Questions and concerns remain on the efficacy of the anti-rabies vaccine

Kozhikode: Even as it is being reported that there are no lapses on the hospital’s side on the death of the Perambra woman, who had completed four doses of the vaccine after being bitten by an infected dog, serious concerns are raised about the efficacy of the anti-rabies vaccine administered.

The Equine anti-rabies vaccine was reportedly administered on the woman, which was from the batch of a 5000 vial consignment borrowed and procured from Tamil Nadu last month when Kerala faced a shortage of anti-rabies vaccines.

The Health workers demand whether the storage protocol was strictly followed while transporting the vaccine from Coimbatore by train to Palakkad and then while distributing it to the Hospitals in Kerala.

The three-month delay in the tender proceedings of the Kerala Medical Services Corporation Limited (KMSCL)in the procurement of the vaccine led to the problem.

After the Equine Anti Rabies Vaccine completely ran out of stock, KMSCL General Manager directed the vaccine manufacturer to send the vaccine without waiting for the Central Drug Testing Laboratory’s final report, on July 14. The vaccine consignment reached Kerala on July 16 night. However, the distribution of the vaccine was stalled within two days following the row. 

As many as 5,000 vials of the vaccine, with batch number 21020, were procured from Tamil Nadu and the consignment reached Palakkad on July 19.

Chandrika, who was bitten by an infected dog on July 21, went to the Taluk Hospital for treatment and was administered Intra Dermal Rabies vaccination (IDRV).

As the bite injuries on her face were severe, she was referred to the Medical College Hospital.

On reaching the Medical College hospital, she was administered the Equine Anti Rabies vaccine on the same day. Two more doses were given on July 24 and 28 respectively.

On August 7, Chandrika developed a fever and has other physical discomforts following which she visited the Cooperative Hospital and was later admitted to the Medical College Hospital. She was shifted to the ICU within 6 hours. Though her last dose was due on August 18, as she was on the ventilator, that dose was not administered. Chandrika died on August 20.

This is where the questions are raised on the efficacy of IDRV and Equine rabies vaccines. It was the Equine vaccine procured by Tamil Nadu for distribution with the report of the Central Drug Testing Laboratory, that was brought to Kerala too. Though the quality of the vaccine was tested, the storage and transportation protocol in the way it was brought by train from Coimbatore to Palakkad and later stored in the hospitals are to be looked into.

Even the atmospheric temperature may affect the quality of the vaccines. Such vaccines are to be stored at a temperature of +2 – +8 degrees celsius.  Although the vaccine is stored in coolers in KMSCL warehouses, the variation in temperature during transportation to the respective hospitals may affect the quality of the vaccine, experts point out.

Saliva sample sent for testing

As Chandrika started presenting symptoms of Rabies infection in an unconscious state, the doctors collected saliva samples and sent for a rabies test.

However, the test report came out to be negative. Samples have been sent after her death also. It can be confirmed only after getting the results.

26,000 vaccine vials reach the State

The state has procured 26,000 vials of Intra Dermal Rabies Vaccine (IDRV), which have completed the testing at the Central Drug Testing Laboratory.

More vaccine consignments are to reach the State as and when the testing for each batch is completed.

There has been a big rise in the number of people reaching hospitals for getting vaccinated after being bitten by cats and dogs.