As India debates together with a typhoid conjugate vaccine in its nationwide immunization program, it’s time to ask whether or not hepatitis A, a rising explanation for acute liver failure, deserves additional precedence. A secure, efficient and long-lasting domestically produced vaccine already exists. What’s lacking is coverage choices. India’s Common Immunization Program (UIP) is without doubt one of the most profitable public well being initiatives within the growing world. We eradicated polio, curbed measles deaths and saved thousands and thousands of younger lives. However because the nation’s well being scenario modifications, vaccination priorities might want to change as nicely.
current articles hinduism He strongly advocated the introduction of typhoid conjugate vaccine (TCV) into UIP. This argument is persuasive. Regardless of India bearing half of the world’s typhoid burden and producing a number of TCVs which were prequalified by the WHO, it has not included them within the nationwide schedule. Nonetheless, when evaluating the adoption of recent vaccines, scientific proof and public well being impression should information selections. From these views, hepatitis A vaccination might deserve even increased precedence.
About hepatitis A
Hepatitis A is a quiet however rising menace. For many years, the virus contaminated most Indians in early childhood, inflicting delicate sickness and conferring lifelong immunity. With improved sanitation, that sample has modified. Fewer kids turn out to be contaminated early, leaving many adolescents and adults unprotected, and the illness turns into rather more extreme in these teams.
A number of outbreaks lately in Kerala, Maharashtra, Uttar Pradesh, and Delhi have highlighted this shift. Mass outbreaks of acute liver failure and deaths have additionally been reported at hospitals. In contrast to typhoid fever, there isn’t any particular therapy for extreme hepatitis A. Restoration typically will depend on supportive care.
Seroprevalence research have revealed that protecting antibodies are steadily declining, from greater than 90% 20 years in the past to lower than 60% in lots of city areas. Because of this, extra younger persons are weak to critical diseases. Hepatitis A is not a benign childhood an infection. It is an rising public well being concern.
vaccine
The excellent news is that hepatitis A is totally preventable. Each reside attenuated and inactivated vaccines present larger than 90-95% safety, and immunity lasts not less than 15-20 years and sometimes for all times. India has its personal indigenous success story right here. Organic E’s Biovac-A, a domestically developed reside attenuated vaccine, has been used within the non-public sector for greater than 20 years and has a superb security and efficacy report.
In contrast to typhoid vaccines, hepatitis A vaccines don’t face the issues of weakened immunity, antibiotic resistance, and provider standing. A single dose of reside vaccine gives sturdy and long-term safety. From a public well being perspective, it’s a mannequin vaccine, secure, efficient, long-lasting and already manufactured in India.
Which one deserves precedence?
Typhoid fever and hepatitis A each trigger vital illness, however the epidemiology and management prospects are very totally different. Mortality from typhoid fever has decreased with immediate antibiotic therapy and improved sanitation, however considerations about antimicrobial resistance stay. Alternatively, hepatitis A happens indiscriminately throughout socio-economic teams, with no particular therapy and rising prevalence amongst older kids and younger folks, the place the illness is extra extreme.
Judging by measurable standards resembling illness burden, vaccine efficacy, sturdiness, cost-effectiveness, and program simplicity, the stability tilts decisively in favor of hepatitis A. Hepatitis A is a low-hanging fruit of vaccine-preventable ailments, a single-dose, long-lasting, and universally out there home product.
Future course
India may begin by introducing hepatitis A vaccination in states with recurrent outbreaks or the place antibody prevalence is declining. This vaccine may be co-administered with present boosters resembling DPT and MR utilizing the identical infrastructure. Common serosurveys can observe inhabitants immunity and information growth. This phased strategy is per UIP’s confirmed mannequin of evidence-based, phased deployment.
This isn’t an argument towards typhoid vaccination. It’s a plea for rational ordering. Whereas controlling typhoid fever is vital, controlling hepatitis A is presently simpler and less expensive. The illness burden is excessive, the vaccine is homegrown, and the science is evident.
India’s immunization program has repeatedly proven foresight, from the early inclusion of hepatitis B to the introduction of rotavirus and pneumococcal vaccines. The addition of hepatitis A can be a pure subsequent step in that continuum of progress. The instruments are prepared, the proof is powerful, and the necessity is pressing. The time to behave is now.
(Dr. Vipin M. Vashhtha is a former nationwide convener of the IAP Immunization Committee. vipinipsita@gmail.com)
issued – November 14, 2025 6:00 AM IST
