Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources
From the UPSC perspective, the following things are important:
Prelims level: MR and its vaccines
Mains level: Hurdles in immunization programme
- Delhi High Court put on hold the govt plan for a measles rubella vaccination campaign in schools across the capital, saying the decision did not have the consent of parents.
- The court’s order introduced a dimension to vaccination — the question of consent — that had not been adequately dealt with earlier.
The MR vaccine
- The latest Global Measles and Rubella Update say India had 56,399 confirmed measles cases and 1,066 confirmed rubella cases in 2018.
- Measles is a serious and highly contagious disease that can cause debilitating or fatal complications, including encephalitis, severe diarrhoea and dehydration, pneumonia, ear infections and permanent vision loss.
- The disease is preventable through two doses of vaccine.
- Congenital Rubella Syndrome, or CRS, is an important cause of severe birth defects.
- A woman infected with the rubella virus early in pregnancy has a 90% chance of passing the virus to her foetus.
- This can cause the death of the foetus, or CRS.
Matter of Dignity
- The petitioners settled principle that choice of an individual, even in cases of life-saving medical treatment, is an inextricable part of dignity which is ought to be protected.
Consent not essential
- The consent of parents is not sought during routine immunization programmes.
- Consent in routine immunization is implied because it is the parents or members of the family who bring the child to the hospital or healthcare centre.
- For such a public good and for a vaccine that is tried and tested, there is ample evidence on safety and efficacy and something which is already a part of the universal immunization programme.
- The MR vaccine was recently introduced in the universal immunization programme. It has to be administered to all children between ages 9 months and 15 years.
- It is also needed to vaccinate those who did not get it earlier, and before they reach the reproductive age group.
- For vaccinations and such public health programmes govt. have never taken consent.
Why in schools
- Schools, rather than health centres or hospitals, were consciously chosen because nowhere else can such large numbers of children in the relevant age group be targeted.
Global best practice
- Parental consent should be obtained prior to vaccination.
- This is the standard practice around the world.
- The WHO recognizes oral, written, and implied consent for vaccination.
- Countries are encouraged to adopt procedures that ensure that parents have been informed and agreed to the vaccination.
- In several US states, it is compulsory to provide vaccination records before seeking admission into school, so that the child is not a danger to others.
- MR vaccine is safe and effective, in use for over 40 years across 150 countries.
- The vaccine being given in the MR campaign is produced in India and is WHO prequalified.
- The same vaccine is being given in the routine immunization programme of India and in neighbouring countries.
- Vaccination is always a voluntary process, and there should not involve compulsion.
- Vaccines should be administered after people are sensitized about the disease and vaccine.