A review of influenza vaccines in high-risk groups across Maharashtra shows that up to 2.5 lakh of pregnant women, 49,424 people with hypertension and diabetes, and 41,512 healthcare workers were immunized in the state against three types of influenza (swine flu -H1N1, H3N2, and Influenza B) in the last five years.
In 2015, a statewide task force, the Communicable Disease Prevention and Control Technical Committee of Maharashtra, was created to address communicable diseases, with a special focus on influenza. The committee, after analyzing the mortality data from influenza, recommended that the state government begin with free and voluntary vaccination against influenza for high-risk groups of pregnant women, people with hypertension and / or diabetes, as well as workers of the health, said Dr. Pradeep Awate, a state epidemiologist. The Indian Express.
Maharashtra is the first state to begin free flu vaccination as of July 20, 2015, and a World Health Organization module on maternal flu vaccination also learned about this initiative. A recent meeting of the National Technical Advisory Group on Immunization presented a review of influenza vaccines in high-risk groups.
In the past five years, a total of 3.70 lakhs of people were immunized against influenza. During 2015-16, of the 1.01 lakh vaccinations, the majority (90,220) were pregnant women who were immunized against influenza. The remaining 7,660 were people with diabetes and hypertension, while 3,476 were healthcare workers. In 2017, a total of 42,492 people in the three high-risk groups were vaccinated, of which 38,170 were pregnant women, while in 2018 there was an additional push to vaccinate people.
A total of 1.28 lakh of people in three high-risk groups were vaccinated in 2018, of which 85,290 were pregnant women, 23,852 were people with diabetes and hypertension, and 18,884 were healthcare workers. In 2019, a total of 65,937 people were vaccinated, of which 40,326 were pregnant women. As of July this year, of the 32,739 people vaccinated against influenza, 26,692 were pregnant women, 4,221 were people with diabetes and hypertension, and 3,210 were health workers.
Dr. Awate said that one of the reasons why there has been less accepting of the vaccine is primarily the fact that influenza cases are area specific. Some years there are more cases of seasonal influenza in cities like Pune, Nagpur, and Mumbai, but not to the same extent in other cities, like Aurangabad. A greater number of vaccinations is registered when there is an increase in cases, said the epidemiologist.
Maharashtra has recorded a total of 19,809 H1N1 (swine flu) cases and a total of 2,417 deaths since 2015. Most of 8,583 cases and 902 deaths occurred in 2015, while in 2016 there was a drop, with 82 cases of pigs. flu and 26 deaths statewide. In 2017, the numbers increased to 6,144 cases and 778 deaths, while in 2018 there were 2,594 cases and 462 deaths. In 2019, Maharashtra reported 2,287 swine flu cases and 246 deaths, while as of July this year, there were 119 cases and three deaths.
The immunity imparted by this vaccine is short-lived (between 8 and 12 months) and therefore an annual vaccination is required, said Dr. Awate. Due to the frequently changing genetic makeup of the influenza virus, WHO decides twice a year which strains of the virus to include in the vaccine. This poses a major challenge for the procurement division and experts said that the efficacy of vaccines also depends on the compatibility of the vaccine virus and the circulating strain. It is a trivalent inactivated vaccine and every year minimum doses of 1.25 lakhs are purchased from pharmaceutical companies with lower rates. Last year Sanofi Pasteur supplied the doses and this year Abbot did.
Ten years ago, a similar urgency for the H1N1 virus, but there are no vaccine candidates
Pune: Ten years ago, there was a similar urgency for a vaccine against the H1N1 virus (swine flu), as cases multiplied and more deaths were recorded. The government then licensed the Serum Institute of India Ltd, Panacea Biotech Ltd, and Bharat Biotech International Ltd to create a local vaccine to combat the H1N1 influenza virus. Serum developed Nasovac, a native vaccine, but once the pandemic was removed, institute officials admitted to having discarded more than seven million doses. At the time, Pune had been the epicenter of the H1N1 virus.
Dr. Subhash Salunkhe, Chairman of the Maharashtra Communicable Disease Prevention and Control Technical Committee, told The Indian Express that during 2009-10, there was much panic when Maharashtra witnessed more than 900 deaths. Once the death rate dropped and cases declined, efforts to vaccinate the population did not get the priority they deserved from the government, Dr. Salunkhe said, adding that he feared a similar situation after Covid-19. There were 5.15 lakh of Covid-19 cases and 17,700 deaths as of Sunday in Maharashtra. “By the time a vaccine is available, deaths are likely to decrease. People only worry when there are deaths, ”said the health expert. Dr. M S Chadha, a former scientist at the National Institute of Virology, said that influenza vaccines should be administered every year. People don’t take it seriously and there is a lack of awareness even among the medical fraternity, he added. ENS
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