IAP Q & A on Vaccines and Vaccinology
IAP Q & A on Vaccines and Vaccinology
Editor-in-Chief Srinivas G Kasi MD DCH
Consultant Pediatrician Kasi Clinic
Bengaluru, Karnataka, India
Executive Editor Bakul Jayant Parekh MD DCH FIAP
Senior Pediatrician Director, BPCH Tertiary Care Center
Mumbai, Maharashtra, India
Editors Arun Wadhwa MD
Consultant Pediatrician
New Delhi, India
Abhay K Shah MD Dped (UNI FIRST) FIAP
Senior Pediatrician and Infectious Diseases Consultant Director Dr Abhay K Shah Children Hospital and Pediatric Infectious Diseases Centre, Maninagar
Ahmedabad, Gujarat, India
Academic Editors Nitin Shah MD DCH
Section Head and Consultant Department of Pediatrics PD Hinduja Hospital
Mumbai, Maharashtra, India
Bhaskar Shenoy MD
Head Department of Pediatrics Chief, Division of Pediatric Infectious Disease Manipal Hospitals
Bengaluru, Karnataka, India
Sanjay Marathe MD DNB
Director Colors Intensive Care Hospital and Marathe Children Hospital
Nagpur, Maharashtra, India
Sanjay Srirampur MD DCH FRCPCH
Head Department of Pediatrics Aditya Superspecialty Hospital
Hyderabad, Telangana, India
Alok Gupta MD (Ped) FIAP
Pediatrician and Counselor Pediatric Specialties Clinic
Jaipur, Rajasthan, India
Foreword Vinod K Paul
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© 2021, Indian Academy of Pediatrics
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IAP Q & A on Vaccines and Vaccinology
First Edition: 2021
9789390595082
Printed at:
- Aashay Abhay ShahMBBS MD(UNI FIRST) FISPGHANPediatric Gastroenterologist and Hepatogist at Dr Abhay K Shah Children Hospital and Pediatric Infectious Diseases CentreAhmedabad, Gujarat, India
- Abhay K ShahMD Dped (UNI FIRST) FIAPSenior Pediatrician and Infectious DiseasesConsultant DirectorDr Abhay K Shah Children Hospital and Pediatric Infectious Diseases Centre,Ahmedabad, Gujarat, India
- Alok GuptaMD (Ped) FIAPPediatrician and CounselorPediatric Specialties ClinicJaipur, Rajasthan, India
- Arun Kumar ManglikMD (Ped) DNB (Ped)Consultant PediatricianILS HospitalsKolkata, West Bengal, India
- Arun WadhwaMDConsultant PediatricianNew Delhi, India
- Baldev S PrajapatiMD DPed FIAP MNAMSHOD and ProfessorGCS Medical CollegeHospital and Research Centre,AhmedabadAakanksha Children Hospital and Postgraduate InstitutionAhmedabad, Gujarat, India
- Bhaskar ShenoyMDHeadDepartment of PediatricsChief, Division of Pediatric Infectious DiseaseManipal HospitalsBengaluru, Karnataka, India
- Chetan TrivediMD DPedConsultant Pediatrician and NeonatologistDirectorNeha Children Hospital and Neonatal Center,Kankaria Ahmedabad, Gujarat, India
- Dhanya DharmapalanMD PG Dip in PID (Oxford)Consultant in Pediatric Infectious DiseasesApollo Hospitals Navi Mumbai and Dr Yewale's Multispecialty Hospital for ChildrenNavi Mumbai, Maharashtra, India
- Harish K PemdeMD FIAPDirector ProfessorDepartment of PediatricsKalawati Saran Children's Hospital and Lady Hardinge Medical CollegeNew Delhi, India
- Jagdish ChinnappaMDConsultant PediatricianManipal HospitalBengaluru, Karnataka, India
- Jaydeep ChoudhuryDNB(Pediatrics) MNAMS FIAPProfessorDepartment of PediatricsInstitute of Child HealthKolkata, West Bengal, India
