Thiruvananthapuram: With government hospitals in Kerala facing an acute shortage of anti-rabies vaccine, the authorities have issued instructions to go in for local purchase at high prices.
The decision is based on various media reports, including by ‘Malayala Manorama’ which highlighted the plight of Vignesh (15) of Parassala who did not receive the vaccine even from Government Medical College, Thiruvananthapuram after he was bitten by a pet dog.
There are two types of vaccines. While the equine rabies immunoglobulin (ERIG) is administered for deep wounds, intradermal rabies vaccine (IDRV) is given for minor injuries. What makes the situation grave in Kerala is that it is the ERIG which is unavailable even in medical college hospitals. At the same time, IDRV is in stock at most hospitals.
Stock position
The situation at various government hospitals in various districts on Saturday was as follows:
In Kozhikode, immunoglobulin is out-of-stock at Medical College and General Hospital.
General Hospital, Ernakulam purchased 200 doses of immunoglobulin using its own funds. Immunoglobulin is available at Government Medical College, Ernakulam and General Hospital, Muvattupuzha. Not available at District Hospital, Ernakulam. In Kollam district, the only government hospital having immunoglobulin is Medical College, Parippally.
In Thrissur, stocks of immunoglobulin were over by March. At Government Medical College, immunoglobulin is bought by local purchase for below-poverty line (BPL) patients and others have to buy from private medical shops.
No immunoglobulin at District Hospital, Palakkad for the last two days. Local purchase carried out at District Women & Children Hospital. No stock in taluk hospitals.
Only two doses left at Medical College Hospital, Kottayam. Patients directed to buy immunoglobulin from private medical shops. On Saturday, four patients, including two children, sought treatment for dog bites. Among them was Bindu (45) from Konni, who had arrived at Kottayam Medical College after she failed to receive the vaccine at Pathanamthitta General Hospital and Adoor Taluk Hospital.
Immunoglobulin is not available at Changanassery Taluk Hospital and Kanjirappally Taluk Hospital also. However, stocks exist at Pala General Hospital and community health centres at Thalayolaparambu and Erumely.
Similarly, Kumarakom Health Centre has adequate stock, which was stored there in view of the G-20 Sherpa meet.
Supply ceases
The government hospitals are facing shortage of the ERIG vaccine as the Kerala Medical Services Corporation has totally stopped the supply. The Corporation has failed to supply the vaccine to government hospitals after its purchase order was rejected by the manufacturer citing errors. Moreover, there was a serious delay on the part of the Corporation in submitting the purchase order.
In the purchase order sent by the Corporation on April 7, the price of a vial was mentioned as Rs 152.46 – which was the rate last year – instead of Rs 264.60, the amount quoted by the company this year.
Moreover, the purchase order was signed by assistant manager and deputy manager (in-charge), instead of the Finance Director or Managing Director of the Corporation. The company said that it could not accept such an order.
Now, it could take another couple of weeks to set things right and make the vaccine available.
Meanwhile, even though the government has allowed local purchase by hospitals, it is pointed out that the price is much higher than the stocks supplied by the Corporation and there is no certainty that the vaccine available was tested at the Central Drugs Laboratory in Kasauli.
