Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Hepatitis A vaccination will be cost-effective in Kerala: study

Note4Students

From UPSC perspective, the following things are important :

Prelims level: About Hepatitis A, B, C ;

Mains level: Diseases and their successful case studies in Federal states;

Why in the News? 

  • Hepatitis A infection in Kerala is shifting from early childhood to adolescents and young adults due to better sanitation and hygiene practices.
    • The inclusion of hepatitis A vaccination into the mainstream immunization program for both one-year-old children and 15-year-old individuals in Kerala shows cost-effectiveness and success.

Present State in Kerala and Overall India:

  • At the Regional level (Kerala): Kerala has been experiencing regular hepatitis A outbreaks, with the 2024 outbreak being particularly severe.
    • As of May 30, over 2,400 cases and 18 deaths have been reported, mainly in districts like Kozhikode, Malappuram, Thrissur, and Ernakulam.
  • At the National Level: Severity in Different Age Groups: Almost 50% of children aged 1-5 years in India were found to be susceptible to the hepatitis A virus.
    • However, the hepatitis A vaccine is currently only available for those who can afford it, and is not part of the national immunization program.

About Hepatitis A infection:

  • The infection is usually mild or asymptomatic in children under six years but can be symptomatic and severe in older children, adolescents, and adults, occasionally leading to liver injury and fatalities.
  • India has recently launched its first indigenously developed hepatitis A vaccine, called Havisure:
    • Havisure was launched in January 2024 by Indian Immunologicals Limited (IIL), a subsidiary of the National Dairy Development Board.
    • IIL plans to manufacture up to 1 million doses of Havisure per year initially, focusing on the domestic market first.
Types of Hepatitis Cause Vaccine
Hepatitis A (HAV) Spread through ingestion of contaminated food or water. Hepatitis A vaccine (e.g., Havrix, Vaqta)
Hepatitis B (HBV) Spread through contact with infectious body fluids (blood, semen, etc.) Hepatitis B vaccine (e.g., Engerix-B, Recombivax HB)
Hepatitis C (HCV)  Spread primarily through blood-to-blood contact, often via injection drug use or unsafe medical procedures. No vaccine is available currently. Treatment focuses on antiviral medications
Hepatitis D (HDV) Requires HBV as a co-infection to cause illness. No specific vaccine for HDV. Prevention relies on hepatitis B vaccination.
Hepatitis E (HEV) Spread through ingestion of contaminated water, similar to HAV A vaccine is available in some regions (e.g., Hecolin in China), but not widely used. Prevention mainly involves improving sanitation and safe drinking water

Benefits of Hepatitis A Vaccination in Kerala:

  • Lifelong Immunity: Vaccination provides lifelong immunity against the hepatitis A virus, protecting individuals from severe infections and health complications later in life.
  • Less Out-of-Pocket Expenditure: Studies have shown that vaccinating children aged one year and adolescents aged 15 years in Kerala using either live attenuated or inactivated vaccines is cost-effective.
    • Vaccination prevents future healthcare expenditures associated with treating hepatitis A infections.
  • Increase in Household savings: Implementing vaccination for adolescents could save Kerala ₹5,872 million to ₹10,553 million over five years, depending on the type of vaccine used.
  • Equal and Universal Accessibility: Due to the inclusion in the universal immunization program, these vaccines are accessible throughout all sections of society, whether rich or poor.

Government Initiatives:

  • National Viral Hepatitis Control Program (NVHCP): The Ministry of Health and Family Welfare launched the NVHCP in July 2018 to prevent and control viral hepatitis in India.
    • The program aims to combat hepatitis and achieve country-wide elimination of hepatitis C by 2030, reduce morbidity and mortality associated with hepatitis B and C, and reduce the risk, morbidity, and mortality due to hepatitis A and E.
  • State-Level Initiatives: Some states like Punjab, Assam, Manipur, Tripura, and Haryana have started free or subsidized hepatitis C treatment programs.
    • Haryana launched its own Hepatitis Control Program in 2013 at PGIMS Rohtak, which was later expanded to all district civil hospitals in the state in 2017.

What is the Prime challenge?

  • Achieving high vaccination coverage among adolescents, who are not covered under the universal immunization program, remains a challenge. Strategies such as school-based vaccination campaigns are proposed to enhance this kind of coverage.

Conclusion:  Implement targeted vaccination campaigns in schools and communities to ensure high coverage among adolescents aged 15 years, who are not currently included in Kerala’s universal immunization program. This can be achieved through collaboration with schools, healthcare providers, and community organizations to raise awareness and facilitate easy access to vaccinations.

Mains PYQ: 

Q What is the basic principle behind vaccine development? How do vaccines work? What approaches were adopted by the Indian vaccine manufacturers to produce COVID-19 vaccines? (UPSC IAS/2022)

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