title: High cost is the primary barrier reported by physicians who prescribe vaccines not included in India's Universal Immunization Program.
abstract: Haemophilus influenzae type B (Hib) vaccine, pneumococcal conjugate vaccine (PCV) and rotavirus (RV) vaccine are available in the private market in India, but, except for Hib in eight states, are not included in India's Universal Immunization Program (UIP). Pediatricians were surveyed about administering non-UIP vaccines. Most give these vaccines to some of their patients (73-83%, depending on vaccine), but few give them to all patients (7-18%). High cost was the most frequently cited barrier (93-96%). Only 10-12% of respondents had concerns about the efficacy of PCV or RV vaccine, and concerns about Hib vaccine efficacy or any vaccine safety issues were rare (1-3%). Practice varied by type of healthcare facility, with pediatricians at government hospitals least likely to administer non-UIP vaccines. Support for the inclusion of all three in the UIP was high (83-95%). Including Hib vaccine, PCV and RV vaccine in India's UIP would be supported by pediatricians and help eliminate the current barrier of high cost of these immunizations.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA gkahn@jhsph.edu.
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Kahn
authors.affiliation: Department of Pediatrics, Child Health Foundation, Kutch, Gujarat 388345, India.
authors.forename: Deep
authors.initials: D
authors.lastname: Thacker
authors.affiliation: Pramukhswami Medical College, Karamsad, Gujarat 370201, India.
authors.forename: Somashekhar
authors.initials: S
authors.lastname: Nimbalkar
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D006192:Haemophilus Infections / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000008:administration & dosage* / Q000191:economics*; D019538:Health Care Surveys; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007194:India; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000191:economics; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data
chemical_list: D018073:Haemophilus Vaccines; D022242:Pneumococcal Vaccines; D022243:Rotavirus Vaccines
keywords: Haemophilus vaccines; India; pneumococcal vaccines; rotavirus vaccines