A Shift in Immunity Strategy
India's immunization landscape has seen a pivotal change with the replacement of the Tetanus Toxoid (TT) vaccine by the indigenously developed Tetanus and adult
Diphtheria (Td) vaccine. This strategic move applies to all age demographics, signifying a proactive approach to tackling preventable diseases. The Td vaccine is particularly crucial for expectant mothers, ensuring protection against maternal and neonatal tetanus and diphtheria, thereby bolstering prenatal care. The recent formal launch of this domestically produced vaccine, spearheaded by Union Health Minister JP Nadda, is anticipated by health experts to significantly fortify immunity and reduce the incidence of both tetanus and diphtheria across the population. This transition is timely, especially considering the recent rise in diphtheria cases among older individuals, which can lead to severe health complications, including hospitalization and even fatalities. By introducing the Td vaccine, India aims to substantially decrease the likelihood of diphtheria outbreaks and safeguard its citizens.
Understanding the Td Vaccine
The Td vaccine, a product of indigenous manufacturing at the Central Research Institute (CRI) in Kasauli, Himachal Pradesh, is a potent combination designed to combat both tetanus and diphtheria. It features a reduced concentration of the diphtheria antigen compared to older formulations, making it specifically suitable for older children and adults. Its recommendation during pregnancy is a key aspect, offering robust protection against maternal and neonatal tetanus and diphtheria during the prenatal period. Furthermore, administering the Td vaccine during pregnancy serves to enhance the mother's immunity and extend the duration of protection, especially for those who may not have completed their recommended booster doses. Health authorities affirm that the Td vaccine is safe, a testament to its widespread adoption in 133 countries globally. The Health Ministry has outlined plans to supply 55 lakh doses to the Universal Immunization Program by April 2026, with a commitment to progressively scale up production to further fortify national immunization efforts.
Boosting Self-Reliance and Access
The introduction of India's homegrown Td vaccine represents a landmark achievement in fortifying the nation's immunization framework, emphasizing self-sufficiency, affordability, and consistent supply. Dr. Neha Rastogi, a Senior Consultant in Infectious Diseases, highlights that locally manufactured vaccines reduce reliance on international sources, thereby guaranteeing uninterrupted defense against tetanus and diphtheria for adolescents and adults. This initiative is designed to facilitate broader vaccine coverage, expedite distribution to even the most remote areas, and enhance overall public health preparedness. By controlling the production process domestically, India can ensure a stable and accessible supply chain, crucial for maintaining high vaccination rates and responding effectively to public health challenges. This move not only strengthens national health security but also makes crucial vaccinations more accessible and affordable for a larger segment of the population.
The Burden of Disease
Recent data underscores the persistent threat of diphtheria in India. According to the National Health Profile 2022, the country recorded 1,586 cases and 22 fatalities due to diphtheria in 2020, followed by 3,677 cases and 47 deaths in 2021. A significant portion, approximately 84 percent, of these cases are concentrated in about ten Indian states. As of June 21, 2024, Odisha reported six deaths and 21 suspected diphtheria cases. Despite over 90 percent coverage of diphtheria vaccination in birth cohorts since 2014, there remain widespread gaps in booster dose administration. Addressing these gaps in routine immunization and ensuring the inclusion of booster dose data are critical public health priorities. Diphtheria, a highly contagious respiratory disease, can be deadly due to its toxin's effect on the heart. While preventable by vaccination, immunity wanes over time, necessitating timely booster shots at ages 10 and 16 for sustained protection. Pregnant women also require two doses to shield both themselves and their newborns. The recent resurgence of diphtheria cases nationally and globally elevates the importance of this vaccine transition as a public health imperative.
