2. Combination vaccines (Presented by Dr. Shyama Saikia)

3. What is combination vaccine? Two or more separate immunogenes that have been physically combines in single preparation.

4. Why combination vaccines Impact on acceptability/better vaccine coverage Efficacy and safety. Cost implication. Impact on storage/cold chain /delivery infrastructure. Impact on monitoring /surveillance/record keeping.

5. IAPCOI endorses the use of combination vaccine but with the following cautionary statement. Manufacturers recommendations adhered to strictly. Mixing of vaccines in the same syringe should not be done unless specifically recommended by manufacturer. Combination vaccines should not be viewed as being more effective than vaccines given separately.

6. Combination vaccine --Advantages Children and parents a) Fewer injections. b) Fewer clinic visit. Providers a) Compliance – increased acceptance & better coverage. b) Simplified logistics – Surveillance/record keeping c) Delivery infrastructure – potential efficiency savings. Community a)Reduced disease burden – reduction in treatment cost.

7. Which combination vaccines are in use? DTPwc OPV DT MMR DTPwc + Hib DTPwc + Hepatitis B DTP + Hib + Hepatitis B Hepatitis A + Hepatitis B

8. Already developed vaccines (not available in India) DTPwc + IPV DTPwc IPV + Hib DTPa +IPV DTPa + Hib + Hepatitis B + IPV DTPa + Hib

9. Under Research a) MMR + Varicella b) DTPa + Hib+ IPV + Hepatitis A+ Hepatitis B ref.-IAP guide book on immunization.

10. THANK YOU.