​Does your child really need all the prescribed vaccines?

The biggest association of paediatricians in India is heavily dependent on funding from vaccine manufacturers. The influence allegedly leading to immunisation guidelines being tweaked to include products of the funding companies. Technical committee members deciding the guidelines being on the board of vaccine manufacturers and getting paid by them. Hefty margins on vaccines being given to paediatricians administering the vaccines. These and several others skeletons came tumbling out of the cupboard of the Indian Academy of Paediatricians (IAP) when the convenor of its Advisory Committee on Vaccines and Immunization Practices (ACVIP) wrote an open letter to the association’s president.

The revelations raise the question whether all vaccines recommended by your paediatrician are actually required or are they pushed to favour vaccine companies that reward the association and its members generously? The controversy was sparked off by the IAP’s recommended Immunisation Schedule 2016 being removed from the website of its journal Indian Paediatrics after being approved by the advisory committee, the IAP office bearers, its executive board and the editorial board of the journal. It was uploaded on August 27 and removed on September 3.

Convener of ACVIP, Dr Vipin Vashishtha, wrote to IAP president Dr Anupam Sachdeva seeking an explanation and raising doubts whether it had been done at the behest of the industry.

Dr Vashishtha had written several times to ACVIP members including Dr Sachdeva on various issues including some members not submitting conflict of interest declarations before taking part in the technical committee meetings. He also questioned why a committee was not constituted to scrutinise the declarations, as was done earlier, since “there may be some attempts to suppress full information or submitting of incorrect info”.

After having received no response to his mails, Dr Vashishtha decided to go public with an open letter in which he raised questions about the working of the IAP and the way every new president relied “heavily on vaccine manufacturers for the funding of Action their so called, annual ‘Plans’ & carry out their key activities and conferences”. The letter added that vaccine companies regularly sponsor key IAP conferences, updates, refresher courses.They also sponsor lectures by opinion leaders in IAP, it pointed out while asking for details of such activities by vaccine companies in the last few years.

“Is it wrong to expose the ‘uscrupulous’ marketing practices of vaccine companies? Is it ‘unethical’ to comment on the excessive cost difference between the MRP of a product and the price at which it is offered to a doctor? Since the private sector of vaccines is poorly supervised, and there is no guideline from the government to control or regulate this sector, is it unconstitutional for IAP ACVIP to highlight these issues?” asked Dr Vashishtha.

When contacted by TOI, Dr Sachdeva said he had nothing to say on the issue as it was an internal matter of the IAP and would be taken up in its board meeting in January. Dr Ajay Gambhir, one of the ACVIP members named by Vashishtha, said the dependence on vaccine industry funding was a problem the association was working to address. “Dr Vashishtha has been a convener of the ACVIP for four to five years. He is well aware of IAP’s ties with the vaccine industry and about members being on the board of vaccine manufacturers. Why is he raising these issues now? The guidelines were taken off the website because there were problems with it and we will take it up in our meeting in January,” said Dr Gambhir.