Jayakrishnan T
Associate Professor, Department of Community Medicine, Government Medical College, Calicut, Kerala, 673 008 INDIA e-mail:
Indian J Med Ethics. 2013 Jul-Sep;10(3):183-90. doi: 10.20529/IJME.2013.054.
The ministry of health and family welfare published the national vaccination policy in April 2011. The policy document drew severe criticism from several public health experts. A review of the print and web-based literature on the national vaccine policy was done and the issues of ethics and equity involved in introducing new vaccines under the Universal Immunisation Programme (UIP) were studied. The average coverage of the UIP vaccines at the national level is below 50%. Despite this, the policy document did not state any concrete strategy for increasing the coverage. The main stumbling block for evidence-based vaccine policy in India is the lack of reliable epidemiological data, which makes it difficult for the National Technical Advisory Group on Immunisation to offer sound technical advice to the government. No attempts have been made to prioritise diseases or the selection of vaccines. The policy suggests the introduction of the following vaccines in the UIP: Haemophilus influenzae type b, pneumococcal vaccine, rotavirus vaccines and human papillomavirus (HPV). This selection is on the grounds of the vaccines' availability, not on the basis of epidemiological evidence or proven cost-effectiveness. This is a critical review of the current vaccination policy and the move to include the rotavirus and HPV vaccines in the UIP.
卫生与家庭福利部于2011年4月发布了国家疫苗接种政策。该政策文件遭到了多位公共卫生专家的严厉批评。对有关国家疫苗政策的纸质及网络文献进行了综述，并研究了在扩大免疫规划（UIP）下引入新疫苗所涉及的伦理和公平问题。国家层面UIP疫苗的平均接种率低于50%。尽管如此，政策文件并未阐明提高接种率的任何具体策略。印度基于证据的疫苗政策的主要绊脚石是缺乏可靠的流行病学数据，这使得国家免疫技术咨询小组难以向政府提供合理的技术建议。未尝试对疾病或疫苗选择进行优先排序。该政策建议在UIP中引入以下疫苗：b型流感嗜血杆菌疫苗、肺炎球菌疫苗、轮状病毒疫苗和人乳头瘤病毒（HPV）疫苗。这一选择是基于疫苗的可获得性，而非基于流行病学证据或已证实的成本效益。这是对当前疫苗接种政策以及将轮状病毒和HPV疫苗纳入UIP举措的批判性综述。
