From the Desk of Coordinator, Bioinformatics CentreVaccinophilia: Boon or Bane |
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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.
January 1, 2024
Dr. B. C. Harinath
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