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Immunization Policy For Armed Forces

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  • Ranjeet Terky
    Respected Teachers and Colleagues An attempt is being made to revise the Armed Forces Immunization Schedule. The presence approach is to recommend the
    Message 1 of 24 , Aug 7, 2011
    Respected Teachers and Colleagues
    An attempt is being made to revise the Armed Forces Immunization Schedule. The presence approach is to recommend the following:
    (a) Include MMR, HiB containing combination, Hep B and Typhoid into the program
    (b) Promulgate the need to administer additional vaccines under spl situations
    (c) Acknowledge the status of non UIP vaccines as optional so as to empower Pediatricians/SHO's to administer them
    (d) Promulgate a new Immunization Schedule and Health Book

    A presentation made at the recent CME at AFMC is attached

    Observations from the steering authorities are as follows:
    (a) Financial effect is not a real problem - the 4 vaccines can be afforded
    (b) Will administering MMR create a rightward shift in incidence of mumps and rubella?
    (c) Why MMR and not MR as recommended by National Schedule for the well performing states
    (d) All HiB containing vaccines to be pentavalent to avoid confusion for paramedics
    (e) Optional vaccines not to be given on a "Patient buys, doctor administers" basis in any manner. Stiff opposition to camps and vendors
    (f) Instead, the vaccination under spl circumstances could be promulgated but not declared exhaustive so that a Pediatrician be allowed to recommend a vaccine outside all these to an individual patient
    (g) Why not include JE
    (h) What is the Pediatrician's take on vit A?
     
    This is a request for views of service Pediatricians on the matter. We need to take the public health perspective so that a proposal acceptable to them is raised. It is requested that views be posted on the forum or communicated to Col Madhuri Kanitkar or me.




    Surg Cdr RW Thergaonkar
    MD (Pediatrics)
    Joint Director Medical Services
    Room No 131. "A" Wing, Sena Bhavan
    New Delhi 110011

  • shamsher dalal
    Dear Ranjeet Thanks for taking the initiative for the much awaited separate immunization schedule for the armed forces. We need to modify the immunization
    Message 2 of 24 , Aug 8, 2011
    • 0 Attachment
      Dear Ranjeet

      Thanks for taking the initiative for the much awaited separate  immunization schedule for the armed forces. We need to modify the immunization schedule as per our need for the following reasons-
      1.  As you mentioned affordability is not an issue. Why should we compromise on pediatric services when other specialties are using drugs costing more than 25,000 -50,000/- per dose of medication? 
      2.  All the mothers are screened for Hepatitis B status during antenatal period.
      3. Our pediatrics population is different in respect to the their nutritional status. We hardly see cases of vitamin A deficiency compared to community seeting where every OPD at PHC you will see 2-3 cases of Vitamin A deficiency.
      4. Clientele is more aware and ask for optional vaccines even if they have to pay for it.

      Issues related to schedule:- 

      1.   Will administering MMR create a rightward shift in incidence of mumps and rubella?
           There is risk for rightward shift with any vaccine. With MMR the rsik is more with one dose schedule. Introduction of two dose schedule will decrease the   
            risk.
      2.  Use of pentavalent vaccine and Hep B at birth and repeat pentavalent at 18 months: Hep B at birth is mainly given to prevent mother to child transmission in an HBs Ag +ve mother, along with passive immunization. If mother is negative than first dose of hepatis B vaccine can be given at 6 wks. Since most of mothers in our set up are screened for HBsAg we can use pentavalent vaccine starting at  weeks of age without jeopardizing the immunzation against hepatitis B. At birth dose to be included under spaecial situations i,e when mother is detected positive.
        Pentavalent at 18 months: Use of pentavalent vaccine (containing Hep B) at 18 months will enhance the immune status as many authorities recommend 4th dose of hepatitis B vaccine if the first three doses are given before 6 months of age. 
      3.  Japanese B encephalitis: to be recommended only in stations which falls into endemic zones.
      4.  Vitamin A: We can do away with vitamin A  in our infants as chances of vitamin A deficiencyare very low and side effect of raised ICT is morecommon.
      5.  Discordance with National program: National program is directed for community and with vast financial considerations. Our population is better nourished and we can afford the cost. 


      Best wishes.



      :06 AM, Ranjeet Terky <rantherg@...> wrote:
       
      [Attachment(s) from Ranjeet Terky included below]

      Respected Teachers and Colleagues
      An attempt is being made to revise the Armed Forces Immunization Schedule. The presence approach is to recommend the following:
      (a) Include MMR, HiB containing combination, Hep B and Typhoid into the program
      (b) Promulgate the need to administer additional vaccines under spl situations
      (c) Acknowledge the status of non UIP vaccines as optional so as to empower Pediatricians/SHO's to administer them
      (d) Promulgate a new Immunization Schedule and Health Book

      A presentation made at the recent CME at AFMC is attached

      Observations from the steering authorities are as follows:
      (a) Financial effect is not a real problem - the 4 vaccines can be afforded
      (b) Will administering MMR create a rightward shift in incidence of mumps and rubella?
      (c) Why MMR and not MR as recommended by National Schedule for the well performing states
      (d) All HiB containing vaccines to be pentavalent to avoid confusion for paramedics
      (e) Optional vaccines not to be given on a "Patient buys, doctor administers" basis in any manner. Stiff opposition to camps and vendors
      (f) Instead, the vaccination under spl circumstances could be promulgated but not declared exhaustive so that a Pediatrician be allowed to recommend a vaccine outside all these to an individual patient
      (g) Why not include JE
      (h) What is the Pediatrician's take on vit A?
       
      This is a request for views of service Pediatricians on the matter. We need to take the public health perspective so that a proposal acceptable to them is raised. It is requested that views be posted on the forum or communicated to Col Madhuri Kanitkar or me.




      Surg Cdr RW Thergaonkar
      MD (Pediatrics)
      Joint Director Medical Services
      Room No 131. "A" Wing, Sena Bhavan
      New Delhi 110011




      --
      Wg Cdr  S S Dalal
      MD (Paed) DM (Neonatology)
      Classified Specialist (Paed) & Neonatologist
      Command Hospital (Air Force)
      Old Airport Road
      Bangalore- 560007
      India
      Moblie: +919900312725
    • Madhuri Kanitkar
      ALL these points were exactly how I put forth at the meeting yesterday and we are on the path of success! Thanks Dala for your inputs and prompt response MK
      Message 3 of 24 , Aug 8, 2011
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        ALL these points were exactly how I put forth at the meeting yesterday and we are on the path of success! Thanks Dala for your inputs and prompt response
        MK

        On Mon, Aug 8, 2011 at 6:05 PM, shamsher dalal <dalalshamsher@...> wrote:
         

        Dear Ranjeet


        Thanks for taking the initiative for the much awaited separate  immunization schedule for the armed forces. We need to modify the immunization schedule as per our need for the following reasons-
        1.  As you mentioned affordability is not an issue. Why should we compromise on pediatric services when other specialties are using drugs costing more than 25,000 -50,000/- per dose of medication? 
        2.  All the mothers are screened for Hepatitis B status during antenatal period.
        3. Our pediatrics population is different in respect to the their nutritional status. We hardly see cases of vitamin A deficiency compared to community seeting where every OPD at PHC you will see 2-3 cases of Vitamin A deficiency.
        4. Clientele is more aware and ask for optional vaccines even if they have to pay for it.

        Issues related to schedule:- 

        1.   Will administering MMR create a rightward shift in incidence of mumps and rubella?
             There is risk for rightward shift with any vaccine. With MMR the rsik is more with one dose schedule. Introduction of two dose schedule will decrease the   
              risk.
        2.  Use of pentavalent vaccine and Hep B at birth and repeat pentavalent at 18 months: Hep B at birth is mainly given to prevent mother to child transmission in an HBs Ag +ve mother, along with passive immunization. If mother is negative than first dose of hepatis B vaccine can be given at 6 wks. Since most of mothers in our set up are screened for HBsAg we can use pentavalent vaccine starting at  weeks of age without jeopardizing the immunzation against hepatitis B. At birth dose to be included under spaecial situations i,e when mother is detected positive.
          Pentavalent at 18 months: Use of pentavalent vaccine (containing Hep B) at 18 months will enhance the immune status as many authorities recommend 4th dose of hepatitis B vaccine if the first three doses are given before 6 months of age. 
        3.  Japanese B encephalitis: to be recommended only in stations which falls into endemic zones.
        4.  Vitamin A: We can do away with vitamin A  in our infants as chances of vitamin A deficiencyare very low and side effect of raised ICT is morecommon.
        5.  Discordance with National program: National program is directed for community and with vast financial considerations. Our population is better nourished and we can afford the cost. 


        Best wishes.



        :06 AM, Ranjeet Terky <rantherg@...> wrote:
         
        [Attachment(s) from Ranjeet Terky included below]

        Respected Teachers and Colleagues
        An attempt is being made to revise the Armed Forces Immunization Schedule. The presence approach is to recommend the following:
        (a) Include MMR, HiB containing combination, Hep B and Typhoid into the program
        (b) Promulgate the need to administer additional vaccines under spl situations
        (c) Acknowledge the status of non UIP vaccines as optional so as to empower Pediatricians/SHO's to administer them
        (d) Promulgate a new Immunization Schedule and Health Book

        A presentation made at the recent CME at AFMC is attached

        Observations from the steering authorities are as follows:
        (a) Financial effect is not a real problem - the 4 vaccines can be afforded
        (b) Will administering MMR create a rightward shift in incidence of mumps and rubella?
        (c) Why MMR and not MR as recommended by National Schedule for the well performing states
        (d) All HiB containing vaccines to be pentavalent to avoid confusion for paramedics
        (e) Optional vaccines not to be given on a "Patient buys, doctor administers" basis in any manner. Stiff opposition to camps and vendors
        (f) Instead, the vaccination under spl circumstances could be promulgated but not declared exhaustive so that a Pediatrician be allowed to recommend a vaccine outside all these to an individual patient
        (g) Why not include JE
        (h) What is the Pediatrician's take on vit A?
         
        This is a request for views of service Pediatricians on the matter. We need to take the public health perspective so that a proposal acceptable to them is raised. It is requested that views be posted on the forum or communicated to Col Madhuri Kanitkar or me.




