OUTLOOK Expose: WHO Pnemonia Vaccine Scam.

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Magazine| Sep 08, 2008

 

EXCLUSIVE controversy: pneumonia vaccine

 

Immunity To Reason

 

India plans to adopt a pneumonia vaccine that doesn't work and has ill

side-effects

 

DEBARSHI DASGUPTA

http://www.outlookindia.com/full.asp?fodname=20080908 & fname=Vaccine+%28F%29 & sid=\

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No Immunity

 

A pneumonia vaccine the government wants to introduce into the immunisation

programme is suspect:

 

The vaccine, Prevenar, is not effective against the most common form of

pneumonia

It just prevents 3.6 instances of radiological pneumonia, a rarer form of

pneumonia, in every 1,000 children vaccinated

It causes severe respiratory disease in every 1.3 cases per 1,000 vaccinated

The vaccine, costing Rs 12,000 for three required doses, is supported by foreign

donor agencies and the WHO

***

How would you react if you were told that your child had contracted a lifelong

ailment because of the side-effects of a vaccine that is part of the

government's immunisation programme? And what if it's discovered that the

vaccine didn't even offer protection in the first place against the disease it

was meant to provide immunity from? It all sounds incredible, but may well be

true if foreign donor agencies and pharmaceutical firms have their way with the

government.

 

It has been revealed that the pneumococcal conjugate vaccine (PCV), a vaccine

against pneumonia that the Union ministry of health and family welfare

reportedly plans to include in a year's time in its universal immunisation

programme, causes severe respiratory disorder in every one child among a

thousand vaccinated. For India, that could potentially mean several thousands of

victims of asthma and respiratory diseases.

 

 

Not only that, the vaccine, which covers seven strains of the pneumococcus

bacteria, has been found to be ineffective against the most common form of

pneumonia—clinical pneumonia. PCV7, as the vaccine is commonly referred to,

also happens to be very expensive. Launched in the Indian market in 2006 under

the brand Prevenar, it is available at a cost of about Rs 12,000 for the three

required doses. On the other hand, the standard treatment of pneumonia using

Septran, as recommended by the WHO, costs only Rs 10.

 

Highlighting these facts, Jacob Puliyel and Sona Chowdhary, both paediatricians

at New Delhi's St Stephen's Hospital, have written to the WHO, questioning

claims of the vaccine's efficacy. Their letter has just been published in the

WHO bulletin. The two culled the facts from studies analysed by the Cochrane

Collaboration, a voluntary global network that reviews healthcare interventions.

" We found this vaccine does not reduce incidence of clinical pneumonia. It just

prevents 3.6 cases of radiological pneumonia per thousand children vaccinated

and that too if they are under the age of two, after which the vaccination is

ineffective, " says Puliyel. Even this marginal benefit comes at a high price,

leave aside the additional cost of treating 1..3 cases of asthma per thousand

caused by the vaccine.

 

In response, the WHO bulletin has also published a reply from a panel of three

experts who admit the vaccine does not reduce instances of clinical pneumonia,

but, paradoxically, cite the 155.8 million worldwide cases of clinical pneumonia

as good reason to introduce the PCV. They, however, argue that the vaccine is

effective in preventing radiological pneumonia and that the respiratory

side-effect should be weighed against this benefit. Clinical pneumonia is the

kind that can be diagnosed with the help of symptoms such as breathlessness and

cough. Radiological pneumonia, on the other hand, can only be detected through

an x-ray that shows the infected patch in the lungs. The former form of the

disease is far more common than the latter.

 

Prevenar, manufactured by US-based Wyeth, has been propped up internationally by

GAVI Alliance, a group that funds immunisation initiatives.It has been supported

by the WHO. The two have been urging developing countries to adopt and integrate

the PCV7 into their immunisation programmes. India seems to be getting there.

Health secretary Naresh Dayal, in an interview to The Times of India in April

this year, had declared the vaccine would be introduced in the immunisation

programme in a year's time. Dayal did not reply to the questions Outlook sent

him by fax. GAVI, on the other hand, in an e-mailed reply, confirmed the

government's intent to introduce the pneumococcal vaccine. " Earlier this year,

the Indian National Technical Advisory Group for Immunisation subcommittee

recommended introduction of pneumococcal vaccine beginning in one state in 2010

and reaching universal coverage by 2015, " wrote Ranjana Kumar, who's on GAVI's

country support team.

 

M.K. Bhan, secretary, department of biotechnology and head of the immunisation

subcommittee, says he is surprised: " I don't know where GAVI got that

information from. We recommended the use of a vaccine against pneumonia whenever

an affordable, locally manufactured, safe and efficacious vaccine is available.

It should also cover at least 70 per cent of the strains in India.. "

 

This brings up a prickly and emotive issue in India's public health discourse,

where many feel that vaccines are thrust upon countries by donor agencies and

pharmaceutical firms with no concern for the local disease burden and other

factors such as varying natural immunity. The extensive immunisation programme,

they feel, is under constant pressure as it assures a captive market. " Local

factors are important for a vaccine's introduction, " says Y. Madhavi, a vaccine

policy analyst at Delhi-based National Institute of Science, Technology and

Development Studies. " There is growing evidence that a vaccine that is suitable

elsewhere may not be effective here. For instance, children with poor immunity

may fail to react positively to a vaccine, " she adds.

 

WHO estimates that each year pneumonia kills about 4,08,000 children under the

age of five in India but authentic data from local population-based studies is

missing. " In the absence of any such data, a vaccine's introduction is

questionable, " says C.M. Gulhati, editor of Monthly Index of Medical

Specialties. " And in any case, this vaccine doesn't merit consideration because

it doesn't cure all kinds of pneumonia and its benefits (3.6/1000) are marginal

compared to the severe side-effects it has (1.3/1000). "

 

The campaign by GAVI and WHO to introduce the PCV7 in India's immunisation

programme has been going on for a while. In 2007, writing in the journal Indian

Pediatrics, Thomas Cherian of the WHO's department of immunisation and Orine S.

Levine of GAVI's PneumoADIP wrote that the Indian government, if it chooses,

could obtain the vaccine with financial aid from GAVI till 2015.. The latter

also wrote to the government in April 2007 asking for " non-binding expressions

of interest " in introducing pneumococcal vaccines. To which, Puliyel responds

sarcastically, " Is this an introductory offer for a product that they want to

sell? " GAVI's Kumar confirmed that the Indian government has to specify while

applying for support on how it plans to secure funds for sustaining the vaccine

costs beyond the period of GAVI's funding.

 

Observers hope that a debate on the issue brings about a more stringent and

reliable mechanism of deciding on vaccines being introduced in the country..

While it's imperative that children need to be protected against pneumonia, the

choice of the vaccine is critical. If it does not even provide immunity, then

why should public money be wasted on it?

 

" It is now 30 years since I have been confining myself to the treatment

ofchronic diseases. During those 30 years I have run against so many histories

of littlechildren who had never seen a sick day until they were vaccinated and

who, in the severalyears that have followed, have never seen a well day since. I

couldn't put my finger onthe disease they have. They just weren't strong. Their

resistance was gone. They wereperfectly well before they were vaccinated. They

have never been well since. " ---Dr. William Howard Hay

 

 

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