Adolescent immunisation in India: need of the hour- PART 3- Future Challenges

Adolescent immunisation in India: need of the hour

Ananya Ray Laskar, Anita S Acharya Department of Community Medicine, Lady Hardinge Medical College, New Delhi. India Corresponding Author: Ananya Ray Laskar A-601, Abhyant Apartments, Vasundhra Enclave, Delhi-110096. India. Email: ananya.ray.laskar@gmail.com  Future Challenges: Barriers to adolescent vaccination may be of three types- Beneficiary or family-related, provider related or system-related. i) Beneficiary related barriers: Changing behaviour among adolescents and their parents or guardians will require education and outreach. While younger children have little or no control over health care decisions, adolescents often play a key role in decision making. Therefore, it is vital that adolescents, as well as their parents, are educated about the need for vaccinating the adolescents and the seriousness of vaccine-preventable diseases. Once empowered, they may generate discussion with their health care providers about vaccines and other preventive health measures. ii) Provider related barriers: Vaccine delivery strategies may be school-based programmes, pulsed delivery through child health days, vaccination days, periodic campaigns, routine provision through health facilities, or combination of strategies can be adopted. Further seroepidemiological studies are needed to be carried out to know the epidemiological patterns and burden of vaccine preventable diseases among adolescents in India. The already existing mechanism for routine immunisation can be utilised optimally by appropriate training and sensitisation. iii) System related barriers: The choice of which vaccine to give, target population among the adolescent age group and mode of administration are important policy decisions that must be guided by a strong scientific rationale, with rigorous inputs from multicentric field epidemiology, irrespective of policies in western countries. Cost-benefit as well as risk-benefit assessment of vaccinating adolescents should be carried out in India, taking into account local serotypes and variations in indigenous host - pathogen - environment interactions. The public sector undertakings manufacturing indigenous vaccines should berevived and upgraded [20]. Conclusion Effective planning of immunisation services for the adolescent will require careful weighing of theadvantages and disadvantages of each individual vaccine by the policy makers. Currently, only a fewvaccines fulfill the criteria for widespread use in adolescents. In the future, we might even have a vaccine against HIV/AIDS to be used in adolescents and many more. So the need of the hour is health promotional messages for the adolescents and their families to convince them that the recommended vaccines are safe and effective and relevant for themselves. Key Points Guidelines for the adolescent vaccination should be incorporated in the National Immunisation Schedule and widely disseminated. A modification such as replacement of TT vaccine with Td (adult type) is recommended for 10 and 16 years. Hepatitis-B vaccine and MR vaccine may be given as catch-up vaccines. In addition, JE vaccine should be included for all adolescents in endemic states in view of the age shift in the incidence. SOURCE- http://www.ijms.in/articles/3/1/adolescent-immunisation-in-india.html