        Surg Cdr RW Thergaonkar
        MD (Pediatrics)
        Joint Director Medical Services
        Room No 131. "A" Wing, Sena Bhavan
        New Delhi 110011




        --
        Wg Cdr  S S Dalal
        MD (Paed) DM (Neonatology)
        Classified Specialist (Paed) & Neonatologist
        Command Hospital (Air Force)
        Old Airport Road
        Bangalore- 560007
        India
        Moblie: +919900312725




        --
        Col Madhuri Kanitkar
        Senior Advisor Pediatrics and Pediatric Nephrology
        Base Hospital Delhi Cantt &
        Prof & HOD Pediatrics
        Army College of Medical Sciences
        New Delhi 110010 India
      • Ranjeet Terky
        Thank you, Sir. Great to have communication from you! Surg Cdr RW Thergaonkar MD (Pediatrics) Joint Director Medical Services Room No 131. A Wing, Sena
        Message 4 of 24 , Aug 8, 2011
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          Thank you, Sir.
          Great to have communication from you!

          Surg Cdr RW Thergaonkar
          MD (Pediatrics)
          Joint Director Medical Services
          Room No 131. "A" Wing, Sena Bhavan
          New Delhi 110011



          --- On Mon, 8/8/11, shamsher dalal <dalalshamsher@...> wrote:

          From: shamsher dalal <dalalshamsher@...>
          Subject: Re: [defencepeds] Immunization Policy For Armed Forces
          To: defencepeds@yahoogroups.com
          Date: Monday, 8 August, 2011, 6:05 PM

           
          Dear Ranjeet

          Thanks for taking the initiative for the much awaited separate  immunization schedule for the armed forces. We need to modify the immunization schedule as per our need for the following reasons-
          1.  As you mentioned affordability is not an issue. Why should we compromise on pediatric services when other specialties are using drugs costing more than 25,000 -50,000/- per dose of medication? 
          2.  All the mothers are screened for Hepatitis B status during antenatal period.
          3. Our pediatrics population is different in respect to the their nutritional status. We hardly see cases of vitamin A deficiency compared to community seeting where every OPD at PHC you will see 2-3 cases of Vitamin A deficiency.
          4. Clientele is more aware and ask for optional vaccines even if they have to pay for it.

          Issues related to schedule:- 

          1.   Will administering MMR create a rightward shift in incidence of mumps and rubella?
               There is risk for rightward shift with any vaccine. With MMR the rsik is more with one dose schedule. Introduction of two dose schedule will decrease the   
                risk.
          2.  Use of pentavalent vaccine and Hep B at birth and repeat pentavalent at 18 months: Hep B at birth is mainly given to prevent mother to child transmission in an HBs Ag +ve mother, along with passive immunization. If mother is negative than first dose of hepatis B vaccine can be given at 6 wks. Since most of mothers in our set up are screened for HBsAg we can use pentavalent vaccine starting at  weeks of age without jeopardizing the immunzation against hepatitis B. At birth dose to be included under spaecial situations i,e when mother is detected positive.
            Pentavalent at 18 months: Use of pentavalent vaccine (containing Hep B) at 18 months will enhance the immune status as many authorities recommend 4th dose of hepatitis B vaccine if the first three doses are given before 6 months of age. 
          3.  Japanese B encephalitis: to be recommended only in stations which falls into endemic zones.
          4.  Vitamin A: We can do away with vitamin A  in our infants as chances of vitamin A deficiencyare very low and side effect of raised ICT is morecommon.
          5.  Discordance with National program: National program is directed for community and with vast financial considerations. Our population is better nourished and we can afford the cost. 


          Best wishes.



          :06 AM, Ranjeet Terky <rantherg@...> wrote:
           
          [Attachment(s) from Ranjeet Terky included below]
          Respected Teachers and Colleagues
          An attempt is being made to revise the Armed Forces Immunization Schedule. The presence approach is to recommend the following:
          (a) Include MMR, HiB containing combination, Hep B and Typhoid into the program
          (b) Promulgate the need to administer additional vaccines under spl situations
          (c) Acknowledge the status of non UIP vaccines as optional so as to empower Pediatricians/SHO's to administer them
          (d) Promulgate a new Immunization Schedule and Health Book

          A presentation made at the recent CME at AFMC is attached

          Observations from the steering authorities are as follows:
          (a) Financial effect is not a real problem - the 4 vaccines can be afforded
          (b) Will administering MMR create a rightward shift in incidence of mumps and rubella?
          (c) Why MMR and not MR as recommended by National Schedule for the well performing states
          (d) All HiB containing vaccines to be pentavalent to avoid confusion for paramedics
          (e) Optional vaccines not to be given on a "Patient buys, doctor administers" basis in any manner. Stiff opposition to camps and vendors
          (f) Instead, the vaccination under spl circumstances could be promulgated but not declared exhaustive so that a Pediatrician be allowed to recommend a vaccine outside all these to an individual patient
          (g) Why not include JE
          (h) What is the Pediatrician's take on vit A?
           
          This is a request for views of service Pediatricians on the matter. We need to take the public health perspective so that a proposal acceptable to them is raised. It is requested that views be posted on the forum or communicated to Col Madhuri Kanitkar or me.




          Surg Cdr RW Thergaonkar
          MD (Pediatrics)
          Joint Director Medical Services
          Room No 131. "A" Wing, Sena Bhavan
          New Delhi 110011




          --
          Wg Cdr  S S Dalal
          MD (Paed) DM (Neonatology)
          Classified Specialist (Paed) & Neonatologist
          Command Hospital (Air Force)
          Old Airport Road
          Bangalore- 560007
          India
          Moblie: +919900312725
        • arvind gupta
          *Dear Ranjit, Shamsher and Madhuri,* Sorry that I am butting in as a outsider now!! But this subject is so close to my heart that I thought I will give a few
          Message 5 of 24 , Aug 9, 2011
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            Dear Ranjit, Shamsher and Madhuri, 

            Sorry that I am butting in as a "outsider" now!! But this subject is so close to my heart that I thought I will give a few inputs from my side: -
            Who?:
            1. Right or duty to administer immunization in the Armed Forces is still a bit mixed up. BCG by the SHO and the rest by Pediatricians. SHO can take over everything in places where there is no pediatrician. In all other places it should be the pediatrician. This role needs to be defined clearly.

            When?:
            2. I feel the present practice of once a week immunization prevalent in most MHs needs to change to the civil practice of "daily Comprehensive Immunization". It was with this aim that Daily Imm Centre at BHDC and Jammu was started. BHDC is a success story. I understand the project at MH Jammu is virtually off for whatever reason. I will be happy to know if there are more centres in Armed Forces following this practice of daily imm. 

            3. Advantages of daily Imm are many-larger numbers, wider coverage for obvious reasons. Every family can not bring their babies for imm on a sat or whatever day! The numbers at BHDC in 2003 and now in 2011 speak for themselves.

            4. The argument that we can't do it in army is rubbish. If a private practitioner can do it-an organization like Armed Forces can do it as well. Wastage is only of BCG which can be regulated and should not be an excuse for not following this practice.

            What?:
            5. Shamsher's argument that our children are not like civilians and are better off is perhaps a little off (Sorry, I am not using the exact words). Our families join their husbands in the cantt area or peace stns for a short time. The rest of the period is spent mostly in rural areas. Hence i will like to follow the IAP or National schedule in AF too. It will ensure uniformity with the rest of the country's population. In any case it will be unfair to change any recommendation regarding imm in AF without proper studies to validate the same.

            6. Most parents are aware of the current practices. Optional vaccines therefore should be offered to everyone on payment in every MH. This will be much better than their going to civil setup and spend phenomenal amount for the same (In most setups a patient will pay Rs 300/- for consultation (a must before he takes imm)+ vaccine at MRP. At BHDC we get it at Institutional price. This is a "good social practice" for our Soldiers and not money making practice which some of our so called honest senior officers (read Commandants/top offrs) think it to be!
            The procurement rates are known to everyone-if they are so scared of the pediatricians making money out of imm,  it can be made a part of DGLP.

            7. I had tried to put all these facts/surmises in writing in the form of an article for AFMJI, but some of our thinking senior pediatricians thought otherwise and sent it back with lots of obs. I gave up!!

            I am glad some young pediatricians are now thinking about it. Please go ahead and implement what you feel is the best for our children of the forces.

            All the best. I am sure with guides and seniors like Madhuri, you will not fail....

            Love and best wishes-Arvind


            --
            Dr Arvind Gupta, MD (Paeds)
            Sr Consultant and Head                                          
            Dept of Pediatrics                                                    
            Asian Institute of Medical Sciences                         
            Badkal Flyover Road, Sec: 21-A                              
            Faridabad (Haryana)-121001

            Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

            Mob: +91-9717915848, +91-9650099133
            Res:  +91-129-4085848


          • Gopinathan Nair
            Dear, it is very gratifying to be considered part of the uniformed brigade. We should move with the world and are in a better position to do it systematically
            Message 6 of 24 , Aug 11, 2011
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              Dear, it is very gratifying to be considered part of the uniformed brigade. We should move with the world and are in a better position to do it systematically and scientifically because of better organisational back up and a younger, highly motivated work force with out any monitory compulsions.I am sure the Armed Forces Paediatricians can take a lead in the field of immunisation.Regards MNG Nair.


              To: defencepeds@yahoogroups.com
              From: brigarvindgupta@...
              Date: Tue, 9 Aug 2011 22:23:24 +0530
              Subject: Re: [defencepeds] Immunization Policy For Armed Forces

               

              Dear Ranjit, Shamsher and Madhuri, 

              Sorry that I am butting in as a "outsider" now!! But this subject is so close to my heart that I thought I will give a few inputs from my side: -
              Who?:
              1. Right or duty to administer immunization in the Armed Forces is still a bit mixed up. BCG by the SHO and the rest by Pediatricians. SHO can take over everything in places where there is no pediatrician. In all other places it should be the pediatrician. This role needs to be defined clearly.

              When?:
              2. I feel the present practice of once a week immunization prevalent in most MHs needs to change to the civil practice of "daily Comprehensive Immunization". It was with this aim that Daily Imm Centre at BHDC and Jammu was started. BHDC is a success story. I understand the project at MH Jammu is virtually off for whatever reason. I will be happy to know if there are more centres in Armed Forces following this practice of daily imm. 

              3. Advantages of daily Imm are many-larger numbers, wider coverage for obvious reasons. Every family can not bring their babies for imm on a sat or whatever day! The numbers at BHDC in 2003 and now in 2011 speak for themselves.

              4. The argument that we can't do it in army is rubbish. If a private practitioner can do it-an organization like Armed Forces can do it as well. Wastage is only of BCG which can be regulated and should not be an excuse for not following this practice.

