E-DRUG: BMJ Open paper on Hib vaccine coverage in India
I would like to bring to your attention a paper we published in the BMJ
Open, titled: "Implications of private sector Hib vaccine coverage for the
introduction of public sector Hib-containing pentavalent vaccine in India:
evidence from retrospective time series data".
This study is the first nationwide analysis of the Haemophilus influenzae
type b (Hib) vaccine uptake in India's private sector market. We provide
baseline information about the state-by-state private sector coverage of
Hib vaccine (prior to its public sector introduction, scheduled April
This case study explains how the non-traditional vaccines behave
with respect to state-specific socioeconomic status in India when these
vaccines are available only in the private sector market through
Please find the abstract pasted below. The complete paper can be accessed
On behalf of all co-authors
Objective: *Haemophilus influenzae* type b (Hib) vaccine has been available
in India's private sector market since 1997. It was not until 14 December
2011 that the Government of India initiated the phased public sector
introduction of a Hib (and DPT, diphtheria, pertussis, tetanus)-containing
pentavalent vaccine. Our objective was to investigate the state-specific
coverage and behaviour of Hib vaccine in India when it was available only
in the private sector market but not in the public sector. This baseline
information can act as a guide to determine how much coverage the public
sector rollout of pentavalent vaccine (scheduled April 2015) will need to
bear in order to achieve complete coverage.
Setting: 16 of 29 states in India, 2009–2012.
Design: Retrospective descriptive secondary data analysis.
Data: (1) Annual sales of Hib vaccines, by volume, from private sector
hospitals and retail pharmacies collected by IMS Health and (2) national
Outcome measures: State-specific Hib vaccine coverage (%) and its
associations with state-specific socioeconomic status.
Results: The overall private sector Hib vaccine coverage among the
2009–2012 birth cohort was low (4%) and varied widely among the studied
Indian states (minimum 0.3%; maximum 4.6%). We found that private sector
Hib vaccine coverage depends on urban areas with good access to the private
sector, parent's purchasing capacity and private paediatricians'
prescribing practices. Per capita gross domestic product is a key
explanatory variable. The annual Hib vaccine uptake and the 2009–2012
coverage levels were several times higher in the capital/metropolitan
cities than the rest of the state, suggesting inequity in access to Hib
vaccine delivered by the private sector.
Conclusions: If India has to achieve high and equitable Hib vaccine
coverage levels, nationwide public sector introduction of the pentavalent
vaccine is needed. However, the role of private sector in universal Hib
vaccine coverage is undefined as yet but it should not be neglected as a
useful complement to public sector services.
Department of Global Health
Boston University School of Public Health
Boston, MA, USA
abhishek sharma <email@example.com>