[SANJAY_DEL]

Questions have very often been raised by members regarding the availability and cost of different vaccines in India. Some doubts have been expressed regarding the need for some immunization procedures.
This thread aims to gather all vaccine related information in one place for easy reference by all. I'll answer all the individual queries posted on this thread.
I'll try to post authenticated information; my being an MD certainly helps towards achieving that goal. Its my modest effort of helping out fellow IMikers.

So here goes:

First, the names of vaccines manufactured in India, and indicative prices.
Prices differ from one company to another, unlike in the West.
Prices are only indicative, and subject to variation.

BCG Vaccine : Rs 90 to Rs 275 for a 10 dose vial.
Oral Polio Vaccine: Rs 72 for 10 doses/ Rs 78 per 2 ml.

DPT (Triple Antigen) Rs 3 / 0.5 ml.
Diptheria antitoxin Rs 86 per vial.
Measles vaccine Rs 33 per dose.
Meningitis A and C Rs 250 for a 10 dose vial.

Hemophilus B Rs 400 for 0.5 ml.
Hemophilus + DPT Rs Rs 500 per 0.5 ml

Diptheria + Tetanus Dual Antigen Rs 7.81 per amp

MMR Rs 69 per 0.5 ml
Influenza vaccine Rs 660 per 0.5 ml

Chicken pox vaccine Rs 1345 PER 0.5 ml

Hepatitis B Rs 181 per 0.5 ml

Hepatitis A Rs 712 360 U
Rs 906 720 U
Typhoid Vaccine Capsular polysaccharide Rs 290 per 0.5 ml
Oral typhoid vaccine Rs 275/ 3 capsules.

Tetanus toxoid Rs 5.40 per 0.5 ml
Pneumococcal vaccine Rs 891 per 0.5 ml

Rabies vaccine Rs 293
Rubella vaccine Rs 36 per 0.5 ml

Yellow fever vaccine Rs 1475 per 0.5 ml

Questions welcome!

[marmaduke]

Hi Sanjay

Thankyou for the great information. Im coming to India in Februay and am debating whether or not to get the Rabies vaccination. Ive had all the other vaccinations but Rabies costs £120 here for the full course of vaccination injections, thats alot of money out of my budget! What would your advice be?

marms

[SANJAY_DEL]

You'll need three shots of the vaccine. (Five would be ideal).
Once you land in India, go for the first dose on the very next day.
That's day zero.
Second dose on day 3,
and third dose on day 7.
Two additional doses on day 14 and day 28.
(By then you'll know how much you've been exposing yourself to dogs and monkeys while traveling in India).
The human diploid cell culture vaccine costs just Rs 293 per dose in India. So 300 X 3 roughly Rs 1000 for the full course.

[marmaduke]

Thanks!

Where do i go to get the shots? I'll be in different places all together on day 3,7,14 and 28. Starting in delhi, then rajasthan for 21 days then down to mumbai. I'll probably be in goa for day 28.

marms

[tacita]

this thread is troubling...

this is a useful resource for limited purposes of cost and availability, etc., and it's generous of sanjay to offer it, but it's important to bear in mind that individual patients and needs can differ significantly.

i, for one, would be hesitant to accept medical advice other than from MDs who know my personal medical and vaccine history. were i a doctor, would be equally hesitant to dispense it, any more than, as a lawyer, i would offer legal advice in the same context. in medicine, of course, the potential ramifications are obviously far more serious, potentially even life threatening.

my doctor advised against rabies. another doctor, for another patient, might advise otherwise. please, travelers, talk to your own doctors! if you choose to get the vaccines in india and your MD ok's that, great, but please also consider the serious implications of being advised here on IM what to get and when.

[SANJAY_DEL]

Originally Posted by janice

this thread is troubling...

this is a useful resource for limited purposes of cost and availability, etc., and it's generous of sanjay to offer it, but it's important to bear in mind that individual patients and needs can differ significantly.

i, for one, would be hesitant to accept medical advice other than from MDs who know my personal medical and vaccine history. were i a doctor, would be equally hesitant to dispense it, any more than, as a lawyer, i would offer legal advice in the same context. in medicine, of course, the potential ramifications are obviously far more serious, potentially even life threatening.

my doctor advised against rabies. another doctor, for another patient, might advise otherwise. please, travelers, talk to your own doctors! if you choose to get the vaccines in india and your MD ok's that, great, but please also consider the serious implications of being advised here on IM what to get and when.

