Chennai, Aug 5:
Introducing the hexavalent (six-in-one) vaccine into India’s Universal Immunisation Programme (UIP) could significantly improve efficiency, reduce the number of injections for infants, and ease the burden on healthcare workers, according to a new study led by the Union Health and Family Welfare Ministry.
The study, conducted by researchers including Dr Pawan Kumar and Dr Kapil Singh from the Union Health Ministry, along with experts from The George Institute for Global Health India, The Gates Foundation, Gavi, The Vaccine Alliance, and John Snow India Private Limited, highlights multiple operational and economic benefits of the combined vaccine.
The hexavalent vaccine protects against six serious diseases — diphtheria, tetanus, pertussis, Hepatitis B, Haemophilus influenzae type b (Hib), and polio — in a single shot. By combining multiple vaccines, it reduces the number of injections infants receive during routine immunisation visits.
India vaccinates nearly 26 million babies annually under the UIP. Currently, children receive multiple vaccines during each visit, increasing the number of injections, adding to caregivers’ time, and placing additional workload on healthcare providers.
The study found that adopting the hexavalent vaccine could bring several advantages, including fewer injections for infants, improved convenience for families, reduced cold-chain storage requirements, and lower use of syringes and related supplies. It would also reduce the time spent by Auxiliary Nurse Midwives (ANMs) on administering vaccines and maintaining records, while easing the workload of vaccine managers and cold-chain handlers.
However, researchers noted that the price of the hexavalent vaccine remains the key factor influencing overall programme costs. Based on historical procurement trends, the study estimates that a 50 per cent reduction in vaccine price would allow operational and system-level savings to offset the higher acquisition costs under the primary immunisation schedule.
The research evaluated two implementation scenarios — replacing the current pentavalent and fractional IPV doses with the hexavalent vaccine in the primary schedule, and replacing both the primary schedule and the DTP booster dose with a hexavalent booster. Costs were assessed from both government and household perspectives, including procurement, logistics, healthcare worker time, and caregiver time.
The findings, published in the peer-reviewed international journal Human Vaccines and Immunotherapeutics, also noted that caregivers generally prefer fewer injectable vaccines during each visit.
Dr Susmita Chatterjee, Programme Head – Health Economics at The George Institute for Global Health India, said combination vaccines are widely recognised for simplifying immunisation systems. “While the hexavalent vaccine involves higher upfront costs, it generates important efficiencies by reducing injections, easing pressure on frontline workers, lowering cold-chain requirements, and saving caregivers’ time,” she said.
The study provides key economic evidence to guide future policy decisions, emphasising the role of strategic vaccine pricing and procurement in strengthening India’s immunisation programme.