LAHORE -  Shortage of important vaccines in the market is disturbing vaccination schedule of kids and putting next generation at risk of getting fatal diseases.

Taking benefit of huge gap between demand and supply, mafia is minting money by charging extra amount on vaccines.

Evan some vaccines that are part of immunisation schedule of Expanded Programme on Immunization (EPI) and readily available at public sector healthcare institutions and EPI centres across the province are not available in the open market.

Pentavalent vaccine, a shield against five deadly diseases, haemophilus influenza type B, whooping cough, tetanus, hepatitis B and diphtheria, administered at six weeks, 10 weeks and 14 weeks of age has gone missing, causing parents to either go to public sector immunisation centres or purchase the same from the black market.

Vaccines for hepatitis A, administered at the age of one year and two years, chicken pox at one year and typhoid given at two years and later followed by a booster dose at the age of five, are not available in the market. Vaccination against these non-communicable diseases is not part of vaccination schedule of EPI.

Pharmacists held government responsible for the prevailing situation, saying lack of regulatory mechanism is forcing companies to create artificial shortage for minting extra money.

“Companies place orders after exhausting existing stock. Manufacturers take seven to eight months to supply vaccines. Gap between demand and supply suits importers because spending on maintaining cold chain is decreased. There is no regulatory mechanism to force importers to place timely orders as per local needs. Absence of this mechanism allows distributers and retailers to create artificial shortage for minting money”, said Dr Noor Muhammad Mehar, president, Drug Lawyers Forum.

“Vaccines procured by the government for EPI are WHO-certified. As such there is no question of quality. Brands not certified by WHO are also available in the market. There is fluctuation in prices but people are unaware. Storage and transportation of sensitive items carrying shorter expiry period is an issue. Companies are careful while placing orders to check wastage of money”, he said.

“Shortage of one vaccine or the other is a routine. EPI provides shield against many lethal diseases but not against all. There are vaccines that need to be administered to save children. Parents want to vaccinate children against chickenpox, mum, rubella, typhoid and hepatitis A. We simply say to the parents that the vaccine is not available. It is up to parents to arrange vaccine”, said consultant neonatologist Dr Muhammad Naeem Sheikh.

“Companies usually do not take risk of importing vaccines in huge quantity due to lesser time of expiry. Need-based imports sometimes create shortage of one vaccine or the other,” said a consultant pediatrician at Jinnah Hospital, Dr Khurram Shahzad.

“People should take benefit from free vaccination at EPI centres. Affording people should definitely vaccinate children against other vaccine preventable diseases. Those available in the market are also of good quality. No consultant could take the risk of administering inferior quality vaccine,” he said.

“All the vaccines procured for EPI are WHO-certified. Unicef is procuring vaccines on behalf of the government, so there is no question of quality. Reason behind purchase of some vaccines from neighboring India is low price and less transportation expenses. India has drastically reduced prices of BCG, tetanus and pentavalent vaccines. Last year pentavalent vaccine was procured from South Korea. Now it has been procured from India due to the lowest bid. Not only Pakistan but also a number of countries are procuring vaccines from India,” said EPI Punjab Director Dr Munir Ahmed.

“After inclusion of rotavirus vaccine in EPI schedule, annual expenses on routine immunisation will be Rs24 billion. We provide Rs3 billion and the remaining expenses will be borne by institutions like Bill and Melinda Gates Foundation and GAVI. It is up to Unicef to procure vaccines. Contract is awarded to the lowest bidder from amongst WHO pre-qualified firms. Some vaccines are procured from India and remaining from other countries. Pneumococcal vaccine is procured from France, rotavirus from Belgium and polio from Belgium and France”, said Dr Munir.

“People should avail free vaccination at EPI Centres. All the vaccines are WHO certified. Due to support of international donor agencies and development partners, these vaccines cost less to the government. One dose of Rotavirus costs us Rs750. Price of the same vaccine in open market is more than Rs3,000. Similarly, one dose of Pneumococcal vaccine costs Rs250 as against Rs3,500 in the market. There is proper system of maintenance of cold chain from warehouse to the end users. Maintenance of cold chain in private sector can be questioned. Moreover, the common man can’t understand which vaccine is WHO-certified or not. People should trust and benefit from free vaccination”, he said, adding EPI was gradually adding more vaccines and booster doses to provide shield to the coming generation against vaccine-preventable diseases.

“There is no issue of shortage of any vaccine that is part of EPI schedule. It takes at least six months to the manufacturers to supply vaccine after placing orders. Vaccines are procured in bulk and on time to avoid shortage. This formula can be followed by a country and not private firms,” he said.