Sep 06, 2024 09:15 PM IST
Routine immunisations need to go beyond routine. The recent stagnation in immunisation coverage highlights the need for renewed vigilance
The recent detection of polio in a two-year-old child in Meghalaya is a stark reminder that India must remain vigilant despite being declared polio-free in 2014. This unfortunate occurrence highlights the importance of strengthening our immunisation efforts. In India, this means intensifying efforts and adding new vaccines against preventable diseases. Any child or adult who can be saved must be saved—this is what immunization does.
India’s success in eliminating diseases like polio and neonatal tetanus is largely due to our Universal Immunisation Programme (UIP). Mission Indradhanush, launched in 2014, reflected India’s commitment and proactive approach to immunisation. Mission Indradhanush, distinct from the UIP, was launched to target children who missed routine vaccinations. Using the polio microplanning approach, health workers conducted house-to-house surveys to identify unvaccinated children, starting in districts with the highest numbers of missed vaccinations. A quantum jump in coverage, through a focus on both newly eligible and previously missed children, was the aim. These efforts have not only earned India global recognition but also reinforced the nation’s position as a leading vaccine supplier. During the Covid-19 pandemic, India demonstrated its commitment to immunisation by allocating ₹35,000 crore to vaccination efforts. The budget for the ongoing fiscal year continues this focus, specifically targeting the rollout of cervical cancer vaccines.
The pandemic, however, presented an unprecedented challenge. Despite this, India managed to execute one of the largest vaccination drives in the world, with CoWIN playing a key role. As with many parts of the world, the pandemic’s focus on Covid-19 vaccinations inadvertently led to disruptions in routine immunisation services. This shift resulted in a decline in overall vaccination coverage, highlighting the need to restore and enhance routine immunisation efforts.
UNICEF data has revealed a concerning stagnation in global childhood immunisation rates, exacerbated by the pandemic. Since 2019, there has been an increase of 2.7 million un- or under-vaccinated children worldwide. The global DTP3 vaccine coverage remains stalled at 84%, and measles vaccination rates have not reached the 95% target necessary to prevent outbreaks. In India, the number of zero-dose children has risen from 1.1 million in 2022 to 1.6 million in 2023.
This underscores India’s need to reinforce immunisation efforts. India can build on the successes of Mission Indradhanush by expanding the range of vaccines, ensuring they reach the underserved areas. This is crucial for overcoming logistical challenges and ensuring that immunisation services are accessible. Furthermore, digital platforms like U-WIN have tremendous potential to go beyond repositories for vaccination records and actively support service delivery. By integrating these platforms into the broader health care system, India can improve vaccine coverage and ensure sustained and effective immunisation efforts. Finally, to ensure we don’t let polio gain the upper hand, we must expedite efforts to expand IPV coverage to all under-five children.
Routine immunisations need to go beyond routine. The recent stagnation in immunisation coverage highlights the need for renewed vigilance. Nothing should lower the focus on immunisation. By learning from successful initiatives and coordinating national efforts, we can overcome the current challenges and ensure every child is protected.
CK Mishra is a former health secretary, GoI, and co-founder of Partnerships for Impact (P4i).The views expressed are personal
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