Boost the boosters : India

Author(s) Rajesh Gupta,
Affiliation(s) 1Department of Pediatrics, Ruxmaniben Deepchand Gardi medical college, Ujjain, India.
Country - ies of focus India
Relevant to the conference tracks Governance and Policies
Summary This study was undertaken to assess status of Tetanus vaccination in school going children. A survey of the booster vaccination of 1000 children age of 5 to 18 years was done at Pediatric out patient department (OPD) for their routine immunization with DPT booster at age of 5 years and Tetanus Toxoid (TT) at 10 and 16 years of age as per the National Immunization schedule. 69% children were vaccinated for DPT booster at 5 years of age. Only 32% children were immunized with TT at age 10 and 15% at age of 16 years. Integration of Education department with the health system is needed to improve coverage of Tetanus immunization is in the community.
Background Tetanus is an acute, spastic paralytic illness historically called lockjaw that is caused by the neurotoxin produced by Clostridium tetani. Tetanus occurs worldwide and is endemic in approximately 90 developing countries. Tetanus is an entirely preventable disease. A serum antibody titer of ≥0.01 U/mL is considered protective. The active immunization with tetanus toxoid has an estimated failure rate of less than 4 per 100 million immunocompetent persons.
Objectives To assess status of Tetanus vaccination in school going children and to make awareness about booster vaccinations in community as well as health professionals.
Methodology A survey of the booster vaccination of the children age of 5 to 18 years was done at Pediatric out patient department (OPD) of R.D.Gardi medical college, Ujjain, M.P., India. Total of 1000 children were screened during the period of June – September 2013 for their routine immunization with DPT booster at age of 5 years and Tetanus Toxoid (TT) at 10 and 16 years of age as per the National Immunization schedule (NIS). Informed verbal consent from the subjects / attendants was taken to be included for the study. The study has been approved by institutional Ethics committee.
Results 69% children were vaccinated for DPT booster at 5 years of age. Only 32% children were immunized with TT at age 10 and 15% at age of 16 years.
Limitations – Survey was based on asking the children or their attendants to recall by their immunization status. No document viz. immunization card was available to confirm. Subject number may not suffice statistical parameters.
Conclusion In spite of simple preventive measures available, tetanus remains a major cause of child mortality in the developing countries. Mortality has been reported to vary from 10% to 39.3% in various series depending on the age group, grade of tetanus, availability of intensive care, complications, etc. Data released by state Government of Madhya Pradesh, India indicates only 67.57% and 67.77% of children were immunized for TT booster at 10 years and 16 years consecutively.
Conclusion – In a developing country like India, infectious diseases are still major causes of child mortality. In spite of available preventive measures, coverage of Tetanus immunization is less in the community. Tetanus immunization can be improved by making policy to integrate education departments with health systems so that school going children may get this vaccine at their schools and at the right age.

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