State Vaccine Policy recommendations submitted


A seven-member committee which was set up by the Government to formulate a Vaccine Policy for the State, headed by B. Ekbal, has recommended the expansion and strengthening of the Universal Immunisation Programme (UIP), introduction of adult immunisation in the State against influenza and pneumococcal infections and uniform and mandatory vaccination of all food handlers in the State against Enteric fever and Hepatitis A.

The committee has also recommended that given the huge increase in the stray animal population and the increase in the incidence of rabies in the State, pre-exposure prophylaxis vaccination against rabies would be worthwhile for Kerala, as it can avoid the need for the expensive rabies immunoglobulin serum and reduce the rabies vaccine doses required in case of accidental exposure in future.

Dr. Ekbal submitted the report to Health Minister Veena George on Monday

The committee, which has given broad-based recommendations which can be implemented as short-term /intermediate / long term priority plans, also does not see any immediate imperative for the State to introduce HPV vaccination for adolescent girls in the State, given the steady decline in cervical cancer incidence in Kerala (current incidence 8/lakh). HPV vaccination may be considered in Kerala only if the cervical cancer incidence goes up from the baseline.

For the first time, the committee has delved deep into the issues in the vaccination of immunologically compromised persons, including those undergoing organ transplant and stem cell transplantation and has drawn up detailed guidelines for the immmunisation of this category of persons.

The committee recommends that in view of the new developments in vaccinology and the re-emergence of vaccine-preventable infections like diphtheria and measles in adults, State-specific modifications be adopted into the existing UIP schedule.

Accordingly, it has recommended that the current UIP be expanded over a period of five years to replace MR (Measles Rubella) vaccine with MMR vaccine (Mumps, Measles,Rubella) and the TD (Tetanus, diphtheria) vaccine at 10 years to be replaced with Tdap, which offers additional protection against pertussis.

Typhoid conjugate vaccine [TCV] at 6-9 months of age, Hepatitis A vaccine at 12 months of age, Varicella vaccination and annual influenza vaccination may be adopted to UIP, the committee has recommended

An epidemiological study should be conducted to assess the burden of Japanese Encephalitis in Kerala, based on which, the State should take a decision on expanding JE vaccination (currently in two districts) to the rest of the State. If so, instead of the single dose, two doses should be administered at 9 and 16 months of age.

Given the high mortality and morbidity due to influenza and pneumococcal infections in the elderly, immunocompromised and those with comorbidities, those above 65 years should be administered Pneumococcal vaccine (PCV 13), 23 valent polysacccharide vaccine (PPSV23) and annual quadrivalent influenza vaccine, the committee has recommended

As mortality and morbidity due to H1N1 in pregnancy is high, quadrivalent influenza vaccine should be considered in pregnancy.

Other recommendations include assessment of the immunisation status amongst guest workers and issue of vaccination cards to them; recording of vaccination status of all students when they join school/college’ and improved capture of vaccination data from private sector


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