Monday, February 10, 2014

India Vaccine News - Painless DPT running short in India - all brands not available!

After the recent controversy regarding the effectiveness of painless DPT vaccines in India, now there is a shortage of almost all brands of Painless (acellular DtaP) vaccines.
Pentaxim, Tripacel (manufacturer Sanofi Aventis) & Infanrix (manufacturer GSK) are all not available at the present point of time, and this shortage is likely to persist at least till the end of February, 2014. 
If there is no availability private practising pediatricians in India will have to switch to the normal DTwP which is likely to lead to increased fever, pain swelling and crying episodes in children.
One option I can recommend at present is to switch to Boostrix/ Adacel at 5 years age (Tdap), so that we can preserve a few doses of DTaP that can be used for other younger children.


Sanja said...

Dear Doctor... I went fo the third dose of Pentaxim for my 14 week old baby and they gave him the normal citing unavailability of the the painless vaccine. He got fever and crying..I have given him crocin but to no avail. Why did this vaccine suddenly dissapear??

Dr. Gaurav Gupta M.D. said...

The cause of shortage can only be explained by the company making these vaccines, but it is now a fact of life that most new vaccines become short (even in the USA), once in a while.
I am sure that the fever / irritability will settle down in the next 1-2 days, and while this is distressing, it would not likely lead to any long term problems in your baby. Hopefully by the time next dose is due for DtaP at 1.5 years, this vaccine (or similar) would be available.

Rads said...

Hi Dr.

Given the ban on Pentaxim, what is the suggestion for children who have already been administered the same both for initial and booster doses. My son is 4 and I am wondering if this means he is not protected long term or do I need to do something else about it.

Dr. Gaurav Gupta M.D. said...

There is NO BAN on Pentaxim. IAP - the official body of the Pediatricians in India, in a controversial move, has recommended that Pentaxim may not be used till further research is done, especially in the Indian context.
However, the vaccine remains approved by the Indian government & is likely to become available again soon.
Your concern regarding your son's protection is quite understandable, and my daughter who is 4 year old is also in the same boat - vaccinated with Pentaxim :)
However, the scientific evidence does NOT suggest that at present anything else needs to be done, and the child is likely to remain protected. I would still be using an acellular vaccine Dtap for my daughter at 5 years age, since I am reluctant to expose her to significant local reactions like pain, swelling & fever, which is significant in 5 year old kids.
I await more scientific evidence to change my prescribing pattern regarding using acellular DPT vaccines.
The only thing I have changed is that I am more open to using the regular DTwP in the younger kids in the primary series - 1.5 months to 4.5 months.

nicky said...

Hello doctor
my baby is 3 months old. I have given him the first dose of pentaxim, n my pead has made me aware that once I start with pentaxim, it has to be continued to the next session as well. As pentaxim is out of stock, plz suggest me a solution. His nxt vaccination date was on 25th of march. It got delayed because of the shortage. Waiting 4 ur response...

Dr. Gaurav Gupta M.D. said...

Here is what I am doing,
For children completing the primary series (less than 6 months old), I am recommending using whatever vaccine is available - the DTwP brands like Pentavac, easyfive, qquinvaxem etc. to continue the vaccination, rather than wait and delay these vaccinations against serious illnesses.
For children coming at 1.5 years for booster doses, waiting for a few weeks is not that critical, PLUS the chances of local side-effects are also more. Hence I am giving the option to parents to decide if they want to wait, or take the DTwP combinations as mentioned above.
Dr Gaurav Gupta