From guidelines to ground reality: maximizing the benefits of IDRV in the fourth year of its implementation.

The updated Thai Red Cross Intradermal (TRC-ID) regimen is the most effective strategy for India as it uses only 40% volume of vaccines in comparison with intramuscular (IM) when 0.5 ml vial is used and 20% when 1-ml vial is used; hence, the cost-effectiveness of intradermal (ID) regimen further increases when 1 ml vial is used. To improve the compliance of ID, postexposure prophylaxis (PEP) given free of cost is the ideal solution. For availability and avoiding administrative delays, universal ID delivery of PEP is the answer. ID is safe, effective, and well tolerated. Technique of ID can be learned easily. Universal ID with 1 ml is the ethical solution, which is easy to administer and monitor, economical, effective, and imparts early immunity (Five E's).