1)Question- What is the specialty of the movie ?
Answer- We have produced a Tamil movie ‘Valiban sutrum ulagam ‘ with the intention of imparting some useful knowledge about some health related problems to those in medical profession and common people.The concept of the movie was appreciated by the Doctors , censor board members and commercial tax officials who had seen the movie
2) Question- What was the motivation for this movie ?
Answer- There are a lot of vaccines in the market which are not necessary to all . The film was taken with the intention of creating an awareness about the unnecessary vaccines to the public and those in medical profession.
3)Question- What are indications for Immunization ?
Answer-. The immunization is required only when the following four criteria are satisfied
1) When the disease caused by that infective agent, if occurs may cause death or disability
2) No treatment is available for that infective agent
3)The infective agent can spread easily and cause an epidemic,
4) The infective agent is present in the population
Vaccines should be administered for only those infections which satisfy the above criteria
4)Question- How the administration of unnecessary vaccines will affect the family?
Answer- As the money spent to the immunization increases , the amount spent for the basic needs like food will decrease .this will decrease the quality of life and predispose to many nutritional deficiency disorders
5)Question- How the administration of unnecessary vaccines will affect the economy of the country?
Answer- One infection ,say ‘B ‘is said to more prevalent in India ,say about 30 million people have been infected already . Now these 30 billion people need not get multiple doses of the vaccine for the Infection ‘B”. We are unnecessarily exposing the 30 billion people for the adverse effects for that the vaccine for ‘B may cause . Also the amount of money wasted on providing the vaccine for B is totally waste .(In India poverty , is the main cause of death , .The money spent of these unnecessary things can be diverted for nutrition )
6)Question- According to reports there are no adverse events reported after vaccination the last four years in Coimbatore ?
Answer- The reporting system had failed . Many adverse effect were not reported . Any event occurring after immunization should be reported .But unfortunately it is not reported by giving lame excuses that the vent is not related to immunization.
7)Question- What is the problem of using many vaccines ? More the vaccines many more diseases can be prevented ?
Answer– All the organs had its limitations. Taking three idlies will be good to the digestive system . But if three idlies ,three poories , three dosai , three chappati are taken there will be indigestion and nothing will be digested . Like wise administering number of vaccines may result in failure of immune system . Recently we are seeing outbreaks of diphtheria in immunized children .The number of vaccines should be reduced otherwise we can see many more vaccine failures in the future .
Many new vaccines are pouring in to the market .Also many new vaccines are under trial and will be introduced shortly and recommended in the near future
8)What are the conditions in which Immunization should be avoided ?
.Immunization should be avoided in the following conditions
Mere availability of vaccine should not be taken as an indication for the immunization. One should weigh the necessity and the benefits the vaccine would cause. Immunization should be avoided in the following conditions
1) When the consequences of the infection against which the child is immunized is not severe and will not lead to any sequlae.
2) When the infection is not found in the geographical area, and the likely ho od of the child moving to the area where the infection is prevalent is not present.
3) When there is an innate immunity. (For example, patients with G6PD deficiency is resistant to malaria)
4) When the infection has already occurred, and caused an immunity ( HERD immunity )
5) When the infection is mild and antibiotics are available.
6) When a natural immunity to the infection occurs in the population.
There are lot of conditions where many vaccines are contraindicated . Everyone should be aware of this . Recently in Madurai child was vaccinated with BCG which contains live Myocobacterium tuberculosis which can cause tuberculosis ( TB) , The organism had spread all over the body causing disseminated tuberculosis . Later the child was diagnosed to have been suffering from ‘ Severe Combined immune deficiency ( SCID)’.Now a case was filed against the Doctor seeking compensation .
the medical people and the public should analyze the pros and cons of a vaccine before administering them .
9)Question- What is the solution for the problem ?.
Answer- The vaccines should be classified as absolutely necessary , optional vaccines and vaccine that are needed only in special occasions.
10)Question- What is the message on multilevel marketing ?
Answer- Another important factor to be condemned is the recommendation of multilevel marketing products by medical consultants for personal gain. Te product s are sold at exorbitant rates . with most of it given as commission for recommending their products . The patients buy them because it was recommended by their medical practioners
11)Question- A message was given regarding cesarean section . What is it ?
Answer- We have come across many doctors who perform cesarean section with out indication to deliver babies .Also many people insist to deliver the babies by cesarean section on auspicious days .Both doctors and the patients are to be blamed for this practice .Many doctors are delivering all the babies by cesarean section saying that they are delivering the babies 2 or 3 days before the expected date of delivery to prevent delivery related complications like birth asphyxia
If this happens in generations the organs like vagina will become vestigial and natural delivery cannot take place in the future generation of that family . Many hormones and substances ate secreted during natural delivery which has protective effect of the child . For example many diseases like asthma is more common in babies delivered by cesarean section .
