|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 4 | Page : 803-804
Universal Immunization Program in India: Time for covering patients with cancer?
Clinical Oncologist, Independent Practice, Kolkata, West Bengal, India
|Date of Submission||22-Oct-2021|
|Date of Decision||25-Oct-2021|
|Date of Acceptance||27-Oct-2021|
|Date of Web Publication||29-Dec-2021|
Clinical Oncologist, Independent Practice, 377, M. B. Road, Kolkata - 700 049, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gangopadhyay A. Universal Immunization Program in India: Time for covering patients with cancer?. Cancer Res Stat Treat 2021;4:803-4
In their review titled, “Vaccination practices, efficacy, and safety in adults with cancer: A narrative review,” Sarkar et al. have comprehensively evaluated the contemporary literature on the burden of vaccine-preventable diseases (VPDs), current vaccination practices, and the efficacy and safety of vaccination in adults with cancer. Although the findings suggested a paucity of large well-designed studies on the efficacy, safety, and optimal administration of vaccines in adults with cancer, the available data indicated that vaccination was safe and offered benefits in this population; nevertheless, the authors observed that vaccine coverage was generally low in these patients. Although comprehensive data from India were lacking, they assumed the trends to be similar. In view of their findings, the authors emphasized on prioritizing and consolidating the role of routine vaccination as a part of standard care in patients with cancer.
Infections are the second most common cause of mortality in patients with cancer and estimates from GLOBOCAN 2020 suggest that low-middle income countries continue to be the major contributors to global mortality from the disease. In the context of infectious diseases in low-middle income countries, a study found communicable, maternal, neonatal, and nutritional diseases to be responsible for approximately a quarter of all deaths in India. Protection against VPDs may therefore offer substantial benefit in this setting.
As the nation with the youngest population worldwide, India has a considerable number of teenage and young adult patients with cancer; these individuals potentially have many years to live and contribute to this vast nation with a rapidly growing economy. According to the recent data from India, the cancer burden is set to increase in the near future. Data also indicate that India has a considerable proportion of patients with vaccine preventable cancers, where immunization plays a vital role in reducing incidence.
The Universal Immunization Program in India offers vaccination to reduce mortality, morbidity, and disability from VPDs nationwide. It currently covers infants, children, and pregnant women in view of their higher vulnerability. Successive initiatives have been launched in recent years to boost immunization coverage in these vulnerable groups. However, despite the rising cancer burden in India, initiatives to include patients with cancer, who are at particularly high risk of infections owing to both immunosuppression and antineoplastic therapy, are lacking.
Increasing coverage of the Universal Immunization Program to include patients with cancer may lower the incidence of VPDs in this population, thereby reducing morbidity, mortality, and the burden on existing cancer care facilities, which are already struggling to provide timely care to those in need. In view of the notable numbers of patients with vaccine-preventable cancers, the scope of the program may be extended to also include eligible at-risk individuals; this will help lower the incidence of preventable cancers nationwide. As studies indicate the period before initiation of cancer-directed therapy to be the safest and most effective for vaccination, it may be prudent to administer vaccines at the time of cancer diagnosis. This may be implemented in stages by appropriate planning and coordination, starting with institutes collaborating in the National Cancer Grid.
If implemented nationwide in a phased manner, this cost-effective intervention may reduce patient waiting times, need for supportive care and hospital admissions, treatment delays, and mortality, thereby aiding timely realization of the United Nations sustainable development goals.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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