- Kamlesh HarishMD (Ped)Senior ConsultantHead, Department of PediatricsESIC HospitalRohini, New Delhi, India
- M SurendranathMD DCH FACIHODDepartment of PediatricsVijay Marie HospitalHyderabad, Telangana, India
- Mohit VohraDNB(Paed)DirectorSashakt Child Care Centre,Jaipur Consultant CKS HospitalJaipur, Rajasthan, India
- Nitin ShahMD DCHSection Head and ConsultantDepartment of PediatricsPD Hinduja HospitalMumbai, Maharashtra, India
- NP SinghMBBS MDHOD and Senior Consultant at Ayushman Hospital and Health ServicesDwarka, New Delhi, India
- P SivaramanMD(Pediatrics)Consultant PediatricianThangam HospitalErode, Tamil Nadu, India
- Pratima ShahMD DPedConsulting PediatricianAnkur Institute of Child HealthAhmedabad, Gujarat, India
- Pravin MehtaMD DCHConsulting PediatricianHindu Sabha HospitalJack N Jill Nursing HomeMumbai, Maharashtra, India
- Raju C ShahMD, DPed FIAP FECPCH(UK)Medical DirectorAnkur Institute of Child HealthAhmedabad, Gujarat, India
- Rohit AgrawalMD DCH FIAPSenior Consultant PediatricianChandra Jyoti Children Hospital and Rainbow Multispecialty Pediatric ClinicMumbai, IndiaConsultant Pediatrician:Kohinoor HospitalMumbai, Maharashtra, India
- Rupesh MasandMDSenior ProfessorDepartment of PediatricsNational Institute of Medical Science and ResearchJaipur, Rajasthan, India
- S BalasubramaniumMD DCH FIAP FRCPCHMedical Director and HeadDepartment of Pediatrics and IAP IDCPID Fellowship CoordinatorKanchi KamakotiCHILDS Trust HospitalChennai, Tamil Nadu, India
- S ShivanandaMDFormer, Director Professor and HeadDepartment of PediatricsIndira Gandhi Institute of Child HealthFormer Professor and HOD,Bangalore Medical College and Medical SuperintendentVanivilas Hospital for Women and Children, BengaluruPresently, Academic Head Department of Pediatrics Fortis HospitalBengaluru, Karnataka, India
- Sanjay MaratheMD DNBDirectorColors Intensive Care Hospital and Marathe Children HospitalNagpur, Maharashtra, India
- Sanjay SrirampurMD DCH FRCPCHHeadDepartment of PediatricsAditya Superspecialty HospitalHyderabad, Telangana, India
- Silky MittalMDEx fellowIAP Pediatric Infectious DiseasesKanchi Kamakoti Childs Trust HospitalChennai, Tamil Nadu, IndiaAssistant ProfessorSri Aurobindo Institute of Medical SciencesIndore, Madhya Pradesh, India
- Srinivas G KasiMD DCHConsultant PediatricianKasi ClinicBengaluru, Karnataka, India
- Suhas V PrabhuMD DCH MNAMSConsultant PediatricianPD Hinduja HospitalMumbai, Maharashtra, India
- Sumitha NayakMD DNB FIAP Adv Cert in Vaccinology (IVI) PGDMLS PGDGCConsultant PediatricianThe Children's ClinicBengaluru, Karnataka, India
- Tanu SinghalMD MScConsultant Pediatrics and Infectious DiseasesDepartment of PediatricsKokilaben Dhirubhai Ambani Hospital and Medical Research InstituteMumbai, Maharashtra, India
- Vijay Kumar GuduruMD (Peds) ACMEProfessor of PediatricsMGM Hospital/Kakatiya Medical CollegeWarangal, Telangana, India
- Vijay YewaleMD DCHHeadInstitute of Child HealthApollo Hospitals, Navi MumbaiDirectorDr Yewale MultispecialtyHospital for ChildrenNavi Mumbai, Maharashtra, India
I am happy to note that the Indian Academy of Pediatrics is publishing a book on common queries on immunizations encountered by healthcare professionals involved in childcare.
