In view of new developments in vaccinology and the availability of new vaccines, there is a need to revise/review the existing immunization recommendations. Process: Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP) had a physical meeting in March, 2020 followed by online meetings (September-October, 2020), to discuss the updates and new recommendations. Opinion of each member was sought on the various recommendations and updates, following which an evidence-based consensus was reached. Objectives: To review and revise the IAP recommendations for 2020-21 and issue recommendations on existing and new vaccines. Recommendations: The major changes include recommendation of a booster dose of injectable polio vaccine (IPV) at 4-6 years for children who have received the initial IPV doses as per the ACVIP/IAP schedule, reemphasis on the importance of IPV in the primary immunization schedule, preferred timing of second dose of varicella vaccine at 3-6 months after the first dose, and uniform dosing recommendation of 0.5 mL (15 µg HA) for inactivated influenza vaccines.

Justification Data generated after the first wave has revealed that some children with Coronavirus 19 (COVID-19) can become seriously ill. Multi-inflammatory syndrome in children (MIS-C) and long COVID cause significant morbidity in children. Prolonged school closures and quarantine have played havoc with the psychosocial health of children. Many countries in the world have issued emergency use authorisation (EUA) of selected COVID-19 vaccines for use in children. In India, a Subject Expert Committee (SEC) has recommended the use of Covaxin (Bharat Biotech) for children from the ages of 2–18 years. The recommendation has been given to the Drugs Controller General of India (DCGI) for final approval. Objective To provide an evidence-based document to guide the pediatricians on the recommendation to administer COVID vaccines to children, as and when they are available for use. Process Formulation of key questions was done by the committee, followed by review of literature on epidemiology and burden of COVID-19 in children, review of the studies on COVID vaccines in children, and the IAP stand on COVID-19 vaccination in children. The available data was discussed in the ACVIP focused WhatsApp group followed by an online meeting on 24 October, 2021, wherein the document was discussed in detail and finalized. Recommendations The IAP supports the Government of India’s decision to extend the COVID-19 vaccination program to children between 2–18 years of age. Children with high-risk conditions may be immunized on a priority basis. The IAP and its members should be a partner with the Government of India, in the implementation of this program and the surveillance that is necessary following the roll-out.

Background: Respiratory illnesses in children form a substantial disease burden in emergency care, outpatients and hospitalised patients. Studies exploring the pattern of emergency room visits and hospitalization for individuals with respiratory complaints could inform decisions regarding the effective organisation and planning of health services.Methods: The present prospective observational study was conducted in children between one month to 18 years of age admitted with acute respiratory illness at Institute of Child Health, Kolkata from1st of February 2015 - 28th of February 2015. Results: Preliminary data shows that most of them were diagnosed provisionally as pneumonia (30%) followed by wheeze associated lower respiratory infection (WALRI) (29%). Approximately 10% of admitted patients required PICU support. Antibiotics and bronchodilators were the most commonly used medications.Conclusions: CRP is significantly elevated in bacterial respiratory tract illnesses but a normal or low CRP does not exclude bacterial infection. Best practice may be to avoid antibiotics where possible unless clinically indicated and hospital courses determine so.

Background: Respiratory infections are increasing globally with parallel increase in world population, pollution, urbanization, overcrowding, global warming and poverty. Multi drug resistant virulent bacteria are growing very rapidly. The objective of this study was to know the prescribing pattern of antibiotics in hospitalized patients suffering from different common respiratory disorders.Methods: This was a retrospective and observational study. Data was captured from 1st January 2016 to 31st December 2016 at ICARE Institute of Medical Sciences and Research and Dr. B.C.Roy Hospital. Total 200 patients were taken for the study of age range from 10 to 50 years.Results: COPD, bronchial asthma, pneumonia and ARIs were the most frequent respiratory illnesses among patients attended Medicine OPD. Most common antibiotics prescribed were co-amoxyclav, ceftriaxone, moxifloxacin, clarithromycin, azithromycin and aminoglycosides.Conclusions: Injudicious use of antibiotics in trivial viral respiratory infections may give rise to antibiotic resistant strains in the community.

Background: India has one of the highest tuberculosis (TB) burdens globally. However, few studies have focused on TB in young children, a vulnerable population, where lack of early diagnosis results in poor outcomes.Methods: The present study was undertaken to assess the sensitivity and specificity of tuberculin test (Mantoux) and BCG test in diagnosis of childhood tuberculosis and to compare above tests as a diagnostic tool and to assess the impact of factors affecting the test. Mantoux test was done with 1 TU contained in 0.1 ml of PPD R23 with tween 80 solution. BCG test was done using a heat stable freeze-dried vaccine, after fresh reconstitution and injected intradermally in left deltoid region with a tuberculin syringe and 27 G hypodermic needle.Results: Tuberculous cases were more common in malnourished subjects more so with severe malnutrition. While maximum positivity 89% was obtained with BCG test, it was only 63% with Mantoux test, done with 5TU of PPD-RT-23. BCG was always positive whenever PPD was positive in any group of children. Sensitivity of Mantoux test was around 63% whereas that of BCG test was 89%. BCG test was more significantly associated with disease than tuberculin test (p <0.001).Conclusions: BCG test is a very sensitive and specific test for diagnosis of childhood tuberculosis. Mantoux test is affected by malnutrition and severity of disease whereas BCG test is affected only minimally. BCG test is more sensitive than Mantoux test (with 5TU PPD RT 23 Tween 80). A BCG induration of ≥10 mm or Mantoux induration ≥15 mm or an accelerated BCG test is indicative of active disease, irrespective of vaccination status of the patient.