New and Underutilized Vaccines

HPV Vaccine - Papilloma Prevention Power

• Types & Coverage:
  • Bivalent (Cervarix): HPV 16, 18
  • Quadrivalent (Gardasil): HPV 6, 11, 16, 18
  • Nonavalent (Gardasil-9): Adds 31, 33, 45, 52, 58
• Mechanism: Recombinant L1 protein Virus-Like Particles (VLPs).
• Primary Target (India): Girls 9-14 years.
  • Catch-up: Up to 26 years; permissive use up to 45 years.
  • Boys also benefit.
• Schedule (IAPCOI recommended):
  • 9-14 yrs: 2 doses (0, 6-12 months).
  • ≥15 yrs / Immunocompromised: 3 doses (0, 1-2, 6 months).
• Prevents: Cancers (cervical, anal, oropharyngeal etc.), genital warts (HPV 6, 11).

  ⭐ HPV types 16 & 18 are responsible for ~70% of cervical cancers.

• 📌 Mnemonic: "Guardasil guards against Papilloma."

PCV & Rotavirus - Childhood Champions

• Pneumococcal Conjugate Vaccine (PCV):
  • Protects: Invasive S. pneumoniae disease (pneumonia, meningitis, bacteremia, sinusitis, otitis media).
  • NIS Schedule: 2 primary doses (6 wks, 14 wks) + 1 booster dose (9 mths).
  • Dose: 0.5 ml, IM (anterolateral aspect of mid-thigh).
  • PCV13 (protects vs 13 serotypes) is commonly used.
• Rotavirus Vaccine (RVV):
  • Prevents: Severe dehydrating rotavirus gastroenteritis (major infant morbidity).
  • NIS Schedule: 3 oral doses at 6, 10, & 14 weeks.
  • Types (India): Rotavac (monovalent, 5 drops/dose), Rotasiil (pentavalent, 2.5 ml/dose).

  ⭐ RVV introduction has led to a substantial decline in severe diarrhea hospitalizations among young children.

  • ⚠️ Key Contraindication: Documented history of intussusception.

Typhoid & Influenza - Fever Fighters

• Typhoid Vaccines:
  • Typhoid Conjugate Vaccine (TCV):
    • Preferred; IM; single dose from 6-9 months.
    • High efficacy (>80%), long immunity.
    • Booster: Consider after 3-5 yrs in high-risk areas.
  • Vi Polysaccharide (ViPS):
    • For >2 years; IM/SC.
    • Booster every 3 years.
  • Oral Ty21a (Live):
    • For >6 years; 3-4 doses.
• Influenza Vaccine (Flu Shot/Nasal Spray):
  • Types: Inactivated (IIV - IM), Live Attenuated (LAIV - Intranasal).
  • Annual vaccination recommended; strains updated yearly.
  • Key groups: Children (6m-5y), Elderly (>65y), Pregnant women (IIV), Chronic illness, HCWs.
  • Dosing (1st time, child 6m-<9y): 2 doses, 4 wks apart. Else, 1 dose.

  ⭐ Pregnant women can receive the inactivated influenza vaccine (IIV) during any trimester.

Other Key Vaccines & Uptake - Vaccine Vanguard

• Key Underutilized Vaccines:
  • Japanese Encephalitis (JE): Live attenuated (SA 14-14-2), 2 doses (9-12m, 16-24m) in endemic districts.
  • Meningococcal (MPSV/MCV): Quadrivalent conjugate (A,C,Y,W-135) preferred; for outbreaks, Hajj pilgrims, lab staff.
  • Oral Cholera Vaccine (OCV): Killed whole-cell, 2 doses (≥2 weeks apart); outbreaks, endemic areas.

⭐ The SA 14-14-2 JE vaccine is safe and effective, manufactured by several Indian companies.

• Boosting Vaccine Uptake:

High‑Yield Points - ⚡ Biggest Takeaways

• Rotavirus vaccine (RVV): Oral, live-attenuated; 6, 10, 14 weeks for severe diarrhea prevention.
• Pneumococcal Conjugate Vaccine (PCV): Protects against S. pneumoniae; schedule 6, 14 weeks & 9 months (booster).
• Inactivated Polio Vaccine (IPV): Additional dose at 14 weeks; fIPV (intradermal) at 6 & 14 weeks.
• Measles-Rubella (MR) vaccine: Replaced measles vaccine; doses at 9-12 months & 16-24 months.
• Human Papillomavirus (HPV) vaccine: Prevents cervical cancer; recommended for girls 9-14 years (2 doses).
• Typhoid Conjugate Vaccine (TCV): Single dose from 6 months; offers longer immunity than Vi-polysaccharide vaccine.