2.5 lakh pregnant women in Maharashtra immunised against three types of influenza in last 5 years

Maharashtra is the first state to have started free-of-cost influenza vaccination from July 20, 2015, and a World Health Organisation module on Maternal Influenza Vaccination too cognisance of this initiative. A review of the influenza vaccinations in the high-risk groups was presented at a recent meeting of the National Technical Advisory Group on Immunisation.

In the last five years, a total of 3.70 lakh persons were immunised against influenza. During 2015-16, of the 1.01 lakh vaccinations, a majority (90,220) were pregnant women who were immunised against influenza. The remaining 7,660 were persons with diabetes and hypertension, while 3,476 were healthcare workers. In 2017, a total of 42,492 persons in all three high-risk groups were immunised, of which 38,170 were pregnant women, while in 2018, an additional push was made to vaccinate the persons.

A total of 1.28 lakh persons in three high-risk groups were vaccinated in 2018, of which 85,290 were pregnant women, 23,852 were persons with diabetes and hypertension, and 18,884 were healthcare workers. In 2019, a total of 65,937 persons were immunised, of which 40,326 were pregnant women. Till July this year, out of 32,739 persons immunised against influenza, 26,692 were pregnant women, 4,221 were persons with diabetes and hypertenstion, and 3,210 were healthcare workers.

Dr Awate said that among the reasons why there has been less uptake of the vaccine, is mainly the fact that influenza cases are area-specific. Some years there are more cases of seasonal influenza in cities like Pune, Nagpur and Mumbai, but not to the same extent in other cities, like Aurangabad. Higher number of vaccinations are registered when there is an increase in cases, the epidemiologist said.

Maharashtra has seen a total of 19,809 cases of H1N1 virus (swine flu) and a total of 2,417 deaths since 2015. The majority of 8,583 cases and 902 deaths were in 2015, while in 2016, there was a dip, with 82 cases of swine flu and 26 deaths across the state. In 2017, the numbers increased to 6,144 cases and 778 deaths, while 2018 saw 2,594 cases and 462 deaths. In 2019, Maharashtra reported 2,287 cases of swine flu and 246 deaths, while till July this year, there were 119 cases and three deaths.

The immunity imparted by this vaccine is short lived – between 8 to 12 months – and hence, annual vaccination is required, Dr Awate said. Due to the frequently changing genetic makeup of influenza virus, virus strains to be included in the vaccine are decided by WHO twice a year. This poses a major challenge for the procurement division and experts said the efficacy of vaccines is also dependent upon matching of the vaccine virus and the circulating strain. This is a trivalent inactivated vaccine and a minimum of 1.25 lakh doses are procured every year from pharmaceutical firms quoting lower rates. Last year, Sanofi Pasteur supplied the doses, and this year, it was done by Abbot.

Ten years ago, similar urgency for H1N1 virus, but no takers for vaccine

Pune: Ten years ago, there was a similar urgency for a vaccine against the H1N1 virus (swine flu), as cases multiplied and more deaths were recorded. Then, Serum Institute of India Ltd, Panacea Biotech Ltd and Bharat Biotech International Ltd had been granted licenses by the government to create a home grown vaccine to battle the H1N1 influenza virus. Serum developed Nasovac – an indigenous vaccine, but once the pandemic retreated, the institute officials had admitted to discarding more than seven million doses. Pune had then been the epicentre of the H1N1 virus.

Dr Subhash Salunkhe, Chairman of Maharashtra Communicable Diseases Prevention and Control Technical Committee told The Indian Express that during 2009-10, there was a great deal of panic as Maharashtra witnessed over 900 deaths. Once the mortality rate fell and cases came down, efforts to vaccinate the population did not get the priority they deserved from the government, Dr Salunkhe said, adding that he feared a similar situation post Covid-19. There were 5.15 lakh Covid-19 cases and 17,700 deaths till Sunday in Maharashtra. “By the time a vaccine is available, it is likely that deaths will come down. People only get worried when there are deaths,” the healthcare expert said. Dr M S Chadha, former scientist with National Institute of Virology, said influenza vaccines need to be taken every year. People do not take it seriously and there is lack of awareness even among the medical fraternity, he added. ENS