Health Ministry Eyes Production of Pentavalent Vaccine

Pentavalent vaccine which protects against five major infections including diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Haemophilus influenzae type b (Hib), was added to the National Immunization Program in November 2014.

Earlier, DPT (diphtheria, pertussis and tetanus) and hepatitis B vaccines were administered separately and Iranian babies were not vaccinated against Hib, which was the leading cause of bacterial meningitis among children under five years in Iran.

Meningitis is an infection of the lining of the brain and spinal cord. It can lead to brain damage and deafness.

A recent study by Tehran University of Medical Sciences (TUMS) showed that the annual incidence rate of the disease was 43 per 100,000 children under five, which is expected to decrease to 6.7 per 100,000 after pentavalent vaccine was added to the national program.

In addition to providing protection against an additional disease, the combination vaccine has some other advantages including: reduced cost of stocking and administering separate vaccines; fewer healthcare visits; improving timeliness of vaccination (some parents and healthcare providers object to administering more than two or three injectable vaccines during a single visit because of a child’s fear of needles and pain) and facilitating the addition of new vaccines into immunization programs.

  Technology Transfer

Currently, pentavalent vaccine is imported from India.

However, the Health Ministry is planning to acquire the technology for domestic production of the vaccine which will not only save foreign exchange but also reduce the price of the vaccine.

With this in mind, a memorandum of understanding was signed in February with Cuba’s Health Ministry, by which the latter is committed to transfer the technology, and Iran would supply the vaccines for sale in Cuba.

“At present we are working on the modalities of the project infrastructure for producing the vaccine in the country. This phase is scheduled to be completed by the end of the current fiscal year in March 2018,” said Mostafa Qanei, head of the Pasteur Institute last week, Young Journalist Club (YJC) reported.

“The vaccine is expected to be produced for the local market within the next 3-4 years, and in the first phase of production, Iran’s Pasteur Institute will produce five to six million doses which can completely meet domestic need.”

It is very important, however, that combination vaccines are carefully tested before introduction. With all combinations, manufacturers must therefore evaluate the effectiveness of the vaccine components when combined to induce immunity, risk of possible reversion to toxicity, and reaction with other vaccine components, he added.

  Lack of New Vaccines

Immunization is considered to be one of the greatest health interventions to prevent infectious diseases. According to World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) estimates, global immunization coverage of children is at least 80% for the six Expanded Programs on Immunization (EPI) vaccines, against diphtheria, pertussis, tetanus, polio, measles and tuberculosis.

However, there are huge inequalities in access to newer vaccines, such as Hib, rotavirus, pneumonia and human papilloma virus (HPV), between developed and developing countries.

In Iran, the current immunization provides lifesaving protection against several diseases such as diphtheria, pertussis, tetanus, polio, measles, rubella, mumps, tuberculosis, hepatitis B, and Haemophilus influenza- introduced in the national program in 2014.

But the program needs to be beefed up for vaccination against several potentially harmful diseases like chickenpox, and HPV which causes cervical cancers.

While the HPV vaccine is available in Iran (it costs $200 to receive all three doses), and is recommended between ages 9 and 13, it has not been placed in the national immunization program. Many Iranians are not still aware of the availability of the vaccine at domestic drugstores.

Annually, around 1,000 Iranian women are diagnosed with cervical cancer. Nearly all cases of cervical cancer are caused by HPV. At present, cervical cancer is the fifth leading cause of death among Iranian women and the second leading cause of cancer morbidity after breast cancer.