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High cost is the primary barrier reported by physicians who prescribe vaccines not included in India's Universal
Geoffrey D Kahn1, Deep Thacker2, Somashekhar Nimbalkar3
1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA gkahn@jhsph.edu.
Insights
Pediatricians in India often administer Haemophilus influenzae type B (Hib), pneumococcal conjugate (PCV), and rotavirus (RV) vaccines privately. High cost is a major barrier, but inclusion in the Universal Immunization Program (UIP) is strongly supported.
Area of Science:
- Pediatrics
- Vaccinology
- Public Health
Background:
- Haemophilus influenzae type B (Hib), pneumococcal conjugate (PCV), and rotavirus (RV) vaccines are available privately in India.
- These vaccines are largely absent from India's Universal Immunization Program (UIP), except for Hib in eight states.
Purpose of the Study:
- To survey pediatricians regarding the administration of non-UIP vaccines (Hib, PCV, RV).
- To identify barriers to administering these vaccines and gauge support for their inclusion in the UIP.
Main Methods:
- A survey of pediatricians across India was conducted.
- The survey assessed vaccine administration practices, perceived barriers, and opinions on UIP inclusion.
Main Results:
- Most pediatricians administer non-UIP vaccines to some patients (73-83%), but few administer them universally (7-18%).
- High cost is the primary barrier (93-96%), with minimal concerns regarding vaccine efficacy or safety (1-12%).
- Pediatricians at government facilities were less likely to administer these vaccines; support for UIP inclusion was high (83-95%).
Conclusions:
- Including Hib, PCV, and RV vaccines in India's UIP would be widely supported by pediatricians.
- UIP inclusion would address the significant barrier of high out-of-pocket costs for these essential immunizations.
Abstract:
Haemophilus influenzae type B (Hib) vaccine, pneumococcal conjugate vaccine (PCV) and rotavirus (RV) vaccine are available in the private market in India, but, except for Hib in eight states, are not included in India's Universal Immunization Program (UIP). Pediatricians were surveyed about administering non-UIP vaccines. Most give these vaccines to some of their patients (73-83%, depending on vaccine), but few give them to all patients (7-18%). High cost was the most frequently cited barrier (93-96%). Only 10-12% of respondents had concerns about the efficacy of PCV or RV vaccine, and concerns about Hib vaccine efficacy or any vaccine safety issues were rare (1-3%). Practice varied by type of healthcare facility, with pediatricians at government hospitals least likely to administer non-UIP vaccines. Support for the inclusion of all three in the UIP was high (83-95%). Including Hib vaccine, PCV and RV vaccine in India's UIP would be supported by pediatricians and help eliminate the current barrier of high cost of these immunizations.
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