Friday, May 26, 2017

Why it may be a good thing that the Dengue vaccine is NOT available in India right now?

I am a Pediatrician, and a large percentage of my work involves preventive pediatrics and counseling. I am also a big fan of vaccines, so why am I saying that NOT having Dengue vaccines in India is a good thing? Read on….
I understand that Dengue is a very serious problem, and as a pediatrician I have personally diagnosed and treated many kids with Dengue in Chandigarh and surrounding areas.
The problem, in my opinion, is the way new vaccines are generally launched in India. Previously the drug controlling authority (DCGI) used to ask for small trials on 150 to 200 people and we used to test if the vaccine was leading to good antibody response after 3 months in these people. Once this was confirmed, the vaccine was allowed to be used without any further research in our kids.
On the other hand, most developed countries would ask any vaccine company to do large studies in their own country/ continent before allowing use of a newer vaccine.
For the first time, it appears that the Govt of India is asking the Vaccine Company (Sanofi Pasetur) to do large scale trials in our country for the Dengue vaccine before launching it. The scientific data thus generated will help us to recommend the vaccine far more effectively.
However, if the permission is given by the GOI to launch the vaccine with small amount of data (as before), then we will end up with limited data. This means we will have to rely on studies from foreign countries to decide how effective this vaccine will be in our situation. For a new vaccine like Dengue, I believe this is NOT the right way to go.
Sure, large studies will take at least 2-3 years, but the results will help us get a better idea on how and when to use the vaccine for kids & adults in the future. This is why I am recommending waiting and watching and getting high quality data from India for the Dengue vaccine, before launching it.
What do you feel as a parent or a doctor?