Vaccines and Immunization

Biography

Biography: Pramod Jog

Abstract

Vaccines recommended under the National Immunization Program (NIP) are based on the promises that they will prevent the morbidity and mortality due to the illnesses that they cover, and have a high prevalence in that country. Hence, they become the first priority for any practitioner of medicine—both in public and in private sector. Sometimes, local and seasonal epidemiology will also have a bearing. Besides the burden of the disease, certain child specific conditions will also determine the priorities in vaccination. Affordability and cost of the vaccines remain the biggest challenge in deciding priorities in developing countries. The vaccine having lower cost but comparable efficacy should be preferred to enable more vaccines in one’s immunization kitty. Many ethical questions will also weigh while deciding priorities. This talk discusses role of all these issues on deciding a vaccination schedule of an individual child in office setting. Vaccination remains one of the most cost-effective preventions in the medical field. Even the cost of most expensive vaccines is less than the burden of the morbidity and mortality of the illnesses, and the cost of their treatment thereof. Every child has the right to receive all the approved, age appropriate vaccines in that country. Yet not many would be able to afford them. Therefore, the private practitioner has to prioritize on the offering of as many vaccines as possible to as many children coming to his/her facility. Designing an immunization schedule of an individual child with resource strains is indeed a daunting task. One has to prioritize various vaccines based on disease epidemiology, affordability, risk to that particular child, and also availability of affordable vaccines in the vicinity. Hence, various factors need to be considered while prioritizing the vaccines. These factors can be conveniently placed in the form of a mnemonic Nescafe which stands for need, efficacy, safety, cost, affordability, flexible situations and ethical issues.