune diseases.
  • Symptoms: Can be asymptomatic or include jaundice, dark urine, fatigue, nausea, and abdominal pain.

The 5 Types of Hepatitis Virus

Hepatitis A (HAV):

  • An acute infection spread via the faecal-oral route (contaminated food/water).
  • Preventable by vaccine.

Hepatitis B (HBV):

  • Transmitted via infected blood, body fluids, or from mother to child.
  • Preventable by vaccine.

Hepatitis C (HCV):

  • Transmitted primarily via infected blood (e.g., contaminated injections, transfusions).
  • No vaccine is available.

Hepatitis D (HDV):

  • Only infects individuals already infected with HBV; dual infection is more severe.
  • Prevented by the Hepatitis B vaccine.

Hepatitis E (HEV):

  • Transmitted by consuming contaminated food or water.
  • Vaccines exist but are not widely available.