All agreed.
Please do consult with your consultant MD at home / travel clinic regarding the required immunization schedule.
This information is intended to supplement the above, not replace it.

[Mio]

What about Dukoral? It's a vaccine for both Cholera and travel diarrhoe.

[SANJAY_DEL]

Cholera vaccine is not manufactured in India.

Some large pharmacies in central Delhi import medicines which are in demand, so its possible to find Dukoral with them.

[SteamBuff]

In the UK the recommendation for Rabies PRE-Exposure is Day 0, Day 7 and Day 21-28. The timings you quoted are the UK recommendations for POST- Exposure i.e you have been bitten etc.
(and I believe that the Rabies vaccine can reduce the effectivness of some anti-malerials)

The other fact people have to take into account is that some vaccine take 7 to 28 days to become effective.

I would recommend where possible to speak to your own Doctor or Travel Clinic and try and get the Jabs in advance of your travels.

[SANJAY_DEL]

Originally Posted by SteamBuff

In the UK the recommendation for Rabies PRE-Exposure is Day 0, Day 7 and Day 21-28.
(and I believe that the Rabies vaccine can reduce the effectivness of some anti-malerials)

The other fact people have to take into account is that some vaccine take 7 to 28 days to become effective.

I would recommend where possible to speak to your own Doctor or Travel Clinic and try and get the Jabs in advance of your travels.

The Advisory Committee on Immunization Practices (ACIP) recommends a series of 1-mL doses of modern cell culture vaccine given IM on days 0, 7, and 21 or 28.
Two booster doses can be given if an exposure occurs.
Regarding antimalarial prophylaxis, it may be pertinent to note that rabies is 100 % fatal. Malaria remains treatable with a good outcome in the majority of cases. It is the anti-malarials that may reduce effectiveness of rabies vaccine, and not the other way round.
Chloroquine, and possibly other related antimalarials, interferes with the antibody response to rabies vaccine. If the intradermal route is used for pre-exposure rabies immunization, rabies prophylaxis should be initiated at least one month prior to travel [i.e., at least 2 weeks before initiation of antimalarial therapy] to allow for the formation of adequate rabies antibodies; if rabies prophylaxis cannot be initiated at least one month prior to travel, the intramuscular route should be used for pre-exposure rabies prophylaxis, since the intramuscular route is considered to have an adequate margin of safety when given within 2 weeks of antimalarial therapy. If post-exposure therapy is required during concurrent use of chloroquine, it is prudent to test for an adequate response to the rabies vaccine.

[cyberhippie]

Sanjay it's worth mentioning that some of the Rabies vaccinations made in India are made from Bovine Stock which doesn't agree with everyone!!

Nice thread my man!!

[SANJAY_DEL]

No, there are no bovine vaccines!
There are different cell lines that are used to make vaccines:
1 Chicken Fibroblast Cell Culture vaccine = Rabipur
2 Vero cell line vaccine = Verorab
3 Human Diploid Cell Culture vaccine = Rabivax

All the different types are available in India.

I must emphasize that this is not an attempt to create any controversy regarding your recommended immunization schedule.
Also, this is not the first time this issue has come up on IndiaMike.
I'm only trying to compile it in one place for current users.

[cyberhippie]

Ok Doc, I read somewhere that some vaccines in India were still made from bovine material!!

But your'e the Doc!!

[cyberhippie]

Sanjay I believe the correct term is fetal bovine cell rabies vaccine which is it seems still produced in India!!
This causes problems in some (very few) when used as a post post-exposure prophylaxis following after a dog bite!!
Can this also be used as a pre vaccine???
Care to comment!!

[SANJAY_DEL]

That vaccine may lead to peripheral neuropathy and is therefore not recommended.
The Serum Institute of India manufactures the Human diploid cell culture vaccine.