In 2008, the Committee recommended that the NPI suspend the introduction of the DPT-hepatitis B-Hib vaccine, following several cases of hypotonic hypo responsive episodes (HHE), which resulted in five deaths [10].

Rubella vaccine was also placed on hold for a brief period, following S3I-201 molecular weight a series of suspected cases of hypersensitivity among vaccine recipients and one death. Recommendations to reintroduce both the DPT-hepatitis B-Hib and rubella vaccines after independent investigations were also made by the ACCD [11]. The reassurance resulting from the Committee’s recommendations to the panicked public, the media and resistant trade unions has helped restore the public’s confidence in these vaccines, as well as the credibility of the NPI. To deal with such cases, which have started to negatively impact the NPI, the ACCD approved the establishment of an Expert Committee

on AEFI. This sub-committee has become a critical arm of the ACCD in determining the role of vaccines in reported cases of severe AEFI and in making recommendations to minimize adverse events. The sub-committee analyzes reported cases of severe adverse events and deaths possibly linked to vaccination, initiates further detailed investigations, reviews these investigation reports as well as independent investigations, and issues appropriate recommendations. As an example, during the recent spate of deaths among recipients of DPT-hepatitis B-Hib vaccine, an emergency Selleckchem Paclitaxel session of the ACCD was convened to determine how to address the continued occurrence of deaths and cases of severe AEFI. The ACCD assigned the Expert Committee on AEFI the task of conducting an Phosphoprotein phosphatase assessment of all deaths and cases of severe AEFI that were temporally associated with the DPT-hepatitis B-Hib vaccine

and that had been primarily investigated by NPI managers. For exceptionally complex cases, members from the AEFI Expert Committee conducted field investigations to determine causality. The Expert Committee first recommended that the current batch of vaccine be replaced with a new batch, in case the adverse events were due to the particular batch being used. These recommendations were carried out, but as more surveillance data came in showing the continued occurrence of adverse events among children who had received vaccines from the second batch, the Expert Committee recommended to the ACCD that the vaccine be withdrawn from the program until a final determination could be made about the role of the vaccine in these adverse events. The ACCD approved these recommendations—a decision that was not easy to make as opinions among Committee members were divided.