VACCINES FOR SELECTIVE USE

These vaccines are not recommended for routine immunization of Indian children, but only in high-risk children. While discussed in detail in relevant chapters on infections, some important selective-use vaccines include:

• Anti-rabies vaccine (ARV) for post-exposure pro­phylaxis after dog-bite or pre-exposure prophylaxis to occupational animal handlers (Ch 10.27).

• Meningococcal vaccines for: (a) international travellers, e.g. students going abroad for studies or (b) high-risk children with complement deficiency, anatomical or functional asplenia, splenectomy or sickle cell disease, (c) health care workers likely to be exposed to infection and for post-exposure prophylaxis in some cases (Ch 10.10).

• Cholera vaccine for residents and travellers of highly endemic regions and high-risk circumstances for the outbreaks, e.g. Kumbh mela. (Ch 10.11).

• Yellow fever vaccine for travellers to some African/ South American countries. It is a live attenuated vaccine, given as single dose 0.5 ml SC, which fulfills the travel requirements (International certificate of vaccination and prophylaxis) valid for life. Efficacy is ~100% for at least 10 years. While generally safe, yellow fever vaccine carries a rare risk of Yellow fever vaccine associated neurological disease (YELAND) or viscerotropic disease (YELAVD).

9.2.4