Pulse polio . Needs rethinking
Before you read this write up please go through this link written about the same topic in May 2018 .
Last week i had a talk with one of senior official in communicable disease. I wanted to have the latest data about the polio vaccination status of with Oral polio vaccine (OPV) and Injectable polio vaccine (IPV) both at national level and Kerala as i could nt get any data beyond 2016.
What was worrying me was about the weekly report of Polio status WHO.
Most of us worrying about recent political developments are blind about a real threat which any moment is likely to grip our nation. We are sitting on a time bomb.
I don't know whether i am permitted to write about a govt policy . I am supposed to endorse all govt policies as a govt servant.
Yes i ll do that .
But as a person who is keenly watching all these scientific facts i feel it is my duty to warn our fellowmen about this threat.
May be it is nothing like Ebola or NIPA which ll result in mass casualties .
All these eight years we were relaxed with sense of security that Polio is no more a threat to our country as it is reported as eliminated from our country.
I feel any moment this is going to be a myth.
I was talking about these fact with him but he did n't agree. but he seems certain such a threat is far from reality . It wont occur.
I tried to convince him about the fact.
At the end of the discussion i was desperate to know that if this person is unaware of the scientific fact what must be happening at the national level where all these decisions are taking place.
There is a major problem
Administrators , bureaucrats and the politicians decide the policy does n't have enough idea about the scientific facts.
The people who are supposed to advice them also fails to convince them about policies which are likely to have serious consequences.
Many countries reported VDPV to a total of 227 cases. which again is going to be major threat .
They all occurred in countries were polio was eliminated years back. Recently in Philippines and Malaysia .
We have been vaccinating with oral polio since 1978, eliminated wild polio and no VDPV since last four years. we are continuing with OPV and Injectable polio intradermally since 2016.
Then why should we worry ?
This is the exact point I would like to stress
We could have relaxed and considered as safe if our vaccination coverage is 95 percent or at least 90.
We are far from this, at national level. National level there are pockets where the level of vaccination both OPV and intradermal polio vaccination far from safe level.
But we cant claim the same about Injetable polio (IPV). That is far less.
2. IAP schedule has added to the confusion . Sorry to be frank .Just check the IAP schedule 2019.
91 Percent of Indian population depends on national schedule where OPV and Pentavalant vaccine and intradermal IPV is given in all states of India. Selected states have started giving Rotavirus and Pneumococcal vaccines.
IAP schedule there is no OPV in primary doses at 6 , 10, and 14 weeks. Instead it recommends IPV , full dose Intramuscular. This creates a lot of confusion.
People are confused . They are neither getting OPV or IPV , because intra dermal IPV given in govt sector only .
Naturally mother and baby visit the same hospital to get immunized. There starts the confusion, They ll start with the costly schedule which few doctors discuss with parents. .They may not be in a position to complete the same schedule three doses.
May be other factors are the reasons in other states , but Kerala also if we take the status of Polio vaccination we have gone back.
Pulse polio is not a remedy for the real problem.
Please go through the scientific basis of pulse polio in the link above. It is to flood the environment with vaccine virus to replace the wild virus in the environment. In fact at present there is not a single wild virus in the drainage.
We may argue , at least this dose ll give some immunity to the un immunized This again is a wrong belief
Un Immunized kids in the un -reached areas remain un immunized.
Unless we actively plot the area. find out the un-immunized search and go behind them we wont be increasing the coverage.
This pulse polio which will be celebrated all over India with the media and celebrity is going to cost crores of money and manpower without improving the immunity of the kids who need to get immunized.
Hope in the govt setup we are counter checking the vaccine usage with the uploaded data.
What have to improve coverage with Intradermal Polio vaccine, and the confusion created by IAP schedule at the private sector and the layman
Why not we give the Injectable polio to the private sector.?
We can utilize the expertise of IAP 3000 members ll give training to the staff in the periphery to give intradermal polio vaccine.
Supply the Pentavalant vaccine and IPV to private sector. Let this vaccine to be given free of cost and let them submit the vaccination list .IAP was conducting many training programs , recently lactation counselors training was done successfully.
IAP should support the issue to solve the confusion in the schedules. As far as possible try to bring out a common schedule, without fighting the national schedule so that majority get the IPV as intradermal method itself and give OPV to all. Let us deviate from the IAP schedule to join hands with the National schedule.
Unless some method is taken at national level to improve the vaccine coverage of drop out we are at risk .
We have been promoting this and this is the 25th year of pulse polio, But ..
May be it is nothing like Ebola or NIPA which ll result in mass casualties .
All these eight years we were relaxed with sense of security that Polio is no more a threat to our country as it is reported as eliminated from our country.