              What?:
              5. Shamsher's argument that our children are not like civilians and are better off is perhaps a little off (Sorry, I am not using the exact words). Our families join their husbands in the cantt area or peace stns for a short time. The rest of the period is spent mostly in rural areas. Hence i will like to follow the IAP or National schedule in AF too. It will ensure uniformity with the rest of the country's population. In any case it will be unfair to change any recommendation regarding imm in AF without proper studies to validate the same.

              6. Most parents are aware of the current practices. Optional vaccines therefore should be offered to everyone on payment in every MH. This will be much better than their going to civil setup and spend phenomenal amount for the same (In most setups a patient will pay Rs 300/- for consultation (a must before he takes imm)+ vaccine at MRP. At BHDC we get it at Institutional price. This is a "good social practice" for our Soldiers and not money making practice which some of our so called honest senior officers (read Commandants/top offrs) think it to be!
              The procurement rates are known to everyone-if they are so scared of the pediatricians making money out of imm,  it can be made a part of DGLP.

              7. I had tried to put all these facts/surmises in writing in the form of an article for AFMJI, but some of our thinking senior pediatricians thought otherwise and sent it back with lots of obs. I gave up!!

              I am glad some young pediatricians are now thinking about it. Please go ahead and implement what you feel is the best for our children of the forces.

              All the best. I am sure with guides and seniors like Madhuri, you will not fail....

              Love and best wishes-Arvind


              --
              Dr Arvind Gupta, MD (Paeds)
              Sr Consultant and Head                                          
              Dept of Pediatrics                                                    
              Asian Institute of Medical Sciences                         
              Badkal Flyover Road, Sec: 21-A                              
              Faridabad (Haryana)-121001

              Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

              Mob: +91-9717915848, +91-9650099133
              Res:  +91-129-4085848



            • H M SINGH
              I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a
              Message 7 of 24 , Aug 13, 2011
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                I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                         I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                Maj Harsh Mohinder Singh
                MD Paeds

              • Madhuri Kanitkar
                Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through! All the
                Message 8 of 24 , Aug 13, 2011
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                  Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                  All the best
                  MK

                  On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                   

                  I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.

                           I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                  Maj Harsh Mohinder Singh
                  MD Paeds




                  --
                  Col Madhuri Kanitkar
                  Senior Advisor Pediatrics and Pediatric Nephrology
                  Base Hospital Delhi Cantt &
                  Prof & HOD Pediatrics
                  Army College of Medical Sciences
                  New Delhi 110010 India
                • arvind gupta
                  I sincerely hope, this campaign doesn t become just another rhetoric!! Let a core group form a policy after taking into consideration the suggestions by all
                  Message 9 of 24 , Aug 16, 2011
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                    I sincerely hope, this campaign doesn't become just another rhetoric!! Let a core group form a policy after taking into consideration the suggestions by all members at the earliest. Our Pediatric colleagues on top are a dynamic lot and something fruitful may come thro' (Brig Jatana, Rana, Uma, Mukti and Madhuri, Dalal, to mention just a few..... )

                    All the best-Arvind



                    --
                    Dr Arvind Gupta, MD (Paeds)
                    Sr Consultant and Head                                          
                    Dept of Pediatrics                                                    
                    Asian Institute of Medical Sciences                         
                    Badkal Flyover Road, Sec: 21-A                              
                    Faridabad (Haryana)-121001

                    Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

                    Mob: +91-9717915848, +91-9650099133
                    Res:  +91-129-4085848


                  • aparajita gupta
                    dear colleagues, as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the
                    Message 10 of 24 , Aug 31, 2011
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                      dear colleagues,
                      as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the smaller hospitals are commanded by GDs its a tough war getting a dealer inside the hospital premises.if we have a written formulated policy on immunization then may be things could be better.
                      aparajita
                      --- On Sun, 14/8/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                      From: Madhuri Kanitkar <mkanitkar15@...>
                      Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                      To: defencepeds@yahoogroups.com
                      Date: Sunday, 14 August, 2011, 11:57 AM

                       
                      Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                      All the best
                      MK

                      On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                       
                      I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                               I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                      Maj Harsh Mohinder Singh
                      MD Paeds




                      --
                      Col Madhuri Kanitkar
                      Senior Advisor Pediatrics and Pediatric Nephrology
                      Base Hospital Delhi Cantt &
                      Prof & HOD Pediatrics
                      Army College of Medical Sciences
                      New Delhi 110010 India
                    • arvind gupta
                      Uma, Mukti, Rana, Madhuri , Ref mail by Aparajita. This is exactly what I have been harping upon. Let s start with basics and formulate a standard policy. AFMC
                      Message 11 of 24 , Aug 31, 2011
                      • 0 Attachment
                        Uma, Mukti, Rana, Madhuri , Ref mail by Aparajita. This is exactly what I have been harping upon. Let's start with basics and formulate a standard policy. AFMC and AHRR should take the lead. I am getting a bit scared of the total silence from everyone after the initial enthusiasm!! All the best-Arvind

                        On Wed, Aug 31, 2011 at 10:58 PM, aparajita gupta <aparajitadoc@...> wrote:
                         


                        dear colleagues,
                        as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the smaller hospitals are commanded by GDs its a tough war getting a dealer inside the hospital premises.if we have a written formulated policy on immunization then may be things could be better.
                        aparajita
                        --- On Sun, 14/8/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                        From: Madhuri Kanitkar <mkanitkar15@...>

                        Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                        To: defencepeds@yahoogroups.com
                        Date: Sunday, 14 August, 2011, 11:57 AM


                         
                        Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                        All the best
                        MK

                        On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                         
                        I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                                 I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                        Maj Harsh Mohinder Singh
                        MD Paeds




                        --
                        Col Madhuri Kanitkar
                        Senior Advisor Pediatrics and Pediatric Nephrology
                        Base Hospital Delhi Cantt &
                        Prof & HOD Pediatrics
                        Army College of Medical Sciences
                        New Delhi 110010 India




                        --
                        Dr Arvind Gupta, MD
                        Sr Cons and HOD (Paeds) and                                          
                        Chief Medical Administrator                                                     
                        Asian Institute of Medical Sciences                         
                        Badkal Flyover Road, Sec: 21-A                              
                        Faridabad (Haryana)-121001

                        Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

                        Mob: +91-9717915848, +91-9650099133
                        Res:  +91-129-4085848


                      • deepak joshi
                        Aparajita  i had floated a soc to corps HQs in jodhpur and we were able to get rs 2000 per child per year from them. this way i could provide HiB, MMR and
                        Message 12 of 24 , Sep 1, 2011
                        • 0 Attachment
                          Aparajita

                           i had floated a soc to corps HQs in jodhpur and we were able to get rs 2000 per child per year from them. this way i could provide HiB, MMR and Typhoid vaccines free of cost to all children for about an year.Thereafter as the load sky-rocketed, we were subsidising 50% cost. What worked in our favour was a sensitized FWO/ AWWA and backing from Brig MED.
                           But even trying to get paid vaccines into MH dehradun is looking tough because of anonymous complaints earlier when my predecessor had tried. However we are going ahead with it again after informing the higher formations. My Commandant is quite convinced that we should be able to provide the newer vaccines at subsidized rates.

                          regards,

                          deepak joshi

                          --- On Wed, 31/8/11, aparajita gupta <aparajitadoc@...> wrote:

                          From: aparajita gupta <aparajitadoc@...>
                          Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                          To: defencepeds@yahoogroups.com
                          Date: Wednesday, 31 August, 2011, 10:58 PM

                           


                          dear colleagues,
                          as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the smaller hospitals are commanded by GDs its a tough war getting a dealer inside the hospital premises.if we have a written formulated policy on immunization then may be things could be better.
                          aparajita
                          --- On Sun, 14/8/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                          From: Madhuri Kanitkar <mkanitkar15@...>
                          Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                          To: defencepeds@yahoogroups.com
                          Date: Sunday, 14 August, 2011, 11:57 AM

                           
                          Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                          All the best
                          MK

                          On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                           
                          I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                                   I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                          Maj Harsh Mohinder Singh
                          MD Paeds




                          --
                          Col Madhuri Kanitkar
                          Senior Advisor Pediatrics and Pediatric Nephrology
                          Base Hospital Delhi Cantt &
                          Prof & HOD Pediatrics
                          Army College of Medical Sciences
                          New Delhi 110010 India

                        • vivek kumar
                          dear seniors and colleagues we at gorakhpur give the patient optional vaccine on subsidised rates from civil firm. problem we face sometime when patient gets
                          Message 13 of 24 , Sep 2, 2011
                          • 0 Attachment
                            dear seniors and colleagues

                            we at gorakhpur give the patient optional vaccine on subsidised rates from civil firm. problem we face sometime when patient gets an optional vaccine  free of cost from some command hospital and when they come to gorakhpur they are very skeptical and show doubts.
                            in todays scenario where patient wants everything starting from rotavirus,prevenar etc inspite of telling them about the categorisation of vaccines it sometimes becomes very difficult. i have also faced this business of  anonymous complaint. there should be a common policy that eg vaccines like hib,typhoid,MMR would be given free in all service hospitals. for other vaccines if parents wish they will have to buy.

                            Sqn Ldr Vvek Kumar
                            Gorakhpur 

                            On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi <deepakjoshi6562@...> wrote:
                             

                            Aparajita

                             i had floated a soc to corps HQs in jodhpur and we were able to get rs 2000 per child per year from them. this way i could provide HiB, MMR and Typhoid vaccines free of cost to all children for about an year.Thereafter as the load sky-rocketed, we were subsidising 50% cost. What worked in our favour was a sensitized FWO/ AWWA and backing from Brig MED.
                             But even trying to get paid vaccines into MH dehradun is looking tough because of anonymous complaints earlier when my predecessor had tried. However we are going ahead with it again after informing the higher formations. My Commandant is quite convinced that we should be able to provide the newer vaccines at subsidized rates.

