The Hindu Delhi Page 4
Dr Maturam Santosham from Johns Hopkins School of Public Health USA, and co-chairman of the ROTA Council has written in The Hindu on the need to turn the corner on child health (31/7/14). However his prescription appears seriously flawed. He writes impassionedly in favor of introducing the Rotavirus vaccine saying that the average cost of hospitalization for each episode of rotavirus diarrhea is Rs 3000.
However the paper published in the Lancet states that the vaccine that has now been licensed in India has so little efficacy that 55 babies will have to be given the vaccine (costing about Rs 180/child) to prevent diarrhea in 1 child. The cost of vaccine to vaccinate 55 children (to prevent 1 case of diarrhea) will be Rs 9900. It is obvious that it is cheaper for the Government of India to pay the full cost of all children admitted with rotavirus diarrhea (Rs 3000/case of diarrhea) than it is to try and control diarrhea with this poor efficacy vaccine (Rs 9900 per case of diarrhea avoided).
According to the Lancet paper there is a risk that one child in every 2000 babies vaccinated will develop intussusceptions which is a condition where the intestine telescopes into itself and leads to intestinal obstruction and bleeding from the gut. In rural India where there are no pediatric surgeons or radiologist to diagnose the problem or treat it, it has a mortality of up to 40%. The chance of developing intussusceptions with this new vaccine is actually 5 times greater than the Rotashield rotavirus vaccine that was withdrawn from the international market because of this risk.
The anxiety of public health experts in the country cannot be brushed aside without better evidence about the safety of the vaccine.