Introduction of newer vaccines in Immunization Programme of India: Challenges to be addressed

S. Dasgupta
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Abstract

Small Pox eradication will continue to be regarded as the humanity’s greatest triumph for all times to come. Since then, several health achievements were attained that too made significant contributions towards the goals of human survival and development. Substantial reductions in deaths and disabilities have been observed in diseases like childhood Tuberculosis, Pertussis, Diphtheria, Measles and paralytic Polio. In India, considerable reduction in vaccine preventable disease (VPD) burden was observed following launch of Expanded Programme of Immunization (EPI) in 1978. Reported number of Pertussis cases came down from 320109 (1980) to 25206 (2015). Measles cases reduced from 114036 to 25488 in the same time interval. Maternal and Neonatal Tetanus has been eliminated from most part of the world including India. There were 18975 paralytic Polio cases reported in 1980, which came down to ‘zero’ in 2011, and South-East Asia region including India declared free of WPV in 2014. We are at the end game phase of another great landmark, Polio eradication. In all these successes, immunization was the core intervention.Millennium Development Summit in 2000 focused on intensification of child health interventions for attainment of the MDG-4 of reducing under-five deaths. The benefits of traditional EPI vaccines are already evident. Worldwide, the projected number of deaths averted by Measles vaccine (including SIA rounds) during 2011-2020 will be around 14.1 million. Introduction of newer and less utilized vaccines may further boost the attainment of MDG-4. Universalizing Hepatitis-B vaccine may prevent 6 million child deaths by 2020. Newer vaccine Hib may avert 1.7 million deaths. Sustaining the current vaccines and upscaling the programme with newer vaccines is expected to prevent 25 million child deaths worldwide during 2011-2020. Also, a number of new vaccines, like malaria, dengue, new-generation tuberculosis and typhoid conjugate vaccines are in advanced stages of development and may be available in the coming years.
在印度免疫规划中引入新疫苗:有待解决的挑战
根除天花将继续被视为人类在未来所有时代最伟大的胜利。自那时以来,取得了若干卫生成就,这些成就也为人类生存和发展的目标作出了重大贡献。儿童结核病、百日咳、白喉、麻疹和麻痹性小儿麻痹症等疾病的死亡和残疾大幅减少。在印度,自1978年启动扩大免疫规划(EPI)以来,疫苗可预防疾病负担显著减少。报告百日咳病例数从1980年的320109例下降到2015年的25206例。麻疹病例在同一时间内从114036例减少到25488例。包括印度在内的世界大部分地区已经消除了孕产妇和新生儿破伤风。1980年报告的麻痹性脊髓灰质炎病例为18975例,2011年降至“零”,包括印度在内的东南亚地区于2014年宣布无脊髓灰质炎。我们正处于消灭脊髓灰质炎这一伟大里程碑的最后阶段。在所有这些成功中,免疫接种是核心干预措施。2000年千年发展首脑会议的重点是加强儿童保健干预措施,以实现减少五岁以下儿童死亡的千年发展目标4。传统的扩大免疫疫苗的好处已经很明显。在世界范围内,2011-2020年期间,麻疹疫苗(包括新发麻疹疫苗)预计避免的死亡人数约为1 410万。采用更新和较少利用的疫苗可进一步促进千年发展目标4的实现。到2020年,普及乙型肝炎疫苗可防止600万儿童死亡。较新的Hib疫苗可避免170万人死亡。在2011-2020年期间,维持现有疫苗并使用新疫苗扩大该规划,预计可在全世界预防2500万儿童死亡。此外,一些新疫苗,如疟疾、登革热、新一代结核病和伤寒结合疫苗,正处于开发的后期阶段,可能在未来几年内上市。
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