What does an Indian medical scientist think about vaccines?

There is a system for introducing vaccines into India. Many factors have to be considered.

- What is the incidence of the disease in the country. Is there some regions where it is concentrated? Does the incidence justify a vaccine?
- What is the mortality rate from the disease? Is it high enough to justify a vaccine?
- What is the safety profile of the vaccine? Has it been tested on Indian populations and found safe? What safety issues are being ignored?
- What are the alternatives to the vaccine? Can other safer public health measures control the disease better than the vaccine? 
- Is the disease easily treatable at a lesser cost? Vaccines are a costly measure as they also involve logistics and staff to administer. Is there a cost benefit in using the vaccine or by avoiding it?
- Who are the children who should receive the vaccine and who should not? What are the contraindications of the vaccine?
- Must the vaccine be given to all or can it be restricted to regions of high incidence?
- Is there a mechanism in place to monitor the above process that consists of capable members free from conflict of interest?
- Is there a system of monitoring adverse effects and addressing them in a transparent manner and which too is free from conflict of interest? 
- Is there pressure from international agencies to introduce the vaccine and influence the process?

All these are important non negotiable issues whenever a vaccine is introduced into the country. I protested the oral polio vaccine because it is a hasty decision considering that the vaccine has a history of causing paralysis. We also do not know how it will affect the gut microbes. Are the cases of encephalitis we are witnessing in regions where intensive drives are on because of the vaccine?

I am not opposed to vaccines but systems and procedures must be in place if we are to behave responsibly. Vaccines cannot be included in any schedule simply because someone somewhere is manufacturing them.

I have publicly voiced all my concerns. They have taken away my job. Tomorrow they can also stop my pension. This is not the way a profession dedicated to health must behave.

I am happy you are raising your voice. The people should know. Transparency on matters of vaccines is essential.

- Padmabhusan Dr Pushpa Mittra Bhargava. Founder Director, Center for Cellular and Molecular Biology, Hyderabad.