nclusion of Pune–based Serum Institute of India's five–in–one pentavalent vaccine in the Union government's national immunisation programme will brace up the needy children against hemophilus influenzae type b (Hib) infections − a leading cause of childhood bacterial meningitis, pneumonia, and other serious infections in India.

While the government's free immunisation programme has been for long giving DPT (diphtheria, pertussis, tetanus) and hepatitis B vaccines, there has been no provision for Hib infections which are almost entirely preventable with vaccine.

The Hib organism is estimated to kill more than 3,70,000 children worldwide each year. Nearly 20% of these deaths may occur in India, say experts. The SII's pentavalent vaccine provides protection against diphtheria, pertussis, tetanus, hepatitis B and Hib infections in a single shot.

When contacted, Suresh Jadhav, executive director of SII, said: "The government included our vaccine in the immunisation programme on December 14. First it was given to children in Kerala. Now, it is going to be given to children in Tamil Nadu and will be extended to six other states. Inclusion of pentavalent vaccine will definitely benefit children to get protection against Hib."

T U Sukumaran, president of the Indian Academy of Paediatrics (IAP), the national body of paeditricians, said: "The IAP has been pursuing inclusion of Hib vaccine in the national immunisation programme with the government. Inclusion of pentavalent vaccine that lends protection against Hib among others will considerably bring down the morbidity and mortality related to Hib organism, especially among the needy children."

Paediatrician Sharad Agarkhedkar, former president of the Indian Medical Association (IMA), said: "The Hib vaccine has been available in the private sector for many years and paediatricians have been prescribing it to those who afford to buy it. However, many underprivileged children have been deprived of the benefits of the vaccine. With the inclusion of the pentavalent vaccine in the national immunisation programme, infants from the poor strata of society can receive the protection for free. Hib infections can affect children as early as three months of age. Giving the vaccine at 6, 10 and 14 weeks of life will protect them against the potentially serious infections." Asked whether the children administered pentavalent

vaccine would have to go for a booster dose again at one–and–a–half years of life, Prasad Kulkarni, senior director of SII, said: "The pentavalent vaccine doses will be administered to the infants at 6, 10 and 14 weeks of age. After that, children will need a booster dose of DPT and Hib at 15 to 18 months of age."

The pentavalent vaccine will replace the current hepatitis B and DPT vaccinations. Parents would welcome the introduction of pentavalent vaccine for the primary reason that it would bring down the number of pricks the child gets during vaccination. Hib is a leading cause of childhood bacterial meningitis, pneumonia, and other serious infections. Hib diseases can be almost completely eliminated through routine vaccination. Global burden of Hib disease is substantial.

"The US government introduced Hib vaccine as part of routine immunisation programme in 1990 and within the span of four to five years, they eradicated Hib–related infections to the tune of 95 per cent," said Sanjay Lalwani, medical director and head of the paediatrics department at a city hospital.

Clinical trials of the pentavalent vaccine were conducted at Bharati Vidyapeeth medical college in 2007–08 Lalwani was the principal investigator. "Hib infections are common in children below the age of two years and this organism causes major life threatening infections like meningitis, pneumonia and acute laryngotracheobronchitis," Lalwani said. The current coverage of Hib vaccine through private clinics is less than 4%. The Global Alliance for Vaccines and Immunisation (GAVI) funded for inclusion of the Hib vaccine in the form of pentavalent vaccine in 10 states of the country, Lalwani said.