                            regards,

                            deepak joshi

                            --- On Wed, 31/8/11, aparajita gupta <aparajitadoc@...> wrote:

                            From: aparajita gupta <aparajitadoc@...>
                            Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                            To: defencepeds@yahoogroups.com
                            Date: Wednesday, 31 August, 2011, 10:58 PM

                             


                            dear colleagues,
                            as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the smaller hospitals are commanded by GDs its a tough war getting a dealer inside the hospital premises.if we have a written formulated policy on immunization then may be things could be better.
                            aparajita
                            --- On Sun, 14/8/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                            From: Madhuri Kanitkar <mkanitkar15@...>
                            Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                            To: defencepeds@yahoogroups.com
                            Date: Sunday, 14 August, 2011, 11:57 AM

                             
                            Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                            All the best
                            MK

                            On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                             
                            I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                                     I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                            Maj Harsh Mohinder Singh
                            MD Paeds




                            --
                            Col Madhuri Kanitkar
                            Senior Advisor Pediatrics and Pediatric Nephrology
                            Base Hospital Delhi Cantt &
                            Prof & HOD Pediatrics
                            Army College of Medical Sciences
                            New Delhi 110010 India


                          • krish010@yahoo.com
                            It was great during a recent trip to India to meet olds friends (Mukti, Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the defence
                            Message 14 of 24 , Sep 2, 2011
                            • 0 Attachment
                              It was great during a recent trip to India to meet olds friends (Mukti, Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the defence peds family.
                              I am interested to follow the discussion about non schedule vaccines and am very impressed by the awareness in thee group. Iam glad to note the efforts of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any other vaccine and supplies like syringes and refrigerator thermometer at no cost from the district health officer at Gaziabad. This was not the result of any personnel connection.

                              As a result of some collaboration in newborn screening for sickle cell disease in different parts of India, I have had discussions about pneumococcal vaccines. Frankly, with India accounting for 43 million out of 150 million cases of pneumonia in children under five each year, it is time to think out of the box about expanding our repertoire of vaccines. We in the armed forces can lead ands do not have to follow the national schedule. I cringe at the mention of costs. What is the appropriate cost to save one healthy child's life?.. If AFMSD can not do this, this would be a good cause for AFWWA/AWWA/NOWA to champion.
                              I am so excited to be a ( honorary?) Member of this great group of physicians

                              Sincerely,
                              Krish

                              While there may be a diversity of opinions on this, I jwant to clarify that I have no relationship with any drug company.


                              Connected by DROID on Verizon Wireless


                              -----Original message-----
                              From: vivek kumar <vk3532@...>
                              To:
                              defencepeds@yahoogroups.com
                              Sent:
                              Fri, Sep 2, 2011 17:52:59 GMT+00:00
                              Subject:
                              Re: [defencepeds] Immunization Policy For Armed Forces

                               

                              dear seniors and colleagues


                              we at gorakhpur give the patient optional vaccine on subsidised rates from civil firm. problem we face sometime when patient gets an optional vaccine  free of cost from some command hospital and when they come to gorakhpur they are very skeptical and show doubts.
                              in todays scenario where patient wants everything starting from rotavirus,prevenar etc inspite of telling them about the categorisation of vaccines it sometimes becomes very difficult. i have also faced this business of  anonymous complaint. there should be a common policy that eg vaccines like hib,typhoid,MMR would be given free in all service hospitals. for other vaccines if parents wish they will have to buy.

                              Sqn Ldr Vvek Kumar
                              Gorakhpur 

                              On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi <deepakjoshi6562@...> wrote:
                               

                              Aparajita

                               i had floated a soc to corps HQs in jodhpur and we were able to get rs 2000 per child per year from them. this way i could provide HiB, MMR and Typhoid vaccines free of cost to all children for about an year.Thereafter as the load sky-rocketed, we were subsidising 50% cost. What worked in our favour was a sensitized FWO/ AWWA and backing from Brig MED.
                               But even trying to get paid vaccines into MH dehradun is looking tough because of anonymous complaints earlier when my predecessor had tried. However we are going ahead with it again after informing the higher formations. My Commandant is quite convinced that we should be able to provide the newer vaccines at subsidized rates.

                              regards,

                              deepak joshi

                              --- On Wed, 31/8/11, aparajita gupta <aparajitadoc@...> wrote:

                              From: aparajita gupta <aparajitadoc@...>
                              Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                              To: defencepeds@yahoogroups.com
                              Date: Wednesday, 31 August, 2011, 10:58 PM

                               


                              dear colleagues,
                              as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the smaller hospitals are commanded by GDs its a tough war getting a dealer inside the hospital premises.if we have a written formulated policy on immunization then may be things could be better.
                              aparajita
                              --- On Sun, 14/8/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                              From: Madhuri Kanitkar <mkanitkar15@...>
                              Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                              To: defencepeds@yahoogroups.com
                              Date: Sunday, 14 August, 2011, 11:57 AM

                               
                              Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                              All the best
                              MK

                              On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                               
                              I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                                       I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                              Maj Harsh Mohinder Singh
                              MD Paeds




                              --
                              Col Madhuri Kanitkar
                              Senior Advisor Pediatrics and Pediatric Nephrology
                              Base Hospital Delhi Cantt &
                              Prof & HOD Pediatrics
                              Army College of Medical Sciences
                              New Delhi 110010 India


                            • Madhuri Kanitkar
                              The policy has been prepared, will be put up to the MSAC and will come out as a letter common to Army Navy and AirForce. They have accepted that MMR and the
                              Message 15 of 24 , Sep 2, 2011
                              • 0 Attachment
                                The policy has been prepared, will be put up to the MSAC and will come out as a letter common to Army Navy and AirForce. They have accepted that MMR and the pentavalent vaccine will be procured against RC and provided free ASAP. The optional vaccines will not be permitted to be sold inside the military hospitals as that amounts to us telling them its best to buy them. These were the thoughts felt by all the senior policy makers when I presented an update in the DG office. However the policy will be reviewed time to time AND GRADUALLY MORE VACCINES PROVIDED FREE. Till then we will be following the guidelines as above. SO some headway has been made. Surg Cdr Thergaonkar has been very helpful in preparing the SOC. a COMMON HEALTH CARD WILL ALSO BE APPROVED FOR CHILDREN UPTO 18 YEARS FOR THE ARMED fORCES
                                .
                                Madhuri Kanitkar
                                On Fri, Sep 2, 2011 at 8:23 PM, vivek kumar <vk3532@...> wrote:
                                 

                                dear seniors and colleagues


                                we at gorakhpur give the patient optional vaccine on subsidised rates from civil firm. problem we face sometime when patient gets an optional vaccine  free of cost from some command hospital and when they come to gorakhpur they are very skeptical and show doubts.
                                in todays scenario where patient wants everything starting from rotavirus,prevenar etc inspite of telling them about the categorisation of vaccines it sometimes becomes very difficult. i have also faced this business of  anonymous complaint. there should be a common policy that eg vaccines like hib,typhoid,MMR would be given free in all service hospitals. for other vaccines if parents wish they will have to buy.

                                Sqn Ldr Vvek Kumar
                                Gorakhpur 

                                On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi <deepakjoshi6562@...> wrote:
                                 

                                Aparajita

                                 i had floated a soc to corps HQs in jodhpur and we were able to get rs 2000 per child per year from them. this way i could provide HiB, MMR and Typhoid vaccines free of cost to all children for about an year.Thereafter as the load sky-rocketed, we were subsidising 50% cost. What worked in our favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                 But even trying to get paid vaccines into MH dehradun is looking tough because of anonymous complaints earlier when my predecessor had tried. However we are going ahead with it again after informing the higher formations. My Commandant is quite convinced that we should be able to provide the newer vaccines at subsidized rates.

                                regards,

                                deepak joshi

                                --- On Wed, 31/8/11, aparajita gupta <aparajitadoc@...> wrote:

                                From: aparajita gupta <aparajitadoc@...>
                                Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                To: defencepeds@yahoogroups.com
                                Date: Wednesday, 31 August, 2011, 10:58 PM

                                 


                                dear colleagues,
                                as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the smaller hospitals are commanded by GDs its a tough war getting a dealer inside the hospital premises.if we have a written formulated policy on immunization then may be things could be better.
                                aparajita
                                --- On Sun, 14/8/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                                From: Madhuri Kanitkar <mkanitkar15@...>
                                Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                To: defencepeds@yahoogroups.com
                                Date: Sunday, 14 August, 2011, 11:57 AM

                                 
                                Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                                All the best
                                MK

                                On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                                 
                                I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                                         I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                                Maj Harsh Mohinder Singh
                                MD Paeds




                                --
                                Col Madhuri Kanitkar
                                Senior Advisor Pediatrics and Pediatric Nephrology
                                Base Hospital Delhi Cantt &
                                Prof & HOD Pediatrics
                                Army College of Medical Sciences
                                New Delhi 110010 India





                                --
                                Col Madhuri Kanitkar
                                Senior Advisor Pediatrics and Pediatric Nephrology
                                Base Hospital Delhi Cantt &
                                Prof & HOD Pediatrics
                                Army College of Medical Sciences
                                New Delhi 110010 India
                              • kawaljit singh
                                respected seniors and colleagues, there is no doubt in anybody s mind that vaccination has improved health scenario and we donot see diptheria, tetanus , polio
                                Message 16 of 24 , Sep 2, 2011
                                • 0 Attachment
                                  respected seniors and colleagues,

                                  there is no doubt in anybody's mind that vaccination has improved health scenario and we donot see diptheria, tetanus , polio etc commonly But
                                  we have some basic issues which need to  address prior to policy making
                                  1. who will give advice on immunisation esp for new vaccines. this is because in many small hospitals there is no pediatrician to give this advice and most other specialists are not aware of the guidelines.
                                  2. now coming to the bigger part of logistical issue ie how much, where, which brand- simple but sensitive issues which need attention
                                  3. coming to financial aspects and complaints in present cases, i had started the thing in gorakhpur in 2006 and never had any complaint in 2-2 1/2 yrs but it is important to keep the parents informed and ADVICE only, decision stays with them, and also stay away from financial dealings, display rates for all to see after taking note on file 

                                  coming to doing it is simple
                                  1. take a note on file from DGAFMS for policy on vaccination
                                  2. have a joint committee, include people from PSM & Medicine
                                  3. Add adolescent, adult and recruit vaccination +/-
                                  4. FOLLOW UP THE CASE


                                  regards
                                  kawal
                                  On Fri, Sep 2, 2011 at 8:23 PM, vivek kumar <vk3532@...> wrote:
                                   

                                  dear seniors and colleagues


                                  we at gorakhpur give the patient optional vaccine on subsidised rates from civil firm. problem we face sometime when patient gets an optional vaccine  free of cost from some command hospital and when they come to gorakhpur they are very skeptical and show doubts.
                                  in todays scenario where patient wants everything starting from rotavirus,prevenar etc inspite of telling them about the categorisation of vaccines it sometimes becomes very difficult. i have also faced this business of  anonymous complaint. there should be a common policy that eg vaccines like hib,typhoid,MMR would be given free in all service hospitals. for other vaccines if parents wish they will have to buy.

