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This is in reference to the article “Immunization coverage at a military station”. Certain points need clarification and are redefined.
The basic principle behind universal immunization programme is that it is the birth right of every child. Further the practice of immunization involves a great amount of counselling and education of parents. This is adopted on the basis of epidemiological profile of the population, option exercised by parents & welfare programmes in the station. Lastly, the delivery of this programme is to be very scientific and based on rigid and accepted protocol.
In Armed Forces, the delivery of this programme is mostly through Station Health Organization and usually prescribed by general duty medical officer. In a minority of cases (mostly in bigger hospitals) immunization clinic is conducted by paediatrician. However, it has been noticed that with increasing awareness among clientele the demand for better immunization facility has been steadily increasing. Failure to meet these demands is leading parents to buy vaccines from chemists. This is fraught with danger including the most important aspect of the programme i.e. ‘cold chain’.
The practice of paediatrician conducting the vaccination programme in a station has definitely brought about tremendous change in terms of quality & quantity. Time has come probably for Armed Forces to adopt this as a policy. Lack of paediatrician should not be a negative factor, because any medical officer could be trained on this programme and regular updating of knowledge & practices can be incorporated in the policy.
Author's observation that paediatrician must include immunization history in outpatient cases is out of place. Every student of paediatrics is trained to focus attention on breast feeding, weaning practices, growth & development and immunization of every child.
Lastly, two comments on the methodology adopted in the study. In any study if exclusion criteria are going to affect the result and inference drawn then those criteria are not valid. A study which is inferring on immunization coverage in a given population, a segment of population (officers) cannot be excluded. Secondly, as per UIP schedule every child will get minimum five doses of OPV including zero dose with BCG at birth. This has not been reflected in the study (Table 1).