High-cost flu shot

The Government of Pakistan must include influenza vaccine in the EPI

Durr-e-Shahwar Siddiqui October 14, 2021
The writer is a Supervisor Pharmacist at a Secondary Care Hospital of Karachi, Pakistan

Flu shots may reduce the risks and severity of influenza. Healthcare professionals and high-risk individuals in Pakistan want to be inoculated by influenza vaccine annually as recommended by the WHO but the continuous drastic incline in the cost of flu shot every year creates a barrier. The Government of Pakistan must include influenza vaccine in the EPI.

Influenza commonly known as ‘flu’ affects respiratory system of all age groups and is considered a major public health issue because 5-10% adults and 20-30% children are infected by it every year globally. Annual epidemics of influenza result in about 3 to 5 million cases of serious illness and approximately 500,000 deaths. In Pakistan, this viral infection spreads in early October, peaking from December to February and tapering in March. Each year, about 20,000 children are hospitalised for flu-related complications and children from 5 to 14 years are more prone to get sick than elders in Pakistan. The WHO recommends seasonal and pandemic influenza vaccination annually to high-risk groups such as healthcare professionals, children, pregnant women, old age patients, hospitalised patients, and those who have close contact with such patients.

Despite clinical guidelines and recommendations by the WHO and SAGE (Strategic Advisory Group of Experts), coverage of immunisation by influenza vaccine in Pakistan is poor due to unawareness and high cost of influenza vaccine. Cases of flu and its related deaths have been increasing in Pakistan since 2009. Lab test for influenza is expensive and is offered by a limited number of labs in the country. The price of influenza vaccine increases every year. Influenza has no specific treatment but flu shots may reduce the risks of infection or decrease the severity of illness. Despite established evidence of the value of flu vaccine in preventing disease and saving the lives of millions of children every year, vaccine hesitancy, lack of awareness, and its affordability have become a topic of major concern in the country.

Pakistan faced severe shortage of influenza vaccine last year when people suffering from respiratory disorders or those prone to serious infections were eager to be vaccinated despite its cost of about Rs1,200. This year the cost of available influenza vaccine is Rs2,000 which is unaffordable. The respiratory problems have become worst nowadays due to the increasing pollution in the air, dust, smoke, dirt, and other associated factors. Moreover, the immune system of recovered individuals from other serious infections such as Covid-19, pneumonia, etc needs extra care and protection along with clinically recommended immunisations. Healthcare professionals and high-risk individuals are in serious need of influenza vaccination but high cost of anti-flu vaccine makes it difficult for them to get inoculated.

The current health policies of Pakistan lack synchronisation with the needs of population leading to the failure in planning and implementation of anti-influenza immunisation programme which needs serious attention of Ministry of Health. Sufficient supply of affordable and effective influenza vaccines along with the implementation of effective surveillance network of immunisation must be ensured throughout the country.

America’s Centers for Disease Control and Prevention (CDC) has been supporting the development of influenza surveillance in Pakistan through a co-operative agreement with Pakistan’s National Institute of Health (NIH) since 2004. Public awareness programmes for preventive and protective measures against influenza must be arranged. A national influenza vaccine policy must be introduced and implemented. It is a dire need of time that influenza vaccination must be included in the expanded programme on immunization (EPI) by the Government of Pakistan. Vaccination rates of influenza must be improved in Pakistan and healthcare professionals must focus on the prior immunisation of high-risk population.

Published in The Express Tribune, October 14th, 2021.

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