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jv W Cy tPW Hm^v saUn FXnIv kn (thmfyw 10, 2013) Fgp Xnb National Vaccine
Policy:Ethical Equity Issues F teJ\n \nmWv Ch FSpptNpXv (tUm. PbIrjvW\v \n)
]cn`mjbneqsS Aw Hpw tNmpt]mIm\nShccpXv Fv IcpXn Cwojn Xs tNpp:
"The criteria for selection of vaccines for the introduction of new vaccines in the UIP touch upon disease
epidemiologyonly to the extent of mentioning Disease burden (incidence/ prevalence, absolute number of
morbidity / mortality,epidemic / pandemic potential) and consideration for pathogen, host and environmental
interactions and long-termimpact of vaccination on disease epidemiology have simplygone missing. Epidemiological
discussions on guiding policy should also consider the burden of a particular disease compared to other
health problems, as well as the extent to which the disease can be controlled by vaccination and the
possibility of the development of more serious infection due to strain replacement, as happened with
Haemophilus influenzae type b (HiB) infection in the West, or age-shifting due to subimmunisation,as in
the case of rubella"
"One of the main stumbling blocks for an evidence-based vaccine policy in India is the lack of reliable
epidemiological data. There are insufficient data on the actual prevalence and incidence of disease,
pathogen strain/serotype variations, and immunity with and without vaccination among populations of
different geographical regions/age groups"
"The current level of disease surveillance inIndia is insufficient to support unequivocal scientific
decisions based on established principles of public health. These limitations severely affect the task of the
NTAGI, on whichthe Union Government currently relies for all its vaccination policy decisions"
"The introduction of more expensive vaccines sold by private manufactures in the public health system
requires a transparent evaluation of the need for the vaccine and the health of the children in the
country, and should not focus solely on the viability of the vaccine industry."
"The mere availability of a safe and efficacious /affordable vaccine cannot be a good enough justification
for its universal use. Vaccines are not consumer goods and should not be advised unless the need for
them is proven on the basis of scientific principles of public health"
"The aim of such a policy seems to be to not have a policy and to utilise vaccines indiscriminately, with
epidemiology taking a back seat. The policy is increasingly determined by the supply push by the
pharmaceutical companies than the pull demand of proven public health needs"
"The introduction of newer vaccines into the immunisation programmes in India has been the subject of
heated debate in recent years. While a number of concerns have been identified, the one that receives
precedence over the others is that the commercial interest of the vaccine manufacturing lobby often
overrides public health interest''
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