In India, children below five years account for 10% of the total population, a group which contributes a significant burden to the morbidity and under five mortality rate associated with infectious diseases. The Universal immunization program (UIP) of GOI has contributed significantly to the reduction of Vaccine preventable diseases (VPDs). The Intensified Mission Indradhanush launched on 25 December 2014 has further contributes to the increased coverage of the UIP vaccines. In recent years, many new vaccines have been introduced in the UIP.
Vaccinology is constantly evolving field and it is essential for healthcare professionals to remain updates. I am happy to note that this book discusses the commonly used vaccines and the basics of vaccinology. In addition, newer vaccine technologies, future vaccines and therapeutic vaccines are also discussed. Ethical issues of vaccinations and vaccine hesitancy, which have assumed significance, are also covered.
I am sure that this book will go a long way in a educating those involved in childcare, in the essentials of vaccinology and contribute to the enhancement of quality childcare in India.
Vinod K Paul
Preface
Vaccination is widely considered as one of the greatest medical achievements of the 20th century. Childhood diseases that were frequently seen less than a generation ago, are now infrequently seen, largely due to vaccines and vaccination programs. In 1979, Smallpox was declared to have been eradicated. The scourge of polio, which devastated the world, leaving many crippled, is largely controlled. In most of the developed world, the incidence of tetanus, diphtheria, Hib and pneumococcal infections have been drastically reduced. In the words of Dr Stanley Plotkin “next to clean water, no single intervention has had so profound an effect on reducing mortality from childhood diseases as has the widespread introduction of vaccines”.
It should be noted that the benefits of newer vaccines were experienced by the developed countries before it could percolate to the lesser developed countries (LDC), where the need was more acute. Till the recent past, it took at least a decade before the newer vaccines were introduced in the LDC. The advent of international health financing agencies like the GAVI and the Bill and Melinda Gates foundation, has hastened the introduction of newer vaccines in the LDC. The rotavirus vaccines and the Pneumococcal Conjugate vaccines (PCV) have been introduced in the LDC almost in parallel with their introduction in the developed countries.
In India, the Expanded Program of Immunizations (EPI) was introduced in 1978 with BCG, OPV, DPT and the whole cell Typhoid vaccines. In 1985, the Universal Immunization program was launched with BCG, OPV, DPT and measles vaccine. TAB vaccine was dropped. For almost two decades no new vaccines were introduced. This was followed by Hepatitis B vaccines, Hib as part of the pentavalent vaccine, IPV and the MR vaccines. Rotavirus vaccines and the PCVs have been introduced sub-nationally.
In the private sector, the introduction of new vaccines has been more rapid and the uptake is also rapid. To date, almost every childhood vaccine in use in the developed countries, are available in the private sector in India.
Every vaccine has its own characteristics, indications, contraindications, interactions with other vaccines, storage conditions and special use recommendations.
Moreover, knowledge about general aspects of vaccinology are also important in day-to-day practice.
Vaccine hesitancy is rearing its ugly head and needs to be tackled in a gentle but effective manner.
Textbooks of vaccines are too lengthy and unsuitable for quick references. For the practitioner, having all this information in a concise and easily readable form is a necessity.
With this objective, the Indian Academy of Pediatrics (IAP), has published this comprehensive book in a question and answer format, brief enough to be easily readable and with adequate information to answer all the questions.
Each chapter has been authored by experts in the field of vaccinology drawn from all over the country. These experts have delved into the literature about vaccines and formulated these all-inclusive chapters.
It is our fervent hope that this book satisfies the needs of postgraduate students, practitioners and everyone involved in the care of children.
Jai IAP, Jai Hind
Editorial Board
Message
Dear Fellow IAPians,
Greetings from Indian Academy of Pediatrics.
It gives me a great honor to write a message from the desk of National President of IAP. I remember discussing the possibility to come up with the first ever IAP's book on various FAQs regarding vaccines with the national convenor of ACVIP committee - Dr Srinivas G Kasi in the beginning of this year. I am very happy to know that Dr Srinivas G Kasi and his team has left no stone unturned in making this dream of mine come true.
