From the Desk of Coordinator, Bioinformatics Centre

Vaccinophilia: Boon or Bane

          Success story in the Smallpox eradication by vaccination has enthusiased the Health Administrators to look towards vaccines for disease control. For various reasons smallpox model could not be repeated in other infectious diseases. After decades of use of BCG vaccine, there are conflicting reports on its effectivity. With recent genomic comparisons, existence of different BCG Strains differing from the original BCG first used in 1921 was reported. Cholera vaccine is being used for short-term protection. The range of possible use of active immunization is rapidly expanding to include the vaccines against infectious diseases that require cellular responses to provide protection (e.g. TB, Leprosy) therapeutic vaccines for chronic infections (e.g. HIV, Hepatitis B and C) and vaccines against non-infectious conditions (e.g. Cancer). Vaccine use is being justified in terms of societal and parental “costs” (mandays lost) rather than in straightforward morbidity and mortality costs. Paediatric immunization schedule is becoming crowded. The National Immunization schedule includes BCG, DPT, Oral Polio and Measles vaccine besides DT and TT. Many more vaccines such as Typhoid, Hepatitis A, influenza viral vaccine are freely available in the country. However there is no clarity about who should exercise the option. In this confusion, the marketing strategy of drug firms is creating undue panic about certain diseases and promoting vaccine sales by giving incentives to prescribing clinicians. Thus hepatitis B is included in India’s Immunization programme. Efforts are to promote Hepatitis C and other Vaccines. Multinational drug firms are advertising number of vaccines as next best to a mother’s protection. Use of recombinant peptide vaccine without extensive evaluation and monitoring, is adding to the complexity of the problem. Relatively little is known about the immune pathogenesis of even best characterized vaccine-associated adverse events (VAAE) causing considerable concern regarding indiscriminate use of vaccines. Report from BBC News provided a timely warning that “weak vaccines strengthen disease”. In case of chronic diseases such as malaria, vaccines that are less effective have the potential to do more harm than good in creating more virulent forms of the disease. There is a feeling that not every infection need to be prevented by vaccination.
          Each living organism is endowed with survival instinct when it comes into universe. It is empowered to survive against odds and unhelpful environment. It is important not to disturb the immune balance. We have to be exposed to certain number of infections in our life time and particularly during infancy. Systemic prevention of these exposures may not benefit the individuals or the species in long  run.All this brings us to sit and objectively think about the use of the vaccine in cool mind before we are driven by market forces and made helpless.
          Leaving vaccines to commercial interests will not serve the interest of humanity. WHO study has reported how industry sponsors can influence clinical trials to produce desired results. There is an urgent need for the extensive study on the identification of vaccines which are essential for prevention or therapy, long term monitoring on effectivity, adverse vaccine reactions and quality control. Vaccine for each organism, strain and sub strain is not justified. Attempts should be made to develop a vaccine to produce broad protection against number of infective organisms.

January 1, 2024                                    Dr. B.  C.  Harinath

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