I feel any moment this is going to be a myth.
I was talking about these fact with him but he did n't agree. but he seems certain such a threat is far from reality . It wont occur.
I tried to convince him about the fact.
At the end of the discussion i was desperate to know that if this person is unaware of the scientific fact what must be happening at the national level where all these decisions are taking place.
There is a major problem
Administrators , bureaucrats and the politicians decide the policy does n't have enough idea about the scientific facts.
The people who are supposed to advice them also fails to convince them about policies which are likely to have serious consequences.
Why should we worry ?
1. The "dangerous seed" is being grown next door and the yield in plenty next door. Any moment it can 'spread in wind' and cross the fence to our field . Pakistan and Afghanistan total reported wild polio cases is 116 till last week.Many countries reported VDPV to a total of 227 cases. which again is going to be major threat .
They all occurred in countries were polio was eliminated years back. Recently in Philippines and Malaysia .
2.Should we worry ?
We have been vaccinating with oral polio since 1978, eliminated wild polio and no VDPV since last four years. we are continuing with OPV and Injectable polio intradermally since 2016.
Then why should we worry ?
This is the exact point I would like to stress
Our routine vaccination status is not that safe situation now especially at national level.
We could have relaxed and considered as safe if our vaccination coverage is 95 percent or at least 90.
We are far from this, at national level. National level there are pockets where the level of vaccination both OPV and intradermal polio vaccination far from safe level.
What about Kerala?
Average 91 percent about OPV , except malappuram where it is less.But we cant claim the same about Injetable polio (IPV). That is far less.
Why these we are going backwards ?
1. Routine immunization is going down is a fact. In spite of Intensified Indradhanush there are areas still the coverage is too low.2. IAP schedule has added to the confusion . Sorry to be frank .Just check the IAP schedule 2019.
91 Percent of Indian population depends on national schedule where OPV and Pentavalant vaccine and intradermal IPV is given in all states of India. Selected states have started giving Rotavirus and Pneumococcal vaccines.
IAP schedule there is no OPV in primary doses at 6 , 10, and 14 weeks. Instead it recommends IPV , full dose Intramuscular. This creates a lot of confusion.
People are confused . They are neither getting OPV or IPV , because intra dermal IPV given in govt sector only .
In Kerala 70 percent of deliveries happening in Private sector.
Naturally mother and baby visit the same hospital to get immunized. There starts the confusion, They ll start with the costly schedule which few doctors discuss with parents. .They may not be in a position to complete the same schedule three doses.
May be other factors are the reasons in other states , but Kerala also if we take the status of Polio vaccination we have gone back.
So why you oppose pulse polio. Why not use this as a remedy for this ?
Sorry.Pulse polio is not a remedy for the real problem.
Please go through the scientific basis of pulse polio in the link above. It is to flood the environment with vaccine virus to replace the wild virus in the environment. In fact at present there is not a single wild virus in the drainage.
We may argue , at least this dose ll give some immunity to the un immunized This again is a wrong belief
Un Immunized kids in the un -reached areas remain un immunized.
Unless we actively plot the area. find out the un-immunized search and go behind them we wont be increasing the coverage.
This pulse polio which will be celebrated all over India with the media and celebrity is going to cost crores of money and manpower without improving the immunity of the kids who need to get immunized.
What is needed .
Stop the idea of Pulse polio and use the same manpower for actively trace the dropouts . Improve the routine vaccination. Heard the availability of inject able polio is no more an issue but the coverage . This issue is more relevant at national levelWhat about Kerala. What remedial measures
Hope our vaccination status and drop out we know very well. Do we know the vaccination status about IPV. Do we get the details of IPV being given in Private set up?Hope in the govt setup we are counter checking the vaccine usage with the uploaded data.
What have to improve coverage with Intradermal Polio vaccine, and the confusion created by IAP schedule at the private sector and the layman
Why not we give the Injectable polio to the private sector.?
We can utilize the expertise of IAP 3000 members ll give training to the staff in the periphery to give intradermal polio vaccine.
Supply the Pentavalant vaccine and IPV to private sector. Let this vaccine to be given free of cost and let them submit the vaccination list .IAP was conducting many training programs , recently lactation counselors training was done successfully.
IAP should support the issue to solve the confusion in the schedules. As far as possible try to bring out a common schedule, without fighting the national schedule so that majority get the IPV as intradermal method itself and give OPV to all. Let us deviate from the IAP schedule to join hands with the National schedule.
Unless some method is taken at national level to improve the vaccine coverage of drop out we are at risk .
What is the harm with doing Pulse polio ?
No harm.We have been promoting this and this is the 25th year of pulse polio, But ..
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