We all have heard about the maxim - “Prevention is better than cure”. The best example of this maxim that I can think of is for vaccines and immunization. In fact, I believe that immunization is the most cost effective invention of the millennium. We know that immunization and vaccine development is a highly dynamic science. Louis Pasteur invented vaccine to prevent Smallpox and since then many more vaccines are being added every year.
Initially there were just a few vaccines. Now, there are a number of vaccines available, some are included in the UIP by the Government, while some vaccines, not included in the UIP, are strongly recommended by IAP. These differences in recommendations often lead to queries in the minds of parents and the Healthcare workers (HCWs). This book to aims to empower those HCWs, responsible for childcare, to gain the knowledge to answer all queries regarding vaccines and vaccinations.
Vaccine hesitancy is rearing it's ugly head all over the world and India is no exception. I am happy to note a full chapter, discussing this issue.
Keeping the above points in mind, the dynamic team of ACVIP led by Dr S G Kasi et al., have come up with answers to many questions in the minds of practising pediatricians and many other healthcare workers. I am certain that this ready reckoner will find its place in many of our libraries - physical as well as digital. I am certain that this ready reckoner will continue to evolve and help many of us for many generations to come. I believe that this is a must have book in every Pediatrician's clinic.
I congratulate the team of editors and contributors who have burnt the midnight oil to bring this masterpiece to our table and helping me in achieving one more milestone and dream this year. I, as a national president and the Chairman of ACVIP committee, compliment the team for the excellent work in spite of the difficult time due to Covid-19 Pandemic. Kudos and three cheers!
Bakul Jayant Parekh
President, 2020
Indian Academy of Pediatrics
Message
I am delighted to know that the IAP is coming out with a book answering the common and uncommon questions in Vaccinology, with Dr Srinivas G Kasi as the Chief Editor. I am sure that with the expertise of all the contributors, this multiauthor, multifaceted book will prove to be a treasure house of knowledge for both practicing pediatricians and postgraduate students. I wish all the success for this venture.
Piyush Gupta
President, 2021
Indian Academy of Pediatrics
Message
Dear Academician Friends,
It is quite heartening to note our Academy is launching a book on FAQs in Vaccinology. As the title implies, this is certainly a comprehensive reference source for all the vaccines which are in vogue.
Our fraternity being the stake holders of wellness of children of our country, are always passionate to provide the most optimal immunization care to our wards. Keeping updated and leaning back to the basics is mandatory to choose and deliver the vaccines and counsel the care takers appropriately.
I am sure Dr Srinivas G Kasi and Team have delivered the goods on immunization front in a consolidated FAQ pace through this book. The vaccinology experts have gone an extra mile to ensure all anticipated queries on immunization domain have been addressed in this unique scientific venture.
I wish this resourceful book on FAQs on Immunization will be a rich addition to the desktop of our fellow academicians in the pediatric segment. Alongside, I congratulate the Editorial and Central IAP Team for this novel initiative.
Remesh Kumar R
President Elect, 2022
Indian Academy of Pediatrics
Acknowledgments
The Editorial Board acknowledges the efforts of Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director–Content and Strategy), Ms Pooja Bhandari (Production Head), and Dr Rajul Jain (Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India, for their commendable efforts in ensuring the publication of this book in time, in spite of the difficulties caused by the Covid-19 pandemic, the national lockdown and suspension of all activities for a period of time.
The Editorial Board is ever thankful to Dr Bakul Jayant Parekh, President IAP 2020, for initiation of this project and his continued guidance at all times.
The Editorial Board acknowledges the support and encouragement of Dr Piyush Gupta President, IAP 2021 and Dr G V Basavaraja HSG 2020–22.
The Editorial Board acknowledges the consent of the IAP Advisory Committee on Vaccines and Immunization Practices (ACVIP), for utilizing some excerpts from the “IAP Guidebook on Immunization, 2018–19.”