Enhancing Immunisation Coverage in India: A Strategy to Combat Antibiotic Misuse and Antimicrobial Resistance

Sub : Sci

Sec : Health

Why in News

The focus on immunisation and its indirect benefits, especially during the post-pandemic period, has gained attention due to its role in reducing the misuse of antibiotics and combating the growing issue of antimicrobial resistance (AMR). Recent studies indicate that insufficient vaccination coverage not only exposes children to preventable diseases but also contributes to unnecessary antibiotic use, escalating the AMR crisis.

Immunisation Data Gaps:

Despite the progress in recovering childhood vaccination rates, India lacks comprehensive data on the disease burden for vaccines like the Pneumococcal Conjugate Vaccine (PCV) and the Haemophilus Influenzae Vaccine (Hib).
These vaccines, crucial for preventing serious respiratory and brain infections, were added to the government’s immunisation program amid the COVID-19 crisis. However, precise data on their effectiveness is unavailable.
Vaccination programs have eradicated diseases like polio in India. The COVID-19 pandemic also underscored the importance of vaccines for all age groups, highlighting the need for public awareness.
The pandemic-induced lockdowns disrupted routine childhood vaccination worldwide. According to 2023 UNICEF data, 73 countries experienced over a 5% decline in childhood vaccination rates. India, however, showed a notable recovery, achieving success in delivering the third dose of the DPT (Diphtheria, Pertussis, Tetanus) vaccine.

About Haemophilus Influenzae Vaccine (Hib):

The Hib vaccine prevents infections caused by Haemophilus influenzae type b bacteria.
Hib bacteria can cause pneumonia, meningitis (brain infection), septicemia (bloodstream infection), and epiglottitis (swelling in the throat).
Children under 5 years of age are most at risk for Hib infections, particularly those under 2 years.
Typically administered in multiple doses starting from 6 weeks of age, often combined with other vaccines like DPT (Diphtheria, Pertussis, Tetanus).
The Hib vaccine has been highly effective in reducing cases of Hib meningitis, one of the leading causes of bacterial meningitis in young children.
The Hib vaccine was introduced in India’s national immunization program to reduce child mortality and combat the spread of respiratory infections.

About Pneumococcal Conjugate Vaccine (PCV):

PCV is designed to prevent infections caused by Streptococcus pneumoniae, which includes diseases like pneumonia, meningitis, and sepsis.
The vaccine is conjugate, meaning it combines several different strains of pneumococcal bacteria to provide broad immunity.
Children under 5, adults over 65, individuals with chronic illnesses, and smokers are most susceptible to pneumococcal infections.
Typically involves a series of doses starting from infancy, with additional doses recommended for older adults and at-risk populations.
PCV has been effective in preventing pneumococcal diseases, reducing hospitalizations, and decreasing the spread of antibiotic-resistant strains.
Major burden states include Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, and Jharkhand.

Threat of Inadequate Immunisation:

Children who are not fully vaccinated face a higher risk of contracting preventable diseases. This often leads to increased medical visits and the overuse of antibiotics, which fuels antimicrobial resistance.
Vulnerable groups, particularly the economically disadvantaged, are most affected, leading to higher healthcare costs and a disproportionate impact on poorer communities.

Impact of Antimicrobial Resistance (AMR):

South and Southeast Asia, including India, account for 6.5% of global antibiotic consumption. The region also uses 54.9% of WHO’s “Watch” classified antibiotics, indicating a preference for high-risk antibiotics.
If AMR is not controlled, it could cause an annual loss of 5-7% of India’s GDP by 2050. Addressing AMR is critical to maintaining economic stability.

About Anti-microbial resistance:

Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death.
As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.
Antimicrobials – including antibiotics, antivirals, antifungals and antiparasitic – are medicines used to prevent and treat infections in humans, animals and plants. Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.