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Vaccine options in India
Dr. M. Vijayalakshmi, M.D (Peds), M.D (USA), F.A.A.P
Disclaimer: By no means do we (AllForKids) claim that this is a comprehensive list of all vaccines
available in India. We do not through this article endorse or recommend any particular product over other
products. It is for the parents and their pediatrician to decide on the most appropriate vaccine to suit the
specific need and situation of their child.

Vaccination Schedule – recommended vaccination schedule as per IAP and AAP guidlines
Age Vaccinations
At Birth BCG,Polio,Hepatitis-B
6 weeks DTaP, Hepatitis-B, HiB, Polio, Pneumococcal
10 weeks DTaP, HiB, Polio, Pneumococcal
14 weeks DTaP, HiB, Polio, Pneumococcal
6 Months Influenza Vaccine, Hepatitis-B
7 Months Influenza Vaccine
9 Months Measles Vaccine
12 Months Chicken Pox
15 months MMR ,Pneumococcal booster
18 months DTaP, Polio,HiB, Hepatitis-A
2 years Typhoid, Hepatitis-A
3 years Annual Pulse Polio, Catch-up vaccines if any
4 years Annual Pulse Polio, Catch-up vaccines if any
5 years DTaP, Polio, MMR Booster
10 years Tdap booster
16 Years Tdap booster

Recommended vaccines for Adults:

1. Chickenpox Vaccine – 2 doses, if not vaccinated previously and not infected previously
2. Hepatitis-A –2 doses, if not vaccinated previously
3. Hepatitis-B – 3 doses, if not vaccinated previously

Advantages of newer generation vaccines

DTaP Vs. DTP

Tdap/DTaP vaccines which are now available in India is a newer version of DTP vaccine. Tdap/DTaP vaccine which
contains acellular pertusis vaccine is safer as it causes lesser adverse reactions than the older DTP vaccine. This
means lesser pain at injection site and lesser incidents of fever after vaccination. The vaccine is supplied in India by
two major vaccine manufactures: as Infanrix/Boostrix by GSK and as Tripacel by Sanofi Pasteur. The U.S.'s Advisory
 Committee on Immunization Practices (ACIP) recommends that children receive DTaP instead of DTP and
adolescents receive Tdap vaccine instead of TT Booster at age 10 and 16 years.

Oral Polio Vaccine Vs. Injectable Polio Vaccine

Oral Polio Vaccine is a live-attenuated vaccine given as drops to children. This is the most common mode of polio
vaccine in India. However , most developed countries have long back switched to Injectable Polio Vaccine (IPV).
Injectable Polio Vaccine or Inactivated Polio Vaccine contains killed virus and thus eliminates the chances of any
occurrence of vaccine associated paralytic poliomyelitis and any vaccine induced wild polio outbreaks.

Recently Government of India decided to start introducing Injectable Polio Vaccine from 2009 starting with 9 districts
of Uttar Pradesh and gradually expand it nationwide.

Injectable Polio Vaccine has now been available in India for some time. These are available as single dose Imovax
and few other brands or in combination with DTaP and HiB as Pentaxim

Combination Vaccines
The advantages of combination vaccines are:

1. Less number of injections for the child and

2. Generally the cost will be less compared to taking the vaccines separately.

Efficacy of some combination vaccines available in India have not been proven by sufficient studies and as such we
do not regularly recommend many of the combinations available in the market.

These are some of the combinations we recommend:

1. Tritanrix HB+Hiberix
2. Infanrix +Hiberix
3. TetraActHIB
4. Tripacel + ActHiB
5. Pentaxim

Optional Vaccines *
*We believe that Optional Vaccines is a myth. Any vaccine if it has been proven safe and effective should be given
children if it is affordable. Also in most of the Europe the US these vaccines are part of the National Immunization
Schedule

1. Prevenar (Pneumococcal)
2. Chicken Pox Vaccine
3. Hepatitis A
4. Rotavirus Vaccine- Oral

Multi-dose Vs. Single Dose(mono dose)

Single dose vaccines may cost slightly higher because of packing and other expenses involved but they are
recommended for the following reasons:
• Less chance of contamination and associated risks
• Less chances of quantity errors by administering nurse or doctor
• Better chance of maintaining efficacy
So wherever possible parents should insist on single dose vaccines for your child.

