THIRUVANANTHAPURAM: An acute shortage of the hepatitis B vaccine is endangering the lives of thousands of high-risk kidney patients. Following delays in vaccination, dialysis units -- already vulnerable environments due to frequent blood exposure -- have become increasingly susceptible to hepatitis B virus (HBV) transmission.
“This is not just a medical issue. It’s a public health crisis in the making,” warns T T Basheer, chairman of the Pratheeksha Organ Recipients Family Association (PORFA) charitable trust.
“The cost of dialysis sessions is rising because hospitals are forced to implement additional precautions to prevent blood-borne infections, including HBV.”
Hepatitis B is a highly contagious and potentially fatal liver infection, especially dangerous for renal failure patients.
Dialysis patients, who undergo treatment several times a week, are among the most vulnerable due to repeated blood handling and the reuse of dialysis equipment. Despite stringent hygiene protocols, cross-contamination remains a risk, and without vaccination, even a single lapse can result in an outbreak.
In government hospitals, a single hemodialysis session costs about `900, largely kept low by the practice of reusing the dialyser -- the artificial kidney filter -- multiple times for the same patient. But this cost-effective method is no longer safe under current conditions.
“When infection risk is high, we cannot reuse the dialyser,” says Dr Sajeev Kumar K S, professor of nephrology at Kottayam Government Medical College Hospital.
“This pushes the cost per patient up `3,200 over five sessions. And if cross-contamination happens, the entire unit is at risk. We’ve seen that before.”
In the absence of sufficient government resources, many families are forced to turn to private facilities, where monthly dialysis costs range from Rs 20,000 to Rs 30,000 -- a financial strain that’s unsustainable for most. The nationwide shortage of the hepatitis B vaccine is attributed to a combination of supply chain disruptions, manufacturing challenges, and increased demand.
As a result, the growing population of kidney patients-most of whom come from economically disadvantaged backgrounds-face greater uncertainty.
Meanwhile, the number of dialysis patients has risen sharply -- from 43,740 in 2020 to 218,410 in 2024 -- a more than fourfold increase. Studies estimate that for every 10 lakh people, there are around 8,000 kidney patients. Alarmingly, over 80% of them come from economically disadvantaged backgrounds.
This crisis is not just a medical emergency-it’s a social challenge as well, one that demands urgent attention to ensure that life-saving treatments like dialysis remain safe, accessible, and affordable for all.
Medical professionals are adopting alternative strategies to minimize infection risk.
“Many dialysis patients are prone to anemia and often require blood transfusions, increasing contamination risks,” says Dr Noble Gracious S S, associate professor at Alappuzha Government TD Medical College.
“However, new medications have helped reduce transfusion needs. We also isolate hepatitis B patients and avoid dialyser reuse when possible to limit the spread. The vaccine shortage can be managed well.”