One of the most effective and cost-effective ways to protect children’s lives and futures.
Immunization is key to child survival. Missing Routine Immunization (RI) can be life-threatening for infants. Immunization is one of the most effective and cost-effective ways to protect children’s lives and futures. More than half of the world’s most vulnerable children still miss out on the essential vaccines they need to survive and live healthy lives. Globally, 1.5 million deaths could be avoided if children were vaccinated.
In the last two decades India has made significant progress in improving health indicators, particularly those related to child health. The country was certified polio-free in 2014 and eliminated maternal and neonatal tetanus in 2015.
Immunization acts as a protective shield, keeping families and communities safe. By vaccinating our children, we are also protecting the most vulnerable members of our community, including new-born babies.
To accelerate full immunization coverage and to reach the unreached, the Government of India launched an ambitious programme called Mission Indradhanush, the largest immunization programme in the world in terms of the number of beneficiaries, geographical coverage and quantities of vaccine used, with nearly 27 million new-borns targeted for immunization annually.
Over nine million immunization sessions are held across India every year towards full immunization coverage. The Programme introduced new vaccines, including the Pneumococcal Conjugate Vaccine (PCV) and Rotavirus Vaccine (RVV). It is also rolling out a country-wide Measles-Rubella Campaign aiming to reach every child wherever they live.
Despite the progress, infectious diseases continue to contribute to a significant proportion of child mortality and morbidity in India. Nearly one million children die before their fifth birthday in India. About one of every four of these deaths are caused by pneumonia and diarrhoea - two leading infectious causes of child deaths worldwide, even though many of them can be saved by interventions such as breastfeeding, immunization and access to treatment.
Only 65 per cent of children in India receive full immunization during the first year of their life. Despite clear evidence around the power of vaccines to save lives and control disease, millions of young children around the world are missing out, putting them and their communities at risk of disease and deadly outbreaks. This is unacceptable in a world where affordable, lifesaving vaccines exist.
In India vaccination coverage varies considerably from state to state, with the lowest rates in the large central states. The highest numbers of partially immunized and non-immunized children are found in large states such as Bihar, Madhya Pradesh, Uttar Pradesh and Rajasthan.
Differences in uptake are geographical, regional, rural-urban, poor-rich and gender-related. On average, girls receive fewer vaccinations than boys and higher birth order infants have lower vaccination coverage.
As per NFHS 4, 2015-16, in India the national average for full immunization is 62 per cent, DPT-3 coverage - 78.4 per cent and for measles first dose - 81.1 per cent. Some of the newer challenges in achieving full immunization coverage include limited capacities of staff, particularly in poor-performing states and at the field level, and gaps in key areas such as predicting demand, logistics and cold chain management, which result in high wastage rates. India also lacks a robust system to track vaccine-preventable diseases.
Protecting every child to survive and thrive
Over the last 70 years, immunization has been at the heart of UNICEF’s work. No organization is better placed to deliver for children around the world. UNICEF is a technical partner of the Government of India’s immunization programme and stands committed to support the Government in ensuring that no child suffers from diseases that can be prevented through vaccination.
Expanding access to immunization is crucial to achieving the Sustainable Development Goals (SDGs). Diseases such as polio and smallpox that once killed thousands of children, have been eliminated and others are close to extinction– primarily due to safe and effective vaccines.
UNICEF partners with government and other stakeholders, including with the Ministry of Health and Family Welfare (MoHFW). UNICEF supports GAVI through proposal development, the annual progress report, and implementation. UNICEF is an active member of the National Technical Advisory Group, the Immunization Action Group, and the Polio Expert Advisory Group to support policy development.
UNICEF ensures the commitment to child rights is matched with action for every boy and girl everywhere by improving routine immunization coverage and saving children’s lives. It works with partners and other stakeholders to narrow the immunization gaps among the poor, marginalized, less educated groups in all geographic locations, rural and urban. By doing so, it ensures that every child who comes for vaccination is not turned away and receives the required and appropriate vaccine and doses. This entails ensuring that every level has the resources required – vaccinators, supplies, skills, motivation and community involvement.
Greater efforts to communicate the benefits and risks of vaccines and address issues with evidence-based information will help improve and sustain public trust in vaccines and health systems worldwide. This is why UNICEF facilitates partnerships with media, especially radio, and with faith based organizations and other community leaders and influencers, to share factual information on the benefits of immunization.
It is vital to spread awareness about the importance of immunization and ensure that parents and caregivers have the requisite information about the immunization cycle. They should know when and where to bring their children for vaccination, the duration between the doses and the importance of not missing a visit.
The recent addition to UNICEF India’s technical support on immunization portfolio is the Measles-Rubella (MR) vaccination. There has been an alarming increase in cases worldwide, even in countries where it had been eliminated - or that were close to doing so. The MR vaccine is safe and effective and has been administered to more than 324 million children in 34 states in India since February 2017. The MR vaccine used in the campaign is manufactured in India and is exported worldwide.
A recent survey in the 190 districts where Mission Indradhanush was recently implemented indicates that after the programme’s campaign the proportion of children with full immunization coverage increased by 18.5 per cent from pre-Mission Indradhanush estimates. The learnings from Mission Indradhanush are being used to reach all missed children across the Country to attain and sustain 90 per cent Full Immunization Coverage in India.
India’s commitment to improving access to vaccines has been a particularly important intervention in reducing child mortality and morbidity, and immunization remains a priority amongst decision-makers at the highest levels of government. Regular and effective immunization may be able to eradicate many diseases that plague India.