DIRECTORATE GENERAL OF HEALTH SERVICES

Institutes

Vaccines and Vaccine Manufacturing Institutes

 1. Background:

Currently, there are 26 diseases, which have effective vaccines available for prevention. These diseases are as under;

 Currently, vaccines candidates are recommended for uses for prevention of 21 vaccine preventable disease. Some vaccines used in combination (i.e. pentavalent) under routine immunization programme. Vaccines against five diseases not recommended. These are; Anthrax, Lyme’s Disease, Shingles (Herpes Zoster), Smallpox and Varicella (Chicken pox).

 2. UIP VACCINES

India has a national programme for immunization, popularly known as ‘Universal Immunization Programme (UIP)’. It aims to vaccinate against 11 vaccine preventable diseases of childhood. The vaccines used under UIP and the diseases prevented are as under;

(i) BCG – Tuberculosis

(ii) Pentavalent

(iii) DPT

(iv) TT

(v) Polio drops-Poliomyelitis

(vi) Measles – Measles

(vii) JEV – Japanese Encephalitis

(viii) Rubella vaccine

(ix) Rotavirus

3. NON-PROGRAM VACCINES:

WHO Advisory Committee on Immunization has recommended use of other vaccines for prevention of diseases as under;

3.1.Vaccines Recommended for All:

•  Haemophilus Influenzae type b (Hib)
•  Pneumococcal Conjugate vaccine (PCV)
•  Rotavirus Vaccine
• Human Papilloma virus Vaccine (HPV)

Advisory committees have submitted that Hib, Pneumococcal and Rotavirus are widely prevalent and causes lot of morbidity and mortality among children >5 years. Human Papilloma virus infection causes cervical cancer and results in pre-mature morbidity and mortality among younger women.

3.2.Vaccines Recommended for High Risk Populations:

• Typhoid vaccine
• Hepatitis A vaccine and
• Cholera vaccine

Typhoid, Hepatitis A, Meningococcal infection and cholera are endemic disease in India and causes significant morbidity and mortality among population groups at risk.

3.3.Vaccines with certain characteristics:

• Mumps vaccine
•  Rubella Vaccine and
•  Influenza vaccine

Mumps, Rubella and Influenza vaccines are recommended with certain characteristics of the programme i.e. only for those areas where Immunization coverage is >80%. If the coverage is less than 80%, it has no effect. India has very few States that have reached required coverage level for considering roll out of these vaccines.

4. Vaccines covered under International Health Regulation:

•  Yellow Fever Vaccine (YFV) and
•  Quadrivalent Meningococcal Meningitis Vaccine (QMMV) 

Vaccination with above mentioned two vaccines of YFV and QMMV is mandatory under International Health Regulations. The average requirement of YFV in India is 1,50,000 doses per annum and that QMMV for vaccination of Hajj Pilgrims in India is about 2,00,000 doses per annum.

5. Post Exposure Vaccination:

•  Rabies vaccine and
•  Anti-snake venom serum 

Rabies vaccine and Anti-snake venom serum have specific indications of post exposure vaccination i.e. people bitten by Dogs and Snakes. Timely vaccination to people bitten by dogs and snakes, 100% prevent disease/death, otherwise both are 100% fatal. Estimated annual dog bite cases in India are 17.4 Million and estimated requirement of TCARV is 87.00 million doses @ 5 doses per case. The estimated snakebite cases per annum are 250000 and estimated requirement of ASVS will be 45.00 lakh vials @ 18 vials per case.

6. ANTI-SERA

Anti-tetanus toxoid serum (ATTS)

Anti-diphtheria toxoid serum (ADTS)

Anti-rabies serum (ARS)

 Anti-snake venom serum (ASVS)

 Anti-scorpion venom serum (AScVS)

 Anti-gas gangrene serum (AGGS)

Widely used anti-sera are ARS and ASVS. ADTS is used in children and are lifesaving drugs. ATTS, AScVS and AGGS are of limited use.

Estimated requirement of vaccines and annual installed capacity of the vaccines are given in table 1. Institution wise vaccines manufactured are given in table 2.

Table No. 1

Annual Requirement and Installed capacity of different vaccines manufactured by Public and Private Sector Institutions

(Qty in lakh of Doses)

Institution-wise Installed capacity of the UIP and Non-UIP vaccines