Classification of VaccinesThe IAPCOI has categorized vaccines into four categories. 1. Vaccines covered under Expanded Program on Immunization (EPI). 2. Vaccines not covered under EPI but recommended by IAP. 3. Vaccines which are to be given after one-to-one discussion with the parents. 4. Vaccines to be given in special circumstances. Category 2 vaccines are those that are unequivocally recommended by the IAP-COI for an individual child if parents can afford the vaccine. Category 3 vaccines are those where the benefits versus cost are not overwhelming as of currently available data and hence are to be administered after one-to-one discussion with parents. When any new vaccine is introduced in the market (and is not part of EPI), IAPCOI has to take decision about categorization of the vaccine in category 2 or 3. This decision is based on the likely disease burden (morbidity and mortality) in the individual child, vaccine efficacy, and cost-benefit ratio for the individual child; all in the Indian context. Unfortunately, for most new vaccines, reliable data specific to India is not available. Hence, this categorization is largely based on expert opinion (Level III). Also it is dynamic and as new information becomes available, transition between categories may occur. |
This process involves an exhaustive review of published literature including standard text books, vaccine trials, recommendations of various countries, World Health Organization (WHO) position papers, literature from the vaccine industry, post-marketing surveillance reports, cost-effective analysis, epidemiology of disease in India and if available Indian studies on vaccine efficacy, immunogenicity and safety.
If knowledge gaps are present then expert opinion is sought to fill the gaps. The existing national immunization schedule and government policies are also considered. The recommendations of IAPCOI are primarily for pediatricians in office practice. In addition, IAPCOI also submits its position on incorporation of various new vaccines in the national immunization schedule.
The IAPCOI meets in person to discuss these matters. At this meeting, the members of the Committee and some invited experts discuss the issues related to vaccines in exhaustive detail. Decisions are taken about all the matters and recorded.
Following the meeting, the recommendaitons are circulated among the members, and any inaccuracies are removed at this stage. The recommendations are then sent to the Executive Committee of the IAP for approval, following which they are published.
The IAP COI publishes a Guidebook for Immunisation from time to time. Interim recommendations, changes in earlier published recommendations, and related matters are published in our official journal, Indian Pediatrics.