Adolescent Immunization schedule: Is there a need to re-look? by Dr Vipin M. Vashishtha

Adolescent immunization (AI) is one of the important yet the most neglected field in India. There is no adolescent-specific schedule in the government's UIP. There is a lack of systematic epidemiological data defining the exact burden of various diseases in the adolescent period.

Immunization of adolescents is vital. The Indian Academy of Pediatrics (IAP) is having a separate adolescent immunization schedule for the private sector, but it was not revised in recent past. With the changing epidemiology of certain vaccine-preventable diseases, rapid development in the field of vaccinology, and the advent of some new, more refined vaccines, there is a need to revisit the existing adolescent schedule.

There should be only two categories of AI, namely, "Vaccines for all adolescents" and "Vaccines to be given under special circumstances" should be formed.

Human Papillomavirus (HPV) vaccine is truly an adolescent-specific vaccine and should remain at the top on the priority list considering the significant burden of cervical cancer in India.

Dengue, the fastest spreading viral infection in the world, is also the number one concern for India. Dengue is primarily a disease of adolescents and adults. At least three Indian companies are involved in developing new dengue vaccine. With the availability of more 'refined' vaccines, its integration in the list of essential adolescent vaccines would make sense.

Tdap along with HPV vaccine is so far considered as a 'mandatory' adolescent vaccine. The experts are now opening to adopt an alternate strategy to use Tdap in anticipation of a local pertussis outbreak rather than on a routine basis in adolescents since it provides only a short- term protection against pertussis.

Mumps is yet another vaccine that needs to be pushed up in the schedule. At least, a single- dose of mumps/MMR is a must for every adolescent irrespective of their past vaccination status. Hepatitis-A, typhoid, varicella, and Hepatitis-B are other diseases against which vaccination should be given a high priority for catch-up immunization of adolescents.

Hence, it is crucial to have a serious relook on the need and utility of the immunization schedule for adolescents. The GoI should also chalk out a separate Adolescent specific immunization schedule, and the IAP should also relook and revise its existing schedule.

To know about the article please click on the link

https://www.indianpediatrics.net/feb2019/feb-101-104.htm

Dr Vipin M. Vashishtha, MD, FIAP, is a pediatrician and Director & Consultant Pediatrician of Mangla Hospital & Research Center. He's been extensively involved in research and has published over 170 articles in national and international indexed journals, edited & published 14 books on VPDs & vaccines.