Polio vaccination strategy under scanner

By Vibha Varshney
Published: Tuesday 15 January 2008

india's National Polio Surveillance Programme reported 471 polio cases until December 14, 2007. Although this is lower than the 676 cases reported in 2006, there is reason for concern. There has been a sharp rise in the number of polio cases caused by a particular virus strain-- p3--which was thought to be under control. Around 402 polio cases caused by the p3 strain were reported this year, up from 28 in 2006. Health experts say shifting to monovalent vaccine--which protects from just one strain of virus (p1)--in late 2005 could have led to the increase in p3 polio cases. Earlier, trivalent vaccine was used, which protected from all the three strains of polio virus- p1, p2, p3.

"We had warned p3 would increase if only the monovalent vaccine against p1 is given," says Onkar Mittal, a Delhi-based consultant on health policy. He says that the government's claims that the monovalent vaccine would be effective has been proved wrong. The vaccine that was introduced amidst objections due to lack of information on its efficacy (see 'How potent?' Down To Earth, August 15, 2007).

The government, however, is hopeful. "p3 virus is easier to control and steps will be taken to eradicate it after the p1 virus is taken care of," says an official of the Union Ministry of Health and Family Welfare. He says the government has started using p3 vaccine in Uttar Pradesh and Bihar, the states with the highest number of polio cases. Use of p1 or p3 will depend on the situation, says the official. Inactivated polio vaccine--used in developed countries--is another vaccination option but the latest meeting of the India Expert Advisory Group in December 2007 ruled out its use because of lack of data on its efficacy and cost.

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