Majority of Indians are unaware of adult vaccinations

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Majority of Indians are unaware of adult vaccinations

The need for vaccination does not end when one becomes an adult

New Delhi, 29 November 2017: As if the fact that the health of India’s citizens is marred by various health conditions was not enough, a recent study has indicated that about 68% of the country’s adults are unaware of adult vaccinations. While a majority of those surveyed thought that vaccinations were only for children, others felt they were healthy and did not require any vaccination. As per the IMA, the need for immunization does not end when one becomes an adult. Protection from vaccines received as a child can wear off over time, and leave a person at risk for new and different diseases.

Adult vaccines are recommended based on many factors. They can help avert and reduce the health consequences of vaccine-preventable diseases among adults. Incomplete and inadequate immunization against many communicable diseases can lead to substantial and unnecessary costs in terms of hospitalization and treatment.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Just like healthy eating, physical activity, and regular check-ups, vaccines also have a very important role in keeping a person healthy, through their adult years as well. Vaccines are one of the most convenient and safest preventive care measures available. Urban lifestyle today includes unhealthy eating, untimely sleeping patterns, erratic work hours, and frequent travels. This has reduced our immunity and made us more susceptible to any disease. We stay at a different place, work at another, and then enjoy visiting a distant location. Coming across different people from different regions, we become prone to any communicable disease. Medical science advanced and there are new, improved facilities and treatments available for many health conditions. During our childhood, there were many diseases without vaccines. Those vaccines are possible now.”

The Indian government has been taking steps towards adult immunization. In 1985, a universal immunization programme was launched across the country to combat Tuberculosis, Tetanus, Diphtheria, Pertussis, Polio, and measles.

Adding further, Dr Aggarwal, said, “All adults over 50 years need to maintain protection against conditions such as seasonal influenza (Flu); pneumococcal disease (pneumonia, sepsis, meningitis); Hepatitis B infection (for adults who have diabetes or are at risk for hepatitis B); tetanus, diphtheria and pertussis (for all adults who have not previously received this); and shingles (for adults 60 years and older).”

Following are some quick facts about adult immunization.

  • Immunization saves 3 million lives every year
  • Except drinking water, no other human undertaking can equal the impact immunization has had in reducing infectious diseases mortality — not even antibiotics
  • Immunization reduces mortality, morbidity, reduces direct and indirect medical cost
  • Flu vaccine has led to a 70% decline in hospitalizations
  • Hepatitis B vaccines have caused a drop in the incidence of liver cancer

Straight from the heart: Affordable ICU Health care

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IMA is the collective consciousness of the medical professionals practicing modern system of medicine and is represented by over 10 lakh doctors directly through its members spread over 32 State Branches and 1750 Local Branches and through FOMA Federation of Medical Associations of India . Through WMA IMA is linked to 112 International Medical Associations. The main objective of IMA is to provide affordable available accessible and accountable quality and safe health care to the public through its members in a stress free environment. The recent Fortis issue has opened a debate on finding and fighting ways to reduce the cost of intensive care. How can affordable health care be achieved IMA is fighting with government for one price one drug one company policy so that cost of 80 of medicine can be reduced. Medicines account for 80 of the total expenditure on healthcare. The government allows the same company to sell the same quality drug at three different costs. On lines of Delhi Government policy patients should be allowed to bring medicines from outside. Only NLEM National list of essential medicines drugs should be prescribed and patient must be explained if any non NLEM drug is prescribed IMA is for providing all emergent services to people which are not within the reach of state government. This can be subsidized by IMA members but should be reimbursed by state governments. Medical profession is not a business and all doctors provide reasonable subsidy to their patients. To continue this subsidy they are entitled for non commercial rates for water electric and property. IMA is for bringing preventable deaths to zero and for that IMA recommends that every preventable death should be audited to find what went wrong so that another such incident does not happen again. Cost of emergent medical care in ICU is 200 on first day of admission 100 on subsequent days and 150 in critical ill terminal patients. Most patients cannot afford terminal care in tertiary care hospitals and this care therefore should be subsidized by the government. Do not resuscitate DNR policy should be enacted by the government so that once a patient develops brain death and or is in a condition of no recovery ventilator care can be stopped. Hospitals should not charge for providing two new bed sheets after the death of a person. At admission weightage should be given to outside tests if done in last 24 hours. These tests need not be repeated. In all corporate hospitals DNB and nursing school should be compulsory so that PG DNB residents and Nursing students are available to serve in ICUs. MCI or DNB should permit one year training fellowship courses in intensive care in these hospitals to reduce the cost of staff. 80 of the cost of intensive care is on fixed cost with 50 on the staff salaries. Better standardization of care practice though protocols and care pathways. Protocolized care for sedation analgesia glycemic control ventilator management and liberation from mechanical ventilation have been shown to reduce variation and improve the outcome of critical illness. Staffing the ICU with a multidisciplinary care team under the supervision of a trained intensivist. Fewer routine care decisions are in the hands of a single individual ultimately reducing unnecessary variability. For example pharmacists and respiratory therapists can standardize length of antibiotic courses and use of low tidal volume ventilation for patients with acute lung injury The frequency of laboratory and radiological tests the use of generic versus name brand drugs and the specific indications for transfusion are all opportunities for physicians to reduce variation in the process and cost of care. Cost control is not just the task of the health policy expert or the hospital administrator it is also the task of the individual ICU clinician. Three areas for improvement. o Standing orders for laboratory studies ECGs and chest x ray films to be eliminated. o Protocols to be developed for the appropriate use of sedation analgesics and neuromuscular blocking agents. o Protocol for weaning from mechanical ventilation should be developed to allow respiratory therapists to proceed through the weaning process A significant method of controlling ICU costs is closely monitoring which patients are admitted and when they are discharged. Lab tests represent a source of cost reduction and physicians must learn to order specific tests and not simply a battery of tests which includes the actual test desired. Limits should be placed on the tests that are ordered in terms of number and frequency. High dependency units HDUs synonymous with intermediate care units intensive observation units step down units or recovery rooms post anesthesia care units PACUs can undertake many of the traditional roles of the intensive therapy unit ITU at a fraction of the cost because costs per patient day are considerably lower in the HDU PACU than in the ITU.