Ensuring that a vaccine you depend on is not a dud

Dr Giridhara Babu has done us a service pointing out that a valuable indicator which should be on vaccine packs is often not there.

Visit

Visiting private clinic for immunization?

Dr Giridhara R Babu, April 08, 2015, DHNS

http://www.deccanherald.com/content/470363/visiting-private-clinic-immunisation.html

He points out that you may be worse off if you get a vaccine shot at a private hospital. Government hospitals usually use vaccine that are guarded by a printed image named the Vaccine Vial Monitor. If the vial is not kept at specified low temperatures all the way from the factory to the place of use, the image changes its shape/color and warns you that the contents cannot be relied upon. Vaccines at private clinics do not necessarily use the VVM device.

I have myself taken expensive “flu shots” in private hospitals and I can assure you that there was no VVM on those packages. Why not? What prevents the government from banning the sale/use of vaccines not protected by VVM?

More information can be found on VVMs, including a very descriptive image, at

http://www.path.org/blog/2014/07/5-billion-strong/

Dr Babu's article goes beyond protecting vaccines through cold chains. There is another point he makes about an unethical medical practice that is unrelated to vaccines. However, that is also worth thinking about and protesting against. 

Flu shots for Indians

For five years now, my wife and I have been taking our annual flu shots regularly on the basis of a niece’s advice – she is a doctor in the US. We have been going to some big time hospital or other in Bangalore because flu shots were rarely available in other Bangalore pharmacies. We had talked to Indian doctors and found that it was not the practice in India to ask people to take annual flu shots.

In the US, the government recommends that everyone who is six months or older be given a flu shot. Visit http://www.niaid.nih.gov/topics/Flu/understandingFlu/Pages/seasonalVaccine.aspx
This site says that over the last 31 years, the number of influenza-associated-deaths in the U. S. have ranged from 3000 to 49,000 per year. 90% of these deaths have been among those above 65 years of age.

It had always puzzled us why Indian medical practice has not insisted that at least those above 65 should take a flu shot regularly.  It is well-known that immunity to flu does not last very long because the virus mutates fast and an annual immunization is necessary.

Things are changing this year. A domestic who works for us told us that some people living near her place are paying Rs 800 each to get some injection that is expected to protect them from swine flu. Should she take it? It is a difficult question to answer, not because of the money, but because whatever she gets has to be authentic. We would hate to see her being cheated by some hack giving her a vitamin injection and charging Rs 800 for it. Do government hospitals give flu shots? Are they stocked with adequate supplies? Which hospital should we contact?

A Web search took me to a website that lists hospitals authorized to treat swine flu cases: http://vaccineindia.org/index.php?option=com_content&view=article&id=395&Itemid=361

Later on in the day, we heard from a relative who was to get admitted today into a big hospital for a procedure tomorrow. However, admission this evening was impossible because of the pressure on hospital rooms from patients suspected to be suffering from swine flu. The patient has been told to fast at home and turn up tomorrow for the procedure.

Public health authorities, obviously, have a difficult task on their hands this year. The reason I write this post is, however, a concern for the long term. Unless reliable flu shots made in India become available in adequate quantity and unless Indian medical practice ensures that high-risk groups get immunization, we could have a major problem on our hands. H1N1 is not a new strain on the scene. It has been around for many years.