                                  Sqn Ldr Vvek Kumar
                                  Gorakhpur 


                                  On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi <deepakjoshi6562@...> wrote:
                                   

                                  Aparajita

                                   i had floated a soc to corps HQs in jodhpur and we were able to get rs 2000 per child per year from them. this way i could provide HiB, MMR and Typhoid vaccines free of cost to all children for about an year.Thereafter as the load sky-rocketed, we were subsidising 50% cost. What worked in our favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                   But even trying to get paid vaccines into MH dehradun is looking tough because of anonymous complaints earlier when my predecessor had tried. However we are going ahead with it again after informing the higher formations. My Commandant is quite convinced that we should be able to provide the newer vaccines at subsidized rates.

                                  regards,

                                  deepak joshi

                                  --- On Wed, 31/8/11, aparajita gupta <aparajitadoc@...> wrote:

                                  From: aparajita gupta <aparajitadoc@...>
                                  Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                  To: defencepeds@yahoogroups.com
                                  Date: Wednesday, 31 August, 2011, 10:58 PM

                                   


                                  dear colleagues,
                                  as  regards the immunization policy some of the hospitals  like mine are way behind in providing the vaccines as per IAP.since most of the smaller hospitals are commanded by GDs its a tough war getting a dealer inside the hospital premises.if we have a written formulated policy on immunization then may be things could be better.
                                  aparajita
                                  --- On Sun, 14/8/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                                  From: Madhuri Kanitkar <mkanitkar15@...>
                                  Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                  To: defencepeds@yahoogroups.com
                                  Date: Sunday, 14 August, 2011, 11:57 AM

                                   
                                  Harsh good to hear from you. On this forum no one is junior or senior. It is our combined voice which will strengthen my resolve to see this through!
                                  All the best
                                  MK

                                  On Sat, Aug 13, 2011 at 1:47 PM, H M SINGH <hms.9791@...> wrote:
                                   
                                  I may be too junior to comment on this, but I strongly agree with the points as suggested by Brig Arvind Gupta. I at my MH, am quite surprised by seeing a number of individuals getting their families from their native places who are not immunized.
                                           I am not able to procure vaccines like MMR and pentavalent vaccines out of Med Store funds due to financial constraints. Thankfully my predecessor made a way and a dealer comes on weekdays from Jhansi with vaccines at subsidized rates. A relief for families who were earlier going to Jhansi for immunisation. It is a nice thought if we can get the vaccines as PVMS.



                                  Maj Harsh Mohinder Singh
                                  MD Paeds




                                  --
                                  Col Madhuri Kanitkar
                                  Senior Advisor Pediatrics and Pediatric Nephrology
                                  Base Hospital Delhi Cantt &
                                  Prof & HOD Pediatrics
                                  Army College of Medical Sciences
                                  New Delhi 110010 India



                                • DALJIT SINGH
                                  Two Things: Firstly, it was great to have Krish sir here and learn all about the exciting work he is doing in Sickle Cell disease and Bone marrow transplant.
                                  Message 17 of 24 , Sep 4, 2011
                                  • 0 Attachment
                                    Two Things:
                                    Firstly, it was great to have Krish sir here and learn all about the
                                    exciting work he is doing in Sickle Cell disease and Bone marrow
                                    transplant. His suggestion on Pneumococcal vaccines is worth looking
                                    in to. We do need data on the load of Pneumococcal disease in our
                                    setup in services before making a decision.
                                    Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                    making the first breakthrough. We will have Pentavalent vaccine and
                                    MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                    as well. It may be a good idea to put up the proposed draft of Family
                                    health card on Defence peds to obtain all the inputs.
                                    Daljit

                                    On 9/3/11, krish010@... <krish010@...> wrote:
                                    > It was great during a recent trip to India to meet olds friends (Mukti,
                                    > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                    >
                                    > defence peds family.
                                    > I am interested to follow the discussion about non schedule vaccines and am
                                    > very impressed by the awareness in thee group. Iam glad to note the efforts
                                    > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                    > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                    > other vaccine and supplies like syringes and refrigerator thermometer at no
                                    > cost from the district health officer at Gaziabad. This was not the result
                                    > of any personnel connection.
                                    >
                                    > As a result of some collaboration in newborn screening for sickle cell
                                    > disease in different parts of India, I have had discussions about
                                    > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                    > 150 million cases of pneumonia in children under five each year, it is time
                                    > to think out of the box about expanding our repertoire of vaccines. We in
                                    > the armed forces can lead ands do not have to follow the national schedule.
                                    > I cringe at the mention of costs. What is the appropriate cost to save one
                                    > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                    >
                                    > for AFWWA/AWWA/NOWA to champion.
                                    > I am so excited to be a ( honorary?) Member of this great group of
                                    > physicians
                                    >
                                    > Sincerely,
                                    > Krish
                                    >
                                    > While there may be a diversity of opinions on this, I jwant to clarify that
                                    >
                                    > I have no relationship with any drug company.
                                    >
                                    >
                                    > Connected by DROID on Verizon Wireless
                                    >
                                    > -----Original message-----
                                    > From: vivek kumar <vk3532@...>
                                    > To: defencepeds@yahoogroups.com
                                    > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                    > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                    >
                                    > dear seniors and colleagues
                                    >
                                    > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                    > civil firm. problem we face sometime when patient gets an optional vaccine
                                    > free of cost from some command hospital and when they come to gorakhpur
                                    > they are very skeptical and show doubts.
                                    > in todays scenario where patient wants everything starting from
                                    > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                    > vaccines it sometimes becomes very difficult. i have also faced this
                                    > business of anonymous complaint. there should be a common policy that eg
                                    > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                    > for other vaccines if parents wish they will have to buy.
                                    >
                                    > Sqn Ldr Vvek Kumar
                                    > Gorakhpur
                                    >
                                    > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                    > <deepakjoshi6562@...>wrote:
                                    >
                                    >> **
                                    >>
                                    >>
                                    >> Aparajita
                                    >>
                                    >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                    >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                    >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                    >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                    >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                    >> But even trying to get paid vaccines into MH dehradun is looking tough
                                    >> because of anonymous complaints earlier when my predecessor had tried.
                                    >> However we are going ahead with it again after informing the higher
                                    >> formations. My Commandant is quite convinced that we should be abl
                                    >
                                    >
                                  • arvind gupta
                                    Dear Madhuri and Ranjit, Great beginning! Let s start with something and gradually move ahead rather than getting stuck with the perfect deal (?? Anna Hazare
                                    Message 18 of 24 , Sep 4, 2011
                                    • 0 Attachment
                                      Dear Madhuri and Ranjit,
                                      Great beginning! Let's start with something and gradually move ahead rather than getting stuck with the perfect deal (?? Anna Hazare effect).

                                      On Sun, Sep 4, 2011 at 10:54 PM, DALJIT SINGH <maapavitra@...> wrote:
                                       

                                      Two Things:
                                      Firstly, it was great to have Krish sir here and learn all about the
                                      exciting work he is doing in Sickle Cell disease and Bone marrow
                                      transplant. His suggestion on Pneumococcal vaccines is worth looking
                                      in to. We do need data on the load of Pneumococcal disease in our
                                      setup in services before making a decision.
                                      Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                      making the first breakthrough. We will have Pentavalent vaccine and
                                      MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                      as well. It may be a good idea to put up the proposed draft of Family
                                      health card on Defence peds to obtain all the inputs.
                                      Daljit



                                      On 9/3/11, krish010@... <krish010@...> wrote:
                                      > It was great during a recent trip to India to meet olds friends (Mukti,
                                      > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                      >
                                      > defence peds family.
                                      > I am interested to follow the discussion about non schedule vaccines and am
                                      > very impressed by the awareness in thee group. Iam glad to note the efforts
                                      > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                      > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                      > other vaccine and supplies like syringes and refrigerator thermometer at no
                                      > cost from the district health officer at Gaziabad. This was not the result
                                      > of any personnel connection.
                                      >
                                      > As a result of some collaboration in newborn screening for sickle cell
                                      > disease in different parts of India, I have had discussions about
                                      > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                      > 150 million cases of pneumonia in children under five each year, it is time
                                      > to think out of the box about expanding our repertoire of vaccines. We in
                                      > the armed forces can lead ands do not have to follow the national schedule.
                                      > I cringe at the mention of costs. What is the appropriate cost to save one
                                      > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                      >
                                      > for AFWWA/AWWA/NOWA to champion.
                                      > I am so excited to be a ( honorary?) Member of this great group of
                                      > physicians
                                      >
                                      > Sincerely,
                                      > Krish
                                      >
                                      > While there may be a diversity of opinions on this, I jwant to clarify that
                                      >
                                      > I have no relationship with any drug company.
                                      >
                                      >
                                      > Connected by DROID on Verizon Wireless
                                      >
                                      > -----Original message-----
                                      > From: vivek kumar <vk3532@...>
                                      > To: defencepeds@yahoogroups.com
                                      > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                      > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                      >
                                      > dear seniors and colleagues
                                      >
                                      > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                      > civil firm. problem we face sometime when patient gets an optional vaccine
                                      > free of cost from some command hospital and when they come to gorakhpur
                                      > they are very skeptical and show doubts.
                                      > in todays scenario where patient wants everything starting from
                                      > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                      > vaccines it sometimes becomes very difficult. i have also faced this
                                      > business of anonymous complaint. there should be a common policy that eg
                                      > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                      > for other vaccines if parents wish they will have to buy.
                                      >
                                      > Sqn Ldr Vvek Kumar
                                      > Gorakhpur
                                      >
                                      > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                      > <deepakjoshi6562@...>wrote:
                                      >
                                      >> **
                                      >>
                                      >>
                                      >> Aparajita
                                      >>
                                      >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                      >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                      >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                      >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                      >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                      >> But even trying to get paid vaccines into MH dehradun is looking tough
                                      >> because of anonymous complaints earlier when my predecessor had tried.
                                      >> However we are going ahead with it again after informing the higher
                                      >> formations. My Commandant is quite convinced that we should be abl
                                      >
                                      >




                                      --
                                      Dr Arvind Gupta, MD
                                      Sr Cons and HOD (Paeds) and                                          
                                      Chief Medical Administrator                                                     
                                      Asian Institute of Medical Sciences                         
                                      Badkal Flyover Road, Sec: 21-A                              
                                      Faridabad (Haryana)-121001

                                      Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

                                      Mob: +91-9717915848, +91-9650099133
                                      Res:  +91-129-4085848


