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No Polio National Immunization Day this yr due to ‘vaccine shortage’. Govt to focus on high-risk areas

Govt to only organise Sub-National Immunization Days for 200 'high-risk' districts. Virologists say no major ramifications likely as India's has good routine vaccination track record.

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New Delhi: A shortage of oral polio vaccines has forced the Union government to cancel this year’s Polio National Immunization Day, ThePrint has learnt.

Under the government’s flagship pulse polio immunisation programme, one ‘National Immunization Day’ (NID) and two ‘Sub-National Immunization Days’ (SNID) are conducted every year, when the bio-oral polio vaccine (bOPV) is administered to children up to 5 years of age. 

This year, the Union government will only organise SNIDs that will focus on 200 “high-risk” districts across 13 states and Union territories.

Assam, Bihar, Delhi, Haryana, Rajasthan, Maharashtra, Madhya Pradesh, Punjab, Gujarat, Uttarakhand, Uttar Pradesh and West Bengal, Jharkhand have been identified for conducting the SNIDs, it is learnt.

A Union Health Ministry spokesperson confirmed that NID is not being held this year, but two SNIDs have been planned. “The first one is scheduled for 28 May and the second one is planned for September this year,” the spokesperson, who did not wish to be named, told ThePrint Monday.

India uses inactive polio vaccine (IPV) and bio-oral polio vaccine (bOPV) — which contain live viruses — to immunise children against polio, a highly infectious disease. According to the World Health Organisation (WHO), the virus, which spreads through person-to-person contact, can invade the nervous system and cause paralysis.

India was certified as polio-free in March 2014, and since then, this status continues. However, routine and supplementary immunisations are considered crucial tools to maintaining high population immunity against the disease that can often be disabling and life-threatening.

The vaccine becomes all the more important considering the outbreak of polio cases in two neighbouring countries, Pakistan and Afghanistan.

Speaking to ThePrint, a senior government official said there has been transmission of wild poliovirus type 1 in two neighbouring endemic countries — Pakistan and Afghanistan — and circulating Vaccine Derived Poliovirus type 2 (cVDPV type 2) in some countries, mostly in Africa, which puts India at high risk of importation.

“This is the reason why the country has a very elaborate polio vaccination and surveillance plan in place,” the official added.

According to government sources, the NID this year was supposed to happen in February but was called off as the public sector undertaking, Bharat Immunologicals and Biologicals Corporation Limited (BIBCOL), under the health ministry, failed to supply nearly 28 crore doses of the vaccine for the campaign.

ThePrint reached BIBCOL for its response over email but has not received a response. This copy will be updated when a response is received.


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What stalled the programme?

According to government officials, bOPV in India is supplied by three manufacturers, including Haffkine and Bharat Biotech, apart from BIBCOL, but vaccines by the first two companies are mostly used in routine immunisation.

For NIDs, bidders are selected two years in advance as it takes that much time to manufacture the vaccines.

According to official sources, BIBCOL was the only bidder to supply bOPV for the National Immunization Day (NID) to be held this year. 

The sources added that BIBCOL was selected two years ago, but by October last year, there was a pendency of 14.73 crore doses on its part and later the PSU conveyed that it was in a position to supply only 1.2 crore vaccine doses for the NID. Citing its financial status, the PSU later withdrew the tender, it is learnt.

The sources said that the government also tried to explore the possibility of procuring bOPV from international vaccine manufacturers, but that could not materialise.

In view of the situation, it was decided that this year only Sub-National Immunisation Day (SNID) will be organised in the “high-risk” districts. 

Nearly seven crore doses of bOPV required for SNID have been supplied by Haffkine and Bharat Biotech, sources told ThePrint. 

Polio vaccination in India

According to the national immunisation schedule, bOPV is offered to all newborns at birth, OPV 1 and IPV 1 are given at 6 weeks; OPV2 at 10 weeks; OPV3 and IPV at 14 weeks and  IPV boosters are given at 9 months of age.

Meanwhile, OPV booster 1 is administered at 16 months of age and OPV Booster 2 at 5 years of age is given through routine immunisation mission Indradhanush, a supplementary immunisation activity.

OPV, which has a live attenuated virus, is administered orally. It is also known to induce better mucosal immunity in the intestines against the pathogen, which predominantly uses the gastrointestinal tract as its portal of entry into the human body.

IPV, on the other hand, contains inactivated polio viruses belonging to all three virus strains (Polio virus 1, 2 3) and a main advantage of using this is there is no risk of developing vaccine-derived poliomyelitis.

But as immunity induced by IPV is lower than OPV, the WHO recommends using both types of vaccines in countries like India.


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‘No major ramifications’

But will the absence of NID this year have ramifications? According to senior virologists, it should have no major ramifications, especially when the average polio vaccination, through routine vaccination, has been good.

According to government data, polio vaccination coverage for the eligible population group has been over 80 per cent for the last several years.

“Keeping up national immunisation days for so long across the country was important, particularly, when routine immunisation was not as good as it is now,” said Dr Gagandeep Kang, who is associated with the Christian Medical College (CMC) in Vellore. 

Speaking to ThePrint, she added that the programme is now becoming more confident that there is robust routine immunisation, so that the national immunisation days can focus on the disease-stricken areas.

Virologist Dr T Jacob John, a professor emeritus at CMC Vellore, pointed out that a safe and efficient method to protect children from any polio, including vaccine-associated polio paralytic, is to give three doses of combination vaccine containing IPV during infancy.

“India can lead all low-income countries in the scientific management of the risk of polio by offering IPV and withdrawing all OPV when IPV coverage reaches 80 per cent or more,” he told ThePrint.

(Edited by Richa Mishra)


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