Hexavalent vaccine could improve efficiency of India's immunisation programme: Study
Introducing the hexavalent (six-in-one) vaccine into India's Universal Immunisation Programme (UIP) could improve the efficiency of the country's childhood immunisation drive, according to a new study conducted by the Union Health Ministry in collaboration with the George Institute for Global Health India, the Gates Foundation, Gavi, the Vaccine Alliance, and John Snow India Private Limited.
The hexavalent vaccine is a combination vaccine that protects infants against six diseases—diphtheria, tetanus, pertussis (whooping cough), Hepatitis B, Haemophilus influenzae type b (Hib), and polio—in a single injection. Researchers note that this approach reduces the number of injections children receive, eases the workload of frontline health workers, lowers cold-chain requirements, and saves time for caregivers.
According to a release from the research group, nearly 26 million Indian infants are vaccinated annually under the national immunisation programme. Currently, children receive multiple vaccines during immunisation visits, which increases the number of injections, places additional demands on caregivers' time, and adds to the workload of healthcare providers.
The study, published in the peer-reviewed journal Human Vaccines & Immunotherapeutics, found that the price of the hexavalent vaccine remains the single largest determinant of overall programme costs. Based on trends in vaccine procurement in India, the researchers estimate that a 50% reduction in the vaccine price would enable operational and system-level savings to outweigh the additional vaccine acquisition costs under the primary immunisation schedule.
The research assessed two implementation scenarios: replacing the current pentavalent and fractional inactivated polio vaccine (IPV) doses with the hexavalent vaccine during the primary immunisation schedule, and replacing both the primary schedule and the diphtheria-tetanus-pertussis (DTP) booster dose with the hexavalent booster. Costs were evaluated from both government and household perspectives, including vaccine procurement, syringes, cold-chain logistics, healthcare worker time, and caregiver time.
Previous stakeholder research cited by the authors found that caregivers generally preferred fewer injectable vaccines during each visit. The new findings suggest that introducing the hexavalent vaccine could deliver several benefits, including fewer injections for infants, making vaccination more convenient for children and families.
Susmita Chatterjee, Program Head for Health Economics at the George Institute for Global Health India, said: "Combination vaccines have long been recognised for simplifying immunisation programmes while improving convenience for families and health systems. Our study demonstrates that although the hexavalent vaccine carries a higher upfront procurement cost, it also generates important efficiencies by reducing injections, easing pressure on frontline health workers, lowering cold-chain requirements and saving caregivers' time. These findings provide important economic evidence that can inform future policy discussions on strengthening India's immunisation programme."