                                    • Madhuri Kanitkar
                                      Hi Daljit, That is a good idea to put the health card proposed format on the defped site. However the vaccination page will be made after the final approval of
                                      Message 19 of 24 , Sep 4, 2011
                                      • 0 Attachment
                                        Hi Daljit,
                                        That is a good idea to put the health card proposed format on the defped site. However the vaccination page will be made after the final approval of the vaccines from O/o DGAFMS. Typhoid vaccine and Hep B has already been approved.
                                        Best wishes
                                        M Kanitkar

                                        On Sun, Sep 4, 2011 at 10:54 PM, DALJIT SINGH <maapavitra@...> wrote:
                                         

                                        Two Things:
                                        Firstly, it was great to have Krish sir here and learn all about the
                                        exciting work he is doing in Sickle Cell disease and Bone marrow
                                        transplant. His suggestion on Pneumococcal vaccines is worth looking
                                        in to. We do need data on the load of Pneumococcal disease in our
                                        setup in services before making a decision.
                                        Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                        making the first breakthrough. We will have Pentavalent vaccine and
                                        MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                        as well. It may be a good idea to put up the proposed draft of Family
                                        health card on Defence peds to obtain all the inputs.
                                        Daljit

                                        On 9/3/11, krish010@... <krish010@...> wrote:
                                        > It was great during a recent trip to India to meet olds friends (Mukti,
                                        > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                        >
                                        > defence peds family.
                                        > I am interested to follow the discussion about non schedule vaccines and am
                                        > very impressed by the awareness in thee group. Iam glad to note the efforts
                                        > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                        > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                        > other vaccine and supplies like syringes and refrigerator thermometer at no
                                        > cost from the district health officer at Gaziabad. This was not the result
                                        > of any personnel connection.
                                        >
                                        > As a result of some collaboration in newborn screening for sickle cell
                                        > disease in different parts of India, I have had discussions about
                                        > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                        > 150 million cases of pneumonia in children under five each year, it is time
                                        > to think out of the box about expanding our repertoire of vaccines. We in
                                        > the armed forces can lead ands do not have to follow the national schedule.
                                        > I cringe at the mention of costs. What is the appropriate cost to save one
                                        > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                        >
                                        > for AFWWA/AWWA/NOWA to champion.
                                        > I am so excited to be a ( honorary?) Member of this great group of
                                        > physicians
                                        >
                                        > Sincerely,
                                        > Krish
                                        >
                                        > While there may be a diversity of opinions on this, I jwant to clarify that
                                        >
                                        > I have no relationship with any drug company.
                                        >
                                        >
                                        > Connected by DROID on Verizon Wireless
                                        >
                                        > -----Original message-----
                                        > From: vivek kumar <vk3532@...>
                                        > To: defencepeds@yahoogroups.com
                                        > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                        > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                        >
                                        > dear seniors and colleagues
                                        >
                                        > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                        > civil firm. problem we face sometime when patient gets an optional vaccine
                                        > free of cost from some command hospital and when they come to gorakhpur
                                        > they are very skeptical and show doubts.
                                        > in todays scenario where patient wants everything starting from
                                        > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                        > vaccines it sometimes becomes very difficult. i have also faced this
                                        > business of anonymous complaint. there should be a common policy that eg
                                        > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                        > for other vaccines if parents wish they will have to buy.
                                        >
                                        > Sqn Ldr Vvek Kumar
                                        > Gorakhpur
                                        >
                                        > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                        > <deepakjoshi6562@...>wrote:
                                        >
                                        >> **
                                        >>
                                        >>
                                        >> Aparajita
                                        >>
                                        >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                        >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                        >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                        >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                        >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                        >> But even trying to get paid vaccines into MH dehradun is looking tough
                                        >> because of anonymous complaints earlier when my predecessor had tried.
                                        >> However we are going ahead with it again after informing the higher
                                        >> formations. My Commandant is quite convinced that we should be abl
                                        >
                                        >




                                        --
                                        Col Madhuri Kanitkar
                                        Senior Advisor Pediatrics and Pediatric Nephrology
                                        Base Hospital Delhi Cantt &
                                        Prof & HOD Pediatrics
                                        Army College of Medical Sciences
                                        New Delhi 110010 India
                                      • Lakshmanan Krishnamurti
                                        Daljit et al,   Please take a look at this paper in the Lancet a couple of years ago on the global estimates of pneumococcal infections. It was an eye opener
                                        Message 20 of 24 , Sep 5, 2011
                                        • 1 Attachment
                                        • 540 KB
                                        Daljit et al,
                                         
                                        Please take a look at this paper in the Lancet a couple of years ago on the global estimates of pneumococcal infections. It was an eye opener for me. Gates foundation may also have some information on this subject. Best Wishes
                                        sincerely,
                                        Krish

                                        --- On Sun, 9/4/11, DALJIT SINGH <maapavitra@...> wrote:

                                        From: DALJIT SINGH <maapavitra@...>
                                        Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                        To: defencepeds@yahoogroups.com
                                        Date: Sunday, September 4, 2011, 12:24 PM

                                         
                                        Two Things:
                                        Firstly, it was great to have Krish sir here and learn all about the
                                        exciting work he is doing in Sickle Cell disease and Bone marrow
                                        transplant. His suggestion on Pneumococcal vaccines is worth looking
                                        in to. We do need data on the load of Pneumococcal disease in our
                                        setup in services before making a decision.
                                        Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                        making the first breakthrough. We will have Pentavalent vaccine and
                                        MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                        as well. It may be a good idea to put up the proposed draft of Family
                                        health card on Defence peds to obtain all the inputs.
                                        Daljit

                                        On 9/3/11, krish010@... <krish010@...> wrote:
                                        > It was great during a recent trip to India to meet olds friends (Mukti,
                                        > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                        >
                                        > defence peds family.
                                        > I am interested to follow the discussion about non schedule vaccines and am
                                        > very impressed by the awareness in thee group. Iam glad to note the efforts
                                        > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                        > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                        > other vaccine and supplies like syringes and refrigerator thermometer at no
                                        > cost from the district health officer at Gaziabad. This was not the result
                                        > of any personnel connection.
                                        >
                                        > As a result of some collaboration in newborn screening for sickle cell
                                        > disease in different parts of India, I have had discussions about
                                        > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                        > 150 million cases of pneumonia in children under five each year, it is time
                                        > to think out of the box about expanding our repertoire of vaccines. We in
                                        > the armed forces can lead ands do not have to follow the national schedule.
                                        > I cringe at the mention of costs. What is the appropriate cost to save one
                                        > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                        >
                                        > for AFWWA/AWWA/NOWA to champion.
                                        > I am so excited to be a ( honorary?) Member of this great group of
                                        > physicians
                                        >
                                        > Sincerely,
                                        > Krish
                                        >
                                        > While there may be a diversity of opinions on this, I jwant to clarify that
                                        >
                                        > I have no relationship with any drug company.
                                        >
                                        >
                                        > Connected by DROID on Verizon Wireless
                                        >
                                        > -----Original message-----
                                        > From: vivek kumar <vk3532@...>
                                        > To: defencepeds@yahoogroups.com
                                        > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                        > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                        >
                                        > dear seniors and colleagues
                                        >
                                        > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                        > civil firm. problem we face sometime when patient gets an optional vaccine
                                        > free of cost from some command hospital and when they come to gorakhpur
                                        > they are very skeptical and show doubts.
                                        > in todays scenario where patient wants everything starting from
                                        > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                        > vaccines it sometimes becomes very difficult. i have also faced this
                                        > business of anonymous complaint. there should be a common policy that eg
                                        > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                        > for other vaccines if parents wish they will have to buy.
                                        >
                                        > Sqn Ldr Vvek Kumar
                                        > Gorakhpur
                                        >
                                        > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                        > <deepakjoshi6562@...>wrote:
                                        >
                                        >> **
                                        >>
                                        >>
                                        >> Aparajita
                                        >>
                                        >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                        >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                        >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                        >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                        >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                        >> But even trying to get paid vaccines into MH dehradun is looking tough
                                        >> because of anonymous complaints earlier when my predecessor had tried.
                                        >> However we are going ahead with it again after informing the higher
                                        >> formations. My Commandant is quite convinced that we should be abl
                                        >
                                        >
                                      • ramakrishna sanjeev
                                        Dear Colleagues,     While expansion to include  MMR & Hib (besides Typhoid which is already there) is great, two issues ,I feel are relevant.  1)    
                                        Message 21 of 24 , Sep 5, 2011
                                        • 0 Attachment
                                          Dear Colleagues,
                                               While expansion to include  MMR & Hib (besides Typhoid which is already there) is great, two issues ,I feel are relevant.
                                            1)               In today's world aren't we denying our patients the right to get there children appropriately vaccinated by not allowing "optional" vaccines to be given? What Krish sir says about Pnuemococcal must be more than relevant in our settings (with the absence of appropriate microbiology facilities in all but the tertiary care centres). We definitely are not seeing Epiglottitis or Measles with the frequency of what was seen in the 90s. Besides why should our children be unimmunized against flu, rotavirus, Hepatitis A & Chickenpox?
                                          2)           We will face an erosion in our clientele once patients start going to civil Pediatricians for these vaccines. 
                                                                        regards,
                                                                         Sanjeev     
                                          --- On Mon, 5/9/11, Lakshmanan Krishnamurti <krish010@...> wrote:

                                          From: Lakshmanan Krishnamurti <krish010@...>
                                          Subject: Re: [defencepeds] Immunization Policy For Armed Forces [1 Attachment]
                                          To: defencepeds@yahoogroups.com
                                          Date: Monday, 5 September, 2011, 3:52 PM

                                           

                                          Daljit et al,
                                           
                                          Please take a look at this paper in the Lancet a couple of years ago on the global estimates of pneumococcal infections. It was an eye opener for me. Gates foundation may also have some information on this subject. Best Wishes
                                          sincerely,
                                          Krish

                                          --- On Sun, 9/4/11, DALJIT SINGH <maapavitra@...> wrote:

                                          From: DALJIT SINGH <maapavitra@...>
                                          Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                          To: defencepeds@yahoogroups.com
                                          Date: Sunday, September 4, 2011, 12:24 PM

                                           
                                          Two Things:
                                          Firstly, it was great to have Krish sir here and learn all about the
                                          exciting work he is doing in Sickle Cell disease and Bone marrow
                                          transplant. His suggestion on Pneumococcal vaccines is worth looking
                                          in to. We do need data on the load of Pneumococcal disease in our
                                          setup in services before making a decision.
                                          Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                          making the first breakthrough. We will have Pentavalent vaccine and
                                          MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                          as well. It may be a good idea to put up the proposed draft of Family
                                          health card on Defence peds to obtain all the inputs.
                                          Daljit

