Are all vaccines recommended by your paediatrician actually required or merely pushed to favour vaccine companies that reward the biggest association of paediatricians in India A key official of the Indian Academy of Paediatricians (IPA) has raised serious issues of funding and conflict in an open letter to the president. The association, one of biggest for paediatricians in India, is heavily dependent on funding from vaccine manufacturers, he pointed out. Immunisation guidelines are tweaked to include products of the funding companies, he alleged, and the technical committee members who decide the guidelines are on the board of vaccine manufacturers and paid by them. Paediatricians, in turn, get hefty margins on vaccines they administer.The open letter was sent by Dr Vipin Vashishtha, convener of IPA’s Advisory Committee on Vaccines and Immunisation Practices (ACVIP), to president Dr Anupam Sachdeva. It followed a controversy sparked off by IAP’s recommended Immunisation Schedule 2016 being removed from the website of its journal, Indian Paediatrics, after being approved by the advisory committee, IAP office bearers, its executive board and the editorial board of the journal. The schedule was uploaded on August 27 and removed on September 3. In his letter, Vashishtha sought an explanation on the move and asked whether it had been done at the behest of the industry.Vashishtha had written to Sachdeva and other ACVIP members several times in the past on various issues, including non-submission of conflict of interest declarations by members before taking part in the technical committee meetings. He also questioned why a committee was not constituted to scrutinise the declarations, as was done earlier, since “there may be some attempts to suppress full information or submitting of incorrect information”.Receiving no response to his mails, Vashishtha decided to go public with an open letter in which he raised questions about the working of the IAP and the way every new president relied “heavily on vaccine manufacturers for the funding of their so called annual ‘Action Plans’ and to carry out their key activities and conferences”. The letter added that vaccine companies regularly sponsor key IAP conferences, updates and refresher courses. They also sponsor lectures by opinion leaders in IAP, it pointed out, while asking for details of such activities by vaccine companies in the past few years.“Is it wrong to expose ‘unscrupulous’ marketing practices of vaccine companies? Is it ‘unethical’ to comment on the excessive cost difference between the MRP of a product and the price at which it is offered to a doctor? Since the private sector of vaccines is poorly supervised, and there is no guideline from the government to control or regulate this sector, is it unconstitutional for IAP ACVIP to highlight these issues?” asked Vashishtha.Contacted by TOI, Sachdeva said he had nothing to say on the issue as it was an internal matter of the IAP and would be taken up in its board meeting in January. Dr Ajay Gambhir, one of the ACVIP members named by Vashishtha, said the dependence on vaccine industry funding was a problem the association was working to address. “Dr Vashishtha has been a convener of the ACVIP for four to five years. He is well aware of IAP’s ties with the vaccine industry and about members being on the board of vaccine manufacturers. Why is he raising these issues now? The guidelines were taken off the website because there were problems with it and we will take it up in our meeting in January,” said Gambhir.