National Vaccine Policy: ethical equity issues

Area of Science:

• Public Health
• Vaccinology
• Health Policy Analysis

Background:

• The Indian Ministry of Health and Family Welfare released the National Vaccination Policy in April 2011.
• The policy has been met with significant criticism from public health experts.
• Key ethical and equity issues surrounding new vaccine introductions into the Universal Immunisation Programme (UIP) were examined.

Purpose of the Study:

• To critically review India's current vaccination policy.
• To analyze the proposed inclusion of new vaccines into the UIP.
• To assess the ethical and equity implications of vaccine policy decisions.

Main Methods:

• A comprehensive review of print and web-based literature on the national vaccine policy.
• Analysis of vaccine coverage data and policy recommendations.
• Examination of factors influencing vaccine selection and implementation.

Main Results:

• National UIP vaccine coverage remains below 50%, with no clear strategy for improvement outlined in the policy.
• A significant lack of reliable epidemiological data hinders evidence-based decision-making for vaccine policy in India.
• Vaccine selection for the UIP (e.g., Haemophilus influenzae type b, pneumococcal, rotavirus, HPV) appears based on availability rather than epidemiological evidence or cost-effectiveness.

Conclusions:

• The current vaccination policy lacks a robust strategy for increasing UIP coverage.
• The absence of reliable epidemiological data is a major impediment to evidence-based vaccine policy in India.
• The rationale for introducing new vaccines, such as rotavirus and HPV, requires further scrutiny based on epidemiological data and cost-effectiveness.