                                          On 9/3/11, krish010@... <krish010@...> wrote:
                                          > It was great during a recent trip to India to meet olds friends (Mukti,
                                          > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                          >
                                          > defence peds family.
                                          > I am interested to follow the discussion about non schedule vaccines and am
                                          > very impressed by the awareness in thee group. Iam glad to note the efforts
                                          > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                          > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                          > other vaccine and supplies like syringes and refrigerator thermometer at no
                                          > cost from the district health officer at Gaziabad. This was not the result
                                          > of any personnel connection.
                                          >
                                          > As a result of some collaboration in newborn screening for sickle cell
                                          > disease in different parts of India, I have had discussions about
                                          > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                          > 150 million cases of pneumonia in children under five each year, it is time
                                          > to think out of the box about expanding our repertoire of vaccines. We in
                                          > the armed forces can lead ands do not have to follow the national schedule.
                                          > I cringe at the mention of costs. What is the appropriate cost to save one
                                          > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                          >
                                          > for AFWWA/AWWA/NOWA to champion.
                                          > I am so excited to be a ( honorary?) Member of this great group of
                                          > physicians
                                          >
                                          > Sincerely,
                                          > Krish
                                          >
                                          > While there may be a diversity of opinions on this, I jwant to clarify that
                                          >
                                          > I have no relationship with any drug company.
                                          >
                                          >
                                          > Connected by DROID on Verizon Wireless
                                          >
                                          > -----Original message-----
                                          > From: vivek kumar <vk3532@...>
                                          > To: defencepeds@yahoogroups.com
                                          > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                          > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                          >
                                          > dear seniors and colleagues
                                          >
                                          > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                          > civil firm. problem we face sometime when patient gets an optional vaccine
                                          > free of cost from some command hospital and when they come to gorakhpur
                                          > they are very skeptical and show doubts.
                                          > in todays scenario where patient wants everything starting from
                                          > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                          > vaccines it sometimes becomes very difficult. i have also faced this
                                          > business of anonymous complaint. there should be a common policy that eg
                                          > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                          > for other vaccines if parents wish they will have to buy.
                                          >
                                          > Sqn Ldr Vvek Kumar
                                          > Gorakhpur
                                          >
                                          > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                          > <deepakjoshi6562@...>wrote:
                                          >
                                          >> **
                                          >>
                                          >>
                                          >> Aparajita
                                          >>
                                          >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                          >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                          >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                          >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                          >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                          >> But even trying to get paid vaccines into MH dehradun is looking tough
                                          >> because of anonymous complaints earlier when my predecessor had tried.
                                          >> However we are going ahead with it again after informing the higher
                                          >> formations. My Commandant is quite convinced that we should be abl
                                          >
                                          >

                                        • Madhuri Kanitkar
                                          Thanks Sir ... -- Col Madhuri Kanitkar Senior Advisor Pediatrics and Pediatric Nephrology Base Hospital Delhi Cantt & Prof & HOD Pediatrics Army College of
                                          Message 22 of 24 , Sep 5, 2011
                                          • 0 Attachment
                                            Thanks Sir

                                            On Mon, Sep 5, 2011 at 10:07 AM, arvind gupta <brigarvindgupta@...> wrote:
                                             

                                            Dear Madhuri and Ranjit,
                                            Great beginning! Let's start with something and gradually move ahead rather than getting stuck with the perfect deal (?? Anna Hazare effect).

                                            On Sun, Sep 4, 2011 at 10:54 PM, DALJIT SINGH <maapavitra@...> wrote:
                                             

                                            Two Things:
                                            Firstly, it was great to have Krish sir here and learn all about the
                                            exciting work he is doing in Sickle Cell disease and Bone marrow
                                            transplant. His suggestion on Pneumococcal vaccines is worth looking
                                            in to. We do need data on the load of Pneumococcal disease in our
                                            setup in services before making a decision.
                                            Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                            making the first breakthrough. We will have Pentavalent vaccine and
                                            MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                            as well. It may be a good idea to put up the proposed draft of Family
                                            health card on Defence peds to obtain all the inputs.
                                            Daljit



                                            On 9/3/11, krish010@... <krish010@...> wrote:
                                            > It was great during a recent trip to India to meet olds friends (Mukti,
                                            > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                            >
                                            > defence peds family.
                                            > I am interested to follow the discussion about non schedule vaccines and am
                                            > very impressed by the awareness in thee group. Iam glad to note the efforts
                                            > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                            > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                            > other vaccine and supplies like syringes and refrigerator thermometer at no
                                            > cost from the district health officer at Gaziabad. This was not the result
                                            > of any personnel connection.
                                            >
                                            > As a result of some collaboration in newborn screening for sickle cell
                                            > disease in different parts of India, I have had discussions about
                                            > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                            > 150 million cases of pneumonia in children under five each year, it is time
                                            > to think out of the box about expanding our repertoire of vaccines. We in
                                            > the armed forces can lead ands do not have to follow the national schedule.
                                            > I cringe at the mention of costs. What is the appropriate cost to save one
                                            > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                            >
                                            > for AFWWA/AWWA/NOWA to champion.
                                            > I am so excited to be a ( honorary?) Member of this great group of
                                            > physicians
                                            >
                                            > Sincerely,
                                            > Krish
                                            >
                                            > While there may be a diversity of opinions on this, I jwant to clarify that
                                            >
                                            > I have no relationship with any drug company.
                                            >
                                            >
                                            > Connected by DROID on Verizon Wireless
                                            >
                                            > -----Original message-----
                                            > From: vivek kumar <vk3532@...>
                                            > To: defencepeds@yahoogroups.com
                                            > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                            > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                            >
                                            > dear seniors and colleagues
                                            >
                                            > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                            > civil firm. problem we face sometime when patient gets an optional vaccine
                                            > free of cost from some command hospital and when they come to gorakhpur
                                            > they are very skeptical and show doubts.
                                            > in todays scenario where patient wants everything starting from
                                            > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                            > vaccines it sometimes becomes very difficult. i have also faced this
                                            > business of anonymous complaint. there should be a common policy that eg
                                            > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                            > for other vaccines if parents wish they will have to buy.
                                            >
                                            > Sqn Ldr Vvek Kumar
                                            > Gorakhpur
                                            >
                                            > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                            > <deepakjoshi6562@...>wrote:
                                            >
                                            >> **
                                            >>
                                            >>
                                            >> Aparajita
                                            >>
                                            >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                            >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                            >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                            >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                            >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                            >> But even trying to get paid vaccines into MH dehradun is looking tough
                                            >> because of anonymous complaints earlier when my predecessor had tried.
                                            >> However we are going ahead with it again after informing the higher
                                            >> formations. My Commandant is quite convinced that we should be abl
                                            >
                                            >




                                            --
                                            Dr Arvind Gupta, MD
                                            Sr Cons and HOD (Paeds) and                                          
                                            Chief Medical Administrator                                                     
                                            Asian Institute of Medical Sciences                         
                                            Badkal Flyover Road, Sec: 21-A                              
                                            Faridabad (Haryana)-121001

                                            Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

                                            Mob: +91-9717915848, +91-9650099133
                                            Res:  +91-129-4085848





                                            --
                                            Col Madhuri Kanitkar
                                            Senior Advisor Pediatrics and Pediatric Nephrology
                                            Base Hospital Delhi Cantt &
                                            Prof & HOD Pediatrics
                                            Army College of Medical Sciences
                                            New Delhi 110010 India
                                          • Lakshmanan Krishnamurti
                                            Madhuri, I am really pleased to see the intiative you and Cdr Thergaonkar have taken to update the immunization schedule for the Armed Forces. Immunization
                                            Message 23 of 24 , Sep 6, 2011
                                            • 0 Attachment
                                              Madhuri,
                                              I am really pleased to see the intiative you and Cdr Thergaonkar have taken to update the immunization schedule for the Armed Forces. Immunization policy is made under 'real world' conditions and each organization and health system has to make decisions based on conditons and considerations unique to its functioning.
                                              I became aware of the magnitude of the problem of Pneumococcus in India in the context of my work in sickle cell disease. Conceivably, the incidence and prevalence in the armed forces mirrors that of the rest of the country.  Allow me to share the folowing in order to inform the discussion:
                                               
                                               
                                               
                                              Best Regards,
                                              sincerely,
                                              Krish


                                              --- On Mon, 9/5/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                                              From: Madhuri Kanitkar <mkanitkar15@...>
                                              Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                              To: defencepeds@yahoogroups.com
                                              Date: Monday, September 5, 2011, 10:31 PM

                                               
                                              Thanks Sir

                                              On Mon, Sep 5, 2011 at 10:07 AM, arvind gupta <brigarvindgupta@...> wrote:
                                               
                                              Dear Madhuri and Ranjit,
                                              Great beginning! Let's start with something and gradually move ahead rather than getting stuck with the perfect deal (?? Anna Hazare effect).

