Agenda Setting in Vaccine Policy and Social Relevance of the Emerging Vaccine Technologies from Public Health Perspective - PART 1

Abstract

Vaccine technologies have remained a favorite tool for the techno-centric policy establishment to address the morbidity and mortality burden of disease while neglecting comprehensive social, economic and health systems development. Even as implementation of immunization for six primary vaccines remains far from optimal, misplaced arguments are furthered for introduction of newer vaccines. Policy on vaccines in India has tended to be swayed by unhealthy considerations that are extraneous to an epidemiological approach. The paper examines relevant literature to highlight the factors shaping the country's vaccination policies; discusses methods for optimal cost benefit analysis of vaccines, and proposes desirable criteria of an epidemiologically guided vaccine policy. For newer vaccines, public health burden of the targeted diseases, their epidemiology, possible ways of ameliorating the disease burden are chronicled to evaluate the desirability of these vaccines in the current scenario. Rota virus vaccine, the Hib pentavalent vaccine and the HPV (Human Papilloma Virus vaccine) are discussed. The paper is organized in two parts. Part 1 deals with the influences guiding vaccine policy and the percepts of a scientific vaccine policy. Part 2 discusses the case studies of Rota virus and Hib pentavalent vaccines; the two vaccines being intensively targeted for inclusion. There is a structured impetuousness on part of the pro-vaccine lobby to push for the inclusion of newer vaccines, without adequate regard to epidemiology and feasibility. Accordingly the paper argues against adoption of these vaccines in public health programs under the present circumstances.