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Vaccine Alert

We will soon have a cheap vaccine against Rotavirus. Why is this important?

Children across the country may breathe a little safer. The government has announced the development of a new low-cost vaccine against Rotavirus, the leading cause of severe diarrhoea. Rotavirus is not a commonly known disease, even among the middle class. The first time I heard of it was when my baby was vaccinated for it as part of a slew of shots. I don’t recall paying any special attention to it, unlike say, Pneumonia. This is partly because nobody I knew had ever talked about it. Even the doctor didn’t seem to emphasise it. And this is in a posh, private hospital.

But here’s why more people should be talking about it.

Research reveals that Rotavirus is the leading cause of diarrhoea in India. In homes around the country, children breathe shallow because of this virus which spreads through mouth and hand, faeces and breath. According to news reports, Rotavirus is responsible for approximately 4,53,000 child deaths each year. In India alone, it kills 1,00,000 children. It sickens hundreds of thousands more who end up in hospital with diarrhoea and its grotesque twin, dehydration. Diarrhoea is the number one killer of children and Rotavirus its main sniper.

Now, a clinical trial of ROTAVAC®, manufactured by Bharat Biotech, has shown that the vaccine significantly reduced severe rotavirus diarrhoea by more than 56 percent during the first year of life, with protection continuing into the second year of life, according to www.rotacouncil.org. Studies conducted across Africa and Asia have also found that rotavirus vaccines reduced the risk of severe rotavirus by more than half during the first year of a child’s life, says a story at www.impatientoptimists.org. This is when children are at greatest risk. In fact, we are all susceptible to Rotavirus but after the first cases of infection, subsequent times are milder and can’t kill us. We develop immunity. But children between 6 months and two years, who have not yet developed immunity, are likely to develop severe diarrhoea because of the virus.

There is a misconception, particularly among the middle class, that almost anything can be evaded if we sanitise our environment. We scrub things to oblivion. We dream in cleaning products. Diarrhoea—that’s about open drains and flowing sewage, isn’t it? Well, only partly. Rotavirus does spread through contaminated hands and surfaces but here’s the catch. More hygienic surroundings do not automatically mean safety. Good hygiene and cleanliness are important but are not enough to control the spread of the virus. So really, a vaccine is the most effective way to battle the disease.

Countries that have introduced the vaccine have seen major reductions in hospitalisations and deaths from diarrhoea. In this context, the announcement comes as a huge relief. The manufacturers have promised to make the drug available for approximately Rs 54 per dose, which is far cheaper than its current price.

The push to introduce cheap Rotavirus vaccine in the market is obviously welcome. A cheap vaccine means that more people will be able to access it. Once people know about the vaccine, they will be more open to taking their child to a hospital or Primary Health Centre where the shot can be administered. The crucial word here is know. Like with other aspects of medical care, spreading awareness is likely to be an uphill task. It needs to be prioritised. Earlier this month, the government launched Special Immunisation Week, a drive to create awareness about routine immunisations. Across four months, one week every month was devoted to conducting special immunisation sessions in high-risk areas across the country. Efforts like this will need to be ramped up.

As it is, close to 75 lakh children miss being vaccinated, most of them from poor and marginalised communities. Even these figures may be optimistic. According to a McKinsey report published in September 2012, the quality of data in public healthcare centres is riddled with errors. Healthcare workers do not record data accurately and there is duplication of data between different levels of workers. This means there is over-reporting. The same report, titled “Transforming India’s Vaccine Market”, also points out that awareness building campaigns have been successful for the Pulse Polio vaccine but mass media and other campaigns never mention other vaccines. Nor are they endorsed in government health programmes.

Of course we must celebrate the arrival of the cheap vaccine, but without losing sight of what comes next.

Anindita Sengupta writes about maternal and reproductive health with a fellowship from the International Reporting Project in Washington, D.C.

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