The crucial role of conjugate vaccines in India

Being a developing country, India is still in its nascent stage when it comes to the availability of superior quality health care services particularly to the marginalized sections of the society. But over the past few years, the country has witnessed tremendous developers in the field of healthcare by augmenting its reach to the untouched parts of the country. This is clearly visible with a significant drop in the mortality rate of newborns in India. And a major credit goes to conjugate vaccines that play a crucial role in the prevention of various diseases.

For example, Streptococcus pneumoniae (pneumococcus) is a major cause of bacterial pneumonia, meningitis and sepsis in children. Otitis media, sinusitis and bronchitis are more common, but less serious manifestations of this infection. It has been estimated that in India incidence of pneumonia among under-fives is 0.37 episodes/year, leading to 43 million new cases. Of all pneumonia cases, 7-13% is severe enough to require hospitalization. Pneumonia causes an estimated 408,000 deaths among under-fives contributing to 19% of child mortality in India.

A large number of evidence shows that common risk factors leading to the development of pneumonia are malnutrition, low birth weight, non-exclusive breast feeding for first 6 months and lack of measles immunization, indoor air pollution and overcrowding. Interventions targeted on most of these risk factors to reduce pneumonia and associated mortality can be effective only in the long-term as they are intimately related to poverty and social-cultural factors.

What is a conjugate vaccine?

A conjugate vaccine is developed by covalently attaching a poor antigen to a carrier protein (preferably from the same microorganism), thereby conferring the immunological attributes of the carrier to the attached antigen.

The first glycoconjugate vaccine for use in humans, a Haemophilus influenzae type b (Hib) conjugate, was licensed in the USA in 1987 and shortly thereafter was introduced into the US infant immunization schedule. The success of the Hib conjugate vaccines in reducing the incidence of invasive Hib disease in childhood [1–3] has accelerated the development of conjugate vaccines designed to prevent infection by other encapsulated bacteria. The imperative driving the development of such vaccines has been the need to find a vaccine formulation that renders bacterial capsular polysaccharides immunogenic in those most at risk of infection.

Since its development, a conjugate vaccine in India plays a great role among children by making them immunized against various diseases. Hilleman Laboratories has kicked off a two-faced strategy to develop low-cost combination vaccine for treatment of invasive meningococcal disease. This modern method has the power to majorly reduce costs and create new IP, allowing developing country manufacturers undertake more conjugate vaccine development projects.

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