Dear Sir,
It was nice to get responses from those who are to take decisions regarding the vaccine policy of India .
I still fear that we at the decision level need to work more to make vaccines accessible like posting more health workers, making their service conditions better and so on. In India half of the sub centres do not have staff; then who is going to vaccinate? Further, one fourth of them are located at a distance of more than 10 km from the nearest habitation. Who would go (all this distance) to get vaccinated? These are the issues that need solution.
Also diseases like Rabies kill more than 20,000 patients every year in India , most of them school-going kids, but we do not have free antirabies vaccine/serum available in the hospitals, for want of money. How to save these children is a question?
There have been many studies by the national institute of epidemiology Chennai and other public health institutes on why people do not get their children vaccinated, and we need to thoroughly go through the reasons and ensure a Functional Vaccine Delivery Mechanism (FVDM) as such , so that even if we wish to introduce a new vaccine it is well utilized.
Another problem is that the states like Himachal, that had very high coverage have actually gone down after the introduction of a new vaccine Hepatitis-B. So introducing newer vaccines where coverage is good is not a universal recipe to follow.
The biggest fallacy is that we do cost effective estimates keeping in view the 80% utilization of the vaccine but we do not reach a half mark in actual practice because we donot have a FVDM.
FVDM may need functional sub-centre with full staff, cold chain and less distance of the sub centre besides a mechanism to keep mothers reminded of the next due date.
Thanks and regards,
Dr Omesh Bharti.
M.B.B.S.,D.H.M.,M.A.E.(Epidemiology)
Directorate of Health Services, Himachal Pradesh, Shimla,
+91 9418120302
[email protected],
[email protected]
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