                                              On Sun, Sep 4, 2011 at 10:54 PM, DALJIT SINGH <maapavitra@...> wrote:
                                               
                                              Two Things:
                                              Firstly, it was great to have Krish sir here and learn all about the
                                              exciting work he is doing in Sickle Cell disease and Bone marrow
                                              transplant. His suggestion on Pneumococcal vaccines is worth looking
                                              in to. We do need data on the load of Pneumococcal disease in our
                                              setup in services before making a decision.
                                              Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                              making the first breakthrough. We will have Pentavalent vaccine and
                                              MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                              as well. It may be a good idea to put up the proposed draft of Family
                                              health card on Defence peds to obtain all the inputs.
                                              Daljit


                                              On 9/3/11, krish010@... <krish010@...> wrote:
                                              > It was great during a recent trip to India to meet olds friends (Mukti,
                                              > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                              >
                                              > defence peds family.
                                              > I am interested to follow the discussion about non schedule vaccines and am
                                              > very impressed by the awareness in thee group. Iam glad to note the efforts
                                              > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                              > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                              > other vaccine and supplies like syringes and refrigerator thermometer at no
                                              > cost from the district health officer at Gaziabad. This was not the result
                                              > of any personnel connection.
                                              >
                                              > As a result of some collaboration in newborn screening for sickle cell
                                              > disease in different parts of India, I have had discussions about
                                              > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                              > 150 million cases of pneumonia in children under five each year, it is time
                                              > to think out of the box about expanding our repertoire of vaccines. We in
                                              > the armed forces can lead ands do not have to follow the national schedule.
                                              > I cringe at the mention of costs. What is the appropriate cost to save one
                                              > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                              >
                                              > for AFWWA/AWWA/NOWA to champion.
                                              > I am so excited to be a ( honorary?) Member of this great group of
                                              > physicians
                                              >
                                              > Sincerely,
                                              > Krish
                                              >
                                              > While there may be a diversity of opinions on this, I jwant to clarify that
                                              >
                                              > I have no relationship with any drug company.
                                              >
                                              >
                                              > Connected by DROID on Verizon Wireless
                                              >
                                              > -----Original message-----
                                              > From: vivek kumar <vk3532@...>
                                              > To: defencepeds@yahoogroups.com
                                              > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                              > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                              >
                                              > dear seniors and colleagues
                                              >
                                              > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                              > civil firm. problem we face sometime when patient gets an optional vaccine
                                              > free of cost from some command hospital and when they come to gorakhpur
                                              > they are very skeptical and show doubts.
                                              > in todays scenario where patient wants everything starting from
                                              > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                              > vaccines it sometimes becomes very difficult. i have also faced this
                                              > business of anonymous complaint. there should be a common policy that eg
                                              > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                              > for other vaccines if parents wish they will have to buy.
                                              >
                                              > Sqn Ldr Vvek Kumar
                                              > Gorakhpur
                                              >
                                              > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                              > <deepakjoshi6562@...>wrote:
                                              >
                                              >> **
                                              >>
                                              >>
                                              >> Aparajita
                                              >>
                                              >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                              >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                              >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                              >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                              >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                              >> But even trying to get paid vaccines into MH dehradun is looking tough
                                              >> because of anonymous complaints earlier when my predecessor had tried.
                                              >> However we are going ahead with it again after informing the higher
                                              >> formations. My Commandant is quite convinced that we should be abl
                                              >
                                              >



                                              --
                                              Dr Arvind Gupta, MD
                                              Sr Cons and HOD (Paeds) and                                          
                                              Chief Medical Administrator                                                     
                                              Asian Institute of Medical Sciences                         
                                              Badkal Flyover Road, Sec: 21-A                              
                                              Faridabad (Haryana)-121001

                                              Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

                                              Mob: +91-9717915848, +91-9650099133
                                              Res:  +91-129-4085848





                                              --
                                              Col Madhuri Kanitkar
                                              Senior Advisor Pediatrics and Pediatric Nephrology
                                              Base Hospital Delhi Cantt &
                                              Prof & HOD Pediatrics
                                              Army College of Medical Sciences
                                              New Delhi 110010 India
                                            • Madhuri Kanitkar
                                              Thanks Krish, Actually I have been raging a war for the past three years as an advocate for childrens health and have finally made in a dent. Had I insisted
                                              Message 24 of 24 , Sep 8, 2011
                                              • 0 Attachment
                                                Thanks Krish,
                                                 Actually I have been raging a war for the past three years as an advocate for childrens' health and have finally made in a dent. Had I insisted we need all, they would not have budged. So I have given priorities. First MMR and Hib. Followed by Rotavirus, Varicella and pnemococcos. These three will be procured at all hospitals for all high risk cases in phase 1 itself. Hope to make a difference.
                                                Madhuri

                                                On Wed, Sep 7, 2011 at 4:53 AM, Lakshmanan Krishnamurti <krish010@...> wrote:
                                                 

                                                Madhuri,
                                                I am really pleased to see the intiative you and Cdr Thergaonkar have taken to update the immunization schedule for the Armed Forces. Immunization policy is made under 'real world' conditions and each organization and health system has to make decisions based on conditons and considerations unique to its functioning.
                                                I became aware of the magnitude of the problem of Pneumococcus in India in the context of my work in sickle cell disease. Conceivably, the incidence and prevalence in the armed forces mirrors that of the rest of the country.  Allow me to share the folowing in order to inform the discussion:
                                                 
                                                 
                                                 
                                                Best Regards,
                                                sincerely,
                                                Krish


                                                --- On Mon, 9/5/11, Madhuri Kanitkar <mkanitkar15@...> wrote:

                                                From: Madhuri Kanitkar <mkanitkar15@...>
                                                Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                                To: defencepeds@yahoogroups.com
                                                Date: Monday, September 5, 2011, 10:31 PM

                                                 
                                                Thanks Sir

                                                On Mon, Sep 5, 2011 at 10:07 AM, arvind gupta <brigarvindgupta@...> wrote:
                                                 
                                                Dear Madhuri and Ranjit,
                                                Great beginning! Let's start with something and gradually move ahead rather than getting stuck with the perfect deal (?? Anna Hazare effect).

                                                On Sun, Sep 4, 2011 at 10:54 PM, DALJIT SINGH <maapavitra@...> wrote:
                                                 
                                                Two Things:
                                                Firstly, it was great to have Krish sir here and learn all about the
                                                exciting work he is doing in Sickle Cell disease and Bone marrow
                                                transplant. His suggestion on Pneumococcal vaccines is worth looking
                                                in to. We do need data on the load of Pneumococcal disease in our
                                                setup in services before making a decision.
                                                Secondly, Congratulations to Col Madhuri and Surg Cdr Thergaonkar for
                                                making the first breakthrough. We will have Pentavalent vaccine and
                                                MMR. I wonder if Typhoid vaccine ( a non-UIP vaccine) could be there
                                                as well. It may be a good idea to put up the proposed draft of Family
                                                health card on Defence peds to obtain all the inputs.
                                                Daljit


                                                On 9/3/11, krish010@... <krish010@...> wrote:
                                                > It was great during a recent trip to India to meet olds friends (Mukti,
                                                > Daljit, ATK Rau et al) and make new friends( Sanjeev, Kartik et al) from the
                                                >
                                                > defence peds family.
                                                > I am interested to follow the discussion about non schedule vaccines and am
                                                > very impressed by the awareness in thee group. Iam glad to note the efforts
                                                > of Deepak Joshi in expanding vaccine coverage. In 1987 as a pediatrician at
                                                > 11AFH Hindan I had no difficulty getting an unlimited supply of MMR or any
                                                > other vaccine and supplies like syringes and refrigerator thermometer at no
                                                > cost from the district health officer at Gaziabad. This was not the result
                                                > of any personnel connection.
                                                >
                                                > As a result of some collaboration in newborn screening for sickle cell
                                                > disease in different parts of India, I have had discussions about
                                                > pneumococcal vaccines. Frankly, with India accounting for 43 million out of
                                                > 150 million cases of pneumonia in children under five each year, it is time
                                                > to think out of the box about expanding our repertoire of vaccines. We in
                                                > the armed forces can lead ands do not have to follow the national schedule.
                                                > I cringe at the mention of costs. What is the appropriate cost to save one
                                                > healthy child's life?.. If AFMSD can not do this, this would be a good cause
                                                >
                                                > for AFWWA/AWWA/NOWA to champion.
                                                > I am so excited to be a ( honorary?) Member of this great group of
                                                > physicians
                                                >
                                                > Sincerely,
                                                > Krish
                                                >
                                                > While there may be a diversity of opinions on this, I jwant to clarify that
                                                >
                                                > I have no relationship with any drug company.
                                                >
                                                >
                                                > Connected by DROID on Verizon Wireless
                                                >
                                                > -----Original message-----
                                                > From: vivek kumar <vk3532@...>
                                                > To: defencepeds@yahoogroups.com
                                                > Sent: Fri, Sep 2, 2011 17:52:59 GMT+00:00
                                                > Subject: Re: [defencepeds] Immunization Policy For Armed Forces
                                                >
                                                > dear seniors and colleagues
                                                >
                                                > we at gorakhpur give the patient optional vaccine on subsidised rates from
                                                > civil firm. problem we face sometime when patient gets an optional vaccine
                                                > free of cost from some command hospital and when they come to gorakhpur
                                                > they are very skeptical and show doubts.
                                                > in todays scenario where patient wants everything starting from
                                                > rotavirus,prevenar etc inspite of telling them about the categorisation of
                                                > vaccines it sometimes becomes very difficult. i have also faced this
                                                > business of anonymous complaint. there should be a common policy that eg
                                                > vaccines like hib,typhoid,MMR would be given free in all service hospitals.
                                                > for other vaccines if parents wish they will have to buy.
                                                >
                                                > Sqn Ldr Vvek Kumar
                                                > Gorakhpur
                                                >
                                                > On Thu, Sep 1, 2011 at 7:43 PM, deepak joshi
                                                > <deepakjoshi6562@...>wrote:
                                                >
                                                >> **
                                                >>
                                                >>
                                                >> Aparajita
                                                >>
                                                >> i had floated a soc to corps HQs in jodhpur and we were able to get rs
                                                >> 2000 per child per year from them. this way i could provide HiB, MMR and
                                                >> Typhoid vaccines free of cost to all children for about an year.Thereafter
                                                >> as the load sky-rocketed, we were subsidising 50% cost. What worked in our
                                                >> favour was a sensitized FWO/ AWWA and backing from Brig MED.
                                                >> But even trying to get paid vaccines into MH dehradun is looking tough
                                                >> because of anonymous complaints earlier when my predecessor had tried.
                                                >> However we are going ahead with it again after informing the higher
                                                >> formations. My Commandant is quite convinced that we should be abl
                                                >
                                                >



                                                --
                                                Dr Arvind Gupta, MD
                                                Sr Cons and HOD (Paeds) and                                          
                                                Chief Medical Administrator                                                     
                                                Asian Institute of Medical Sciences                         
                                                Badkal Flyover Road, Sec: 21-A                              
                                                Faridabad (Haryana)-121001

                                                Res: House No: 880 (GF)/Sec:21-C, Faridabad (Haryana)-121001

                                                Mob: +91-9717915848, +91-9650099133
                                                Res:  +91-129-4085848





                                                --
                                                Col Madhuri Kanitkar
                                                Senior Advisor Pediatrics and Pediatric Nephrology
                                                Base Hospital Delhi Cantt &
                                                Prof & HOD Pediatrics
                                                Army College of Medical Sciences
                                                New Delhi 110010 India




                                                --
                                                Col Madhuri Kanitkar
                                                Senior Advisor Pediatrics and Pediatric Nephrology
                                                Base Hospital Delhi Cantt &
                                                Prof & HOD Pediatrics
                                                Army College of Medical Sciences
                                                New Delhi 110010 India
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