Which figures to go by?
The big question is, how were the figures arrived at? How and in how many districts was the study conducted?
A source at the National Technical Advisory Group on Immunisation (NTAGI), on condition of anonymity, explains how this came to be. “In 1999, there were
nine cases of ‘presumed’ meningitis in a district in Kerala. These figures were projected to the entire state and then the population of the country (which comes out to be 52,000),” he said. “In the same paper, only three cases were reported the following year. But this was not taken into consideration while projecting the figures.”
A writ petition filed in the Delhi High Court, highlighting how newer vaccines are being introduced in the public health system without proper studies or evidence, mentions various conflicting survey results.
One of them, a WHO-sponsored community study in Tamil Nadu, found that the incidence of Hib meningitis was only 0.007 per cent (which comes up to 8,750 cases nationwide). This is in stark contrast to the figures projected by the core committee.
“This is the only proper study. The study was done for two years, with house-to-house surveys every two weeks,” said the source from NTAGI. He added that this comes up to 1,750 cases of Hib meningitis in a birth cohort of 25 million for five years. Taking the mortality to be 10 per cent, 175 infants may die due to the disease.
What is the price to pay?
As mentioned in the previous report, a reply to an RTI query suggested that five children out of 40,000 immunised in the first six months had died. Extending this to a population of 25 million, it would result in 3,125 deaths.
“In a 25 million population cohort, 175 children are saved from death due to Hib-induced meningitis and 3,125 children (may) die after immunisation.”
The All India Drug Action Network (AIDAN), in an “open letter to WHO” says that the reaction in India to the vaccine is a form of “hypersensitivity reaction” to the vaccine, and that there is no method to predict which child will show adverse reactions.
“If DPT vaccine is withdrawn (and the only option is to give the pentavalent vaccine), people will not have an option,” said the source from NTAGI.
In the writ petition to the Delhi Hight Court, the petitioners refer a paper by Madhavi in Current Science in 2006, on how “combination vaccines piggy-back new and relatively useless vaccines on the standard vaccines like DPT.”
With conflicting views, the overall picture still remains unclear to the common man. The impact of this move will unfold in the years to come.
What is Hib?
Hib is a bacterium that causes pneumonia, meningitis, epiglottis and other diseases. Once a child is immunised with Hib vaccine, he/she still can get meningitis or pneumonia due to other viruses or bacteria.
What is pentavalent vaccine?
Pentavalent vaccine combines the protection against five diseases — hepatitis B, DPT (diphtheria, pertussis, tetanus) and Hib in one vaccine.