Hexavalent Vaccine
Why in News?
- A recent study led by the Union Ministry of Health and Family Welfare, in collaboration with the George Institute for Global Health India, Gates Foundation, Gavi and other institutions, examined the feasibility of introducing a hexavalent vaccine into India’s Universal Immunisation Programme (UIP).
- The study found that the vaccine could make childhood immunisation more efficient and convenient, but its economic benefits would depend heavily on reducing the procurement price.
What is a Hexavalent Vaccine?
A hexavalent vaccine is a six-in-one combination vaccine that protects children against:
A hexavalent vaccine is a six-in-one combination vaccine that protects children against:
- Diphtheria
- Tetanus
- Pertussis or whooping cough
- Hepatitis B
- Haemophilus influenzae type b (Hib)
- Polio
It combines the protection currently delivered through the pentavalent vaccine and separate polio vaccination components into a single injection. It should not be confused with a “six-dose” vaccine; hexavalent refers to protection against six diseases.
Key Findings of the Study
The study assessed two possible implementation models:
Key Findings of the Study
The study assessed two possible implementation models:
- Replacing the existing pentavalent and fractional IPV doses in the primary immunisation schedule.
- Replacing these vaccines as well as the DTP booster dose with a hexavalent formulation.
The findings indicate that the vaccine could:
- Reduce the number of injections received by infants.
- Save time for parents and caregivers.
- Reduce the workload of Auxiliary Nurse Midwives and other frontline health workers.
- Lower the use of syringes and other consumables.
- Simplify vaccine records and session management.
- Reduce cold-chain and vaccine-storage requirements.
- Improve convenience and potentially reduce missed vaccination opportunities.
Economic Dimension
- The study found that introducing the hexavalent vaccine would initially increase programme expenditure, mainly because the price per dose is higher than that of the existing vaccines.
- However, a 50% reduction in the vaccine’s unit price could allow operational and system-level savings to offset the additional procurement cost under the primary immunisation schedule.
- Therefore, bulk procurement, domestic manufacturing, technology transfer and negotiations with vaccine producers would be essential before considering nationwide adoption.
Relevance to India’s UIP
- India’s UIP currently uses a combination of vaccines, including pentavalent vaccine, fractional IPV and oral polio vaccine.
- A hexavalent vaccine could simplify programme delivery, especially in areas where health workers face high workloads, cold-chain constraints and difficulties in ensuring repeated vaccination visits.
- However, the study is an economic and operational assessment; it does not by itself mean that the hexavalent vaccine has already been incorporated into India’s nationwide UIP.
Challenges
- Higher initial procurement cost.
- Need for regulatory approval and continuous safety monitoring.
- Requirement of adequate clinical evidence for Indian children and different vaccine formulations.
- Possibility of supply disruption if dependence is placed on a limited number of manufacturers.
- Need to ensure that combination vaccines do not compromise the immunogenicity of individual components.
- Training and updating of immunisation guidelines, vaccine records and cold-chain systems.
Way Forward
- India should consider a phased and evidence-based approach involving pilot introduction in selected states, independent cost-effectiveness assessment and post-marketing surveillance.
- Domestic manufacturing and competitive procurement should be promoted so that the vaccine becomes affordable without compromising safety or quality.
