“Ignoring widespread concern over the safety, efficacy and cost of pentavalent vaccines” — which provide protection against diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenza type b (Hib) — “India’s central health ministry has, this month, approved inclusion of the prophylactic cocktail in the universal immunization program in seven of its provinces,” Inter Press Service reports. Pentavalent vaccines have “had a history of causing adverse reactions and deaths in India’s neighboring countries like Bhutan, Sri Lanka, and Pakistan,” the news service writes, noting that India’s National Technical Advisory Group on Immunisation (NTAGI) in 2010 “recommended limited introduction of pentavalents in southern Kerala and Tamil Nadu and evaluation of results over a year before extension to other states.” Despite this recommendation and outstanding public interest litigation, the government on April 16 announced the vaccines would be introduced in five additional states, IPS reports.

Earlier this month, the All-India Drug Action Network, an umbrella of public health activist groups, sent a letter to WHO Director-General Margaret Chan “asking the health body to ‘re-evaluate’ its recommendation of pentavalent vaccines on the grounds of safety” and “suggested that the cause of the vaccination-related deaths was likely to be ‘hypersensitivity reaction as described in the post mortem report on one of the children (who died) in Kerala,'” according to IPS. Some public health advocates have raised concerns over the cost of the combined immunizations and the Hib portion of the vaccine, saying it might not be necessary in India, the news service notes (Devraj, 4/27).