12)What are the messages you have given in the movie ?
i)Don’t advice unnecessary vaccines
ii)Those who are in medical profession don’t indulge in Multilevel marketing . Then you will prescribe unnecessary products to your patients . The products are sold at exorbitant rates . with most of it given as commission for recommending their products The patients buy them because it was recommended by their medical practioners .
iii)Don’t perform unnecessary cesarean section without indication to deliver the babies . Delivering babies only by cesarean section for generations will result in underdevelopment of organs .
iv) Spending money for unnecessary vaccines will affect the nutrition of the whole family and predispose to nutritional disorders . As the money spent to the immunization increases , the amount spent for the basic needs like food will decrease .this will decrease the quality of life and predispose to many nutritional deficiency disorders in the family .There are many mothers who starve to spare money to provide vaccine for her child . .Some where some one should try to stop all these
v) The vaccine list should be segregated in to vaccines that are definitely needed , vaccines that are optional . Single list will cause confusion and panic
vi) Vaccines should be produced and supplied by government and no one should get profit .Then only recommendation of unnecessary vaccines can be prevented . If the disease against which a vaccine is administered is so dangerous to millions of life , then it should be provided free of cost to all people who are vulnerable vii) Vaccines need should be decided without any conflict of interest
Act of commission is worse than act of omission .
.Some where some one should try to stop all these . We have taken a step towards the objective of explaining few facts about vaccines to the medical personnel and the public
13)Question- What is the specialty of the movie ?
Answer- The movie will take you to 1970s with Hero imitating MGR , and Villians imitating Nambiar and Ashokan
– M.S.Viswanthan , T.M.Soundrarajan, S.P.Balasubramaniam ,P.Suseela and Lyricist Vali had joined hands after about 30 years .
14)Question- What is the specialty of the song ‘ That bhut Tanjavure ….?
Answer- This is the last duet song by TMS and P.Suseela .
15)Question- What is the specialty of ‘Nan Deivathai petra pillai ’ song ?
Answer– One song was written with the names of titles of MGR movies
16)Question- What is the specialty of ‘Unnai naan santhithen’ song ?
Answer- The song was written with the lyrics from songs from MGR movies
PIT FALLS in Indian scenario
1) India does not have transparent and technically competent authorities to arrive at a policy decision concerning the use of old and new vaccines . In many cases it is evident that the negative factors are not taken in to consideration while recommending a vaccine ,Mere availability cannot be considered as an indication of vaccine
2)Local epidemiology is not taken in to consideration at all .
3) Adverse events are poorly understood , investigated and recorded
4) There is no proper study following vaccination .the number of vaccine failures will be known only when a breakthrough infection occurs
5)Proper documentation of vaccinations is not followed in many places This results in missed or extra doses
6)Proper storage and administration of vaccines is not satisfactory in most places . This is even worse in remote and tribal areas.
7)Financial barriers to immunization –In India where most of the people are below the poverty line , they cannot afford thousands of rupees to be spend for vaccines . Hence there is a disparity in administration of vaccines between rich and poor . Also our country is not rich enough to spend millions of rupees to prevent many diseases by immunization
8) There are no proper studies regarding many aspects of vaccines .
9) Lack of vaccine against orphan diseases . these diseases that are prevalent in developing countries and no vaccine market potential in the developed world .Hence no vaccine manufacturers are interested in manufacturing a vaccine for these diseases
10) The media causes a widespread panic and confusion among the scientific community and the public by quoting the rate of spread and number of deaths
Pitfalls in immunogenicity of a vaccine – The immunogenicity of a vaccinewill not be the same for all alike .it will vary from person to person . A person may respond well and other may not respond at all
Pitfalls in Morbidity and mortality The Morbidity and mortality are always quoted in millions all over the world . No infection is going to have the same epidemiological pattern at two places .Then how can you quote the same figure for all over the world. To give a number which will cause panic among the medical people and the public .An infection which is common in India may not be seen in USA or England .Also an infection whack is seen in USA or England may not be seen in India .Then how can we have a common Morbidity and mortality applicable to all places in the world
Pit falls in effective communication – effective communication should be given regarding the benefits and risks of the vaccination to the vaccines and the medical people
Pit falls in immunizing the mother to protect babies – now a concept has been put forward by the vaccine manufacturers .That is to prevent infection in the newborn babies the mothers can be immunized so that the antibodies will be transferred to the fetus in utero giving protection to the newborn . , Shortly we can expect a immunization schedule which includes all vaccines for pregnant mothers .There are hundreds of organisms that can cause infection in the newborn periods , Are we going to give vaccines against those organisms to the mother in the antenatal period . Suppose an organism causes infection in 5% of newborn babies for thousand deliveries it will be 50 cases which can be treated or prevented by maintaining cleanliness , But are we going to give multiple doses for all 1000 mothers . How many vaccines and how many doses are to be given to the antenatal mother to prevent infection in newborn .Also the antibodies produced in the mother can cross the placenta and damage the fetus .
Advertisements– It is true that most of the advertisements are threatening the parents rather than giving information about the vaccine to the parents. Also the advertisement should only carry the information about the vaccine and the disease .Also some common terms are projected as vaccine for jaundice, brain fever etc. There are number of causes for jaundice .So the advertisement should use only the term ‘ the vaccine against hepatitis B’.
Also brain fever is a term used meningitis, encephalitis. There are number of causes for brain fever . In our country tuberculosis, viral menigo-encephalitis is more common than H.influenza. We have not come across any H influenza as a cause of meningitis in the past 25 years. Hence such advertisements should not be done and should be discouraged ..
The morbidity and mortality is projected in millions worldwide to threaten the people and medical practioners . One should know the prevalence in the area where he is living as the epidemiology and pattern of infecting agents will vary from place to place..
If it is a real danger the government can produce the vaccines and provide it to people at low cost . unfortunately many self limiting ,easily treatable diseases are projected as dangerous diseases