The study indicates that the six-in-one vaccine could provide economic benefits, save on the number of injections, improve the efficiency of operations, and become an effective vaccine if it is made available and affordable.
NEW DELHI, 4th August 2026, A study led by Dr. Pawan Kumar and Dr. Kapil Singh from the Ministry of Health and Family Welfare, Government of India along with Dr. Susmita Chatterjee from The George Institute for Global Health India, Dr. Arindam Ray and Dr. Amrita Kumari from The Gates Foundation, Dr. Homero Hernandez from Gavi, The Vaccine Alliance, and Dr. Arup Deb Roy from John Snow India Private Limited found that introducing the hexavalent (six-in-one) vaccine into India's Universal Immunization Programme (UIP) could improve the efficiency of the country's childhood immunization programme. The vaccine will reduce the number of injections that infants receive, ease the workload of frontline health workers, lower cold-chain requirements, and save caregivers' time.
The hexavalent vaccine is a six-in-one combination vaccine that protects children against six serious diseases including diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type b (Hib), and polio in a single shot. By combining multiple vaccines into one, it reduces the number of injections infants receive during routine immunization visits.
Almost 26 million Indian babies are vaccinated annually as part of the nation's immunization programme. At present, children receive multiple vaccines during immunization visits, increasing the number of injections they receive, placing additional demands on caregivers' time, and adding to the workload of healthcare providers.
Researchers found that the price of the hexavalent vaccine remains the single largest determinant of overall programme costs. Based on historical trends in vaccine procurement in India, the study estimates that a 50 per cent reduction in vaccine price would enable the operational and system-level savings to outweigh the additional vaccine acquisition costs under the primary immunization schedule.
The research shows that introducing the hexavalent vaccine could deliver several benefits, including:
- Fewer injections for infants, making vaccination more convenient for children and caregivers
- Lower cold-chain storage requirements
- Reduced use of syringes and other vaccination supplies
- Less time spent by Auxiliary Nurse Midwives (ANMs) administering vaccines and maintaining records
- Lower workload for cold-chain handlers and vaccine managers
- Time savings for parents and caregivers during immunization visits
The study assessed two implementation scenarios: replacing the current pentavalent and fractional IPV doses with the hexavalent vaccine during the primary immunization schedule, and replacing both the primary schedule and the DTP booster dose with the hexavalent booster. Costs were assessed from both government and household perspectives, including vaccine procurement, syringes, cold-chain logistics, healthcare worker time, and caregiver time.
The findings were published in the peer-reviewed, international journal for vaccine research and immunization, Human Vaccines & Immunotherapeutics. Previous stakeholder research cited by the authors found that caregivers generally prefer fewer injectable vaccines during each visit.
"Combination vaccines have long been recognised for simplifying immunization programmes while improving convenience for families and health systems. Our study demonstrates that although the hexavalent vaccine carries a higher upfront procurement cost, it also generates important efficiencies by reducing injections, easing pressure on frontline health workers, lowering cold-chain requirements and saving caregivers' time. These findings provide important economic evidence that can inform future policy discussions on strengthening India's immunization programme.
By:Dr. Susmita Chatterjee
Program Head - Health Economics, The George Institute for Global Health In
The study provides important economic evidence to inform future policy discussions and highlight the importance of strategic vaccine procurement and pricing in improving affordability while strengthening India's immunization programme.