List of Vaccines
This is not a comprehensive list but a list of vaccines that we have used at AllForKids and found to be safe:

1. BCG Vaccine
2. DTaP- Infanrix/Tripacel
3. HiB – Hiberix/Act HiB
4. Tritanrix HB – DPT + Hepatitis B
5. TetraActHiB –DPT + HiB
6. Pentaxim- IPV + DTaP +HiB
7. Injectable(Inatctivated) Polio Vaccine - Imovax
8. Oral Polio Vaccine - OPV
9. Hepatitis B- Engerix B
10. Pneumococcal vaccine- Prevenar
11. Measles Vaccine
12. MMR- Priorix/Tresivac
13. Rubella Vaccine- R-Vac
14. Typhoid Vaccine- Typherix
15. Hepatitis A- HavPur, Avaxim, Haverix
16. Influenza Vaccine- Vaxigrip
17. Chicken pox- Okavax/Varilrix
18. Tdap booster- Boostrix

Vaccine Safety
Vaccines are actually very safe, despite implications to the contrary in many anti-vaccine publications Most vaccine
adverse events are minor and temporary, such as a sore arm or mild fever. These can often be controlled by taking
Paracetamol before or after vaccination. More serious adverse events occur rarely (on the order of one per
thousands to one per millions of doses), and some are so rare that risk cannot be accurately assessed. As for
vaccines causing death, again so few deaths can plausibly be attributed to vaccines that it is hard to assess the risk
statistically. Of all deaths reported to VAERS (Vaccine Adverse Event Reporting System in the USA) between 1990
and 1992, only one is believed to be even possibly associated with a vaccine. Each death reported to VAERS is
thoroughly examined to ensure that it is not related to a new vaccine-related problem, but little or no evidence
suggests that vaccines have contributed to any of the reported deaths or serious side effects. The Institute of
Medicine in its report states that the risk of death from vaccines is "extraordinarily low." Any such extremely low risks
from vaccines pale in comparison to the chances of complications of many serious diseases they protect against.

Vaccine Safety in Indian Context

USA has a very extensive VAERS (Vaccine Adverse Event Reporting System) and reporting any actual or suspected
adverse events are mandatory for all healthcare providers by law. Also the FDA and other federal agencies keep a
close tab on vaccine safety. Unfortunately in India such systems are practically non-existent or poorly managed.
Hence the best possible course of action is to stick to the recommendations from the US as far as vaccine safety is
concerned.
What parents can do?
Do not compromise on quality for the sake of the savings of a few rupees, the well being of your children is much
more important:

1. Vaccines should be administered only by a Pediatrician or at least a nurse with

adequate pediatric training and experience.
2. Insist on mono- dose vaccines when available
3. Check to make sure that the expiry and other information on the vaccine bottle/packet is
correct
4. Make sure that the facility has an effective cold-chain to keep the vaccines safe
5. Ask for a vaccine handout which provides details about the vaccine and any potential
side effects
6. Make sure that the vaccination card is updated by the doctor with the date of
vaccination and other information
7. It is better if the provider is keeping an electronic medical record system to keep track
of the vaccinations provided to your child with its batch number.
8. Know what the usual side effects from vaccine administration are including any pain
and fever and take medicines to reduce the impact when needed

Reading this article does not establish a patient-provider relationship between you and AllForKids for any of its
doctors. You use any of the information provided in this document at your own risk.

Question (Posted on : 20 Jan 2010 )

sir, are there any side effects of pentaxim vaccine and prevnar vaccine. which are the best
companies for these vaccines.
Doctor's Response (Posted on : 22 Jan 2010 )

Pentaxim comprises Tetanus vaccine, Diphtheria vaccine, Hib (haemophilus influenzae type b)
vaccine, Inactivated Polio Vaccineand Acellular pertussis. Local reactions at the injection site
such as pain, erythema (redness) and induration may occur within 48 hours following
administration. Systemic reactions: fever, sometimes greater than 40deg;C, irritability,
drowsiness, sleeping and feeding disturbances, diarrhoea, prolonged inconsolable crying. More
rarely urticaria, skin eruptions, convulsions with or without fever have been observed within 48
hours following administration. Hypotonic or hypotonic - hyporesponsive episodes have been
reported. Oedematous reactions (swelling) of the lower limbs have been reported following the
administration of vaccines containing the Haemophilus influenzae type b valence. These
reactions are sometimes accompanied by fever, pain and crying.
PENTAXIM® [syringe]
Aventis Pasteur

CIMS Class : Vaccines, Antisera & Immunologicals

See related info on PENTAXIM PF-syringe

Contents diphtheria toxoid 30 iu, Haemophilus influenzae 10 mcg, pertussis toxoid

25 mcg, poliomyelitis virus , tetanus toxoid 40 iu

CIMS Class Vaccines, Antisera & Immunologicals

Packing/Presentation

Form Packing (Max Retail Price) Photo

PENTAXIM PF- syringe 0.5ml (2066 INR)