Immunization in India - Key Insights for UPSC Preparation

Table of Contents

Introduction

Immunization has been a cornerstone of India’s public health strategy, playing a crucial role in eliminating deadly diseases like smallpox and polio.
It continues to safeguard millions of lives and strengthen the country’s healthcare system. Despite these remarkable achievements, challenges such as uneven coverage and vaccine hesitancy remain significant hurdles.

Immunization is the process of protecting individuals from infectious diseases by administering vaccines.
These vaccines stimulate the body’s immune system to build resistance against specific pathogens. By doing so, immunization not only protects vaccinated individuals but also contributes to community health through herd immunity.

India has made commendable strides in expanding immunization coverage, evident from the following achievements:

Coverage Improvements: The National Family Health Survey (NFHS-5, 2019–2021) reports that 76% of children aged 12–23 months were fully immunized, a notable increase from 62% in NFHS-4 (2015–2016).
Eradication of Diseases: Smallpox was eradicated in 1977, and polio in 2014, showcasing the success of mass vaccination campaigns.
COVID-19 Vaccination Drive: India conducted one of the world’s largest COVID-19 vaccination programs, administering over 2 billion doses by 2023.

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Universal Immunization Programme (UIP): Launched in 1985, the UIP is one of the largest public health programs globally, targeting around 2.67 crore newborns and 2.9 crore pregnant women annually.
- Diseases Covered:
- Nationwide: Diphtheria, Pertussis, Tetanus, Polio, Measles, Rubella, Hepatitis B, severe forms of Tuberculosis, and Haemophilus influenzae type B-induced Meningitis and Pneumonia.
- Sub-nationally: Rotavirus Diarrhea, Pneumococcal Pneumonia, and Japanese Encephalitis.
Mission Indradhanush (2014): This initiative focuses on vaccinating unvaccinated and partially vaccinated children and pregnant women. Over 5.46 crore children and 1.32 crore pregnant women have been immunized.
Intensified Mission Indradhanush (IMI) 5.0 (2023): Aimed at closing immunization gaps, IMI 5.0 targets children under five and pregnant women who missed routine vaccinations. It includes 12 diseases such as Polio, Measles, Rubella, and Japanese Encephalitis.
Electronic Vaccine Intelligence Network (eVIN): Tracks vaccine stock, logistics, and temperature across all storage levels.
National Cold Chain Management Information System (NCCMIS): Monitors the availability and functionality of cold chain equipment.
Capacity Building: Training centers like the National Cold Chain Training Centre (NCCTE) and National Cold Chain & Vaccine Management Resource Centre (NCCVMRC) focus on maintaining cold chain infrastructure.

Disease Prevention: Vaccination shields against life-threatening diseases like polio, measles, and diphtheria. Landmark successes include the eradication of smallpox and polio.
Reduction in Infant Mortality: Immunization is among the most cost-effective ways to save children under five from preventable diseases.
Cost-Effectiveness: Vaccines reduce the financial burden of treating diseases. For instance, the rotavirus vaccine prevents severe diarrhea, lowering hospitalization costs.
Herd Immunity: High vaccination rates slow the spread of diseases, protecting even unvaccinated individuals.
Economic and Social Benefits: Healthier populations enhance productivity and reduce healthcare costs. Initiatives like Mission Indradhanush contribute to long-term economic gains.
Control of Emerging Diseases: Vaccination campaigns, such as those during the COVID-19 pandemic, significantly reduce the severity and spread of new diseases.
Global Health Contributions: India’s role as the world’s largest vaccine producer helps developing nations strengthen their immunization efforts.
Encouragement of Innovation: Immunization programs foster investment in vaccine research. India’s indigenous development of Covaxin underscores its scientific capabilities.
Addressing Antimicrobial Resistance (AMR): By reducing antibiotic usage, vaccines help combat the growing challenge of AMR.

Geographical Disparities: Immunization rates vary widely, with states like Kerala and Tamil Nadu achieving over 90% coverage, while Uttar Pradesh and Bihar struggle below 60%.
Vaccine Hesitancy: Misinformation, cultural beliefs, and fear of side effects deter many from getting vaccinated. WHO surveys have highlighted reluctance toward newer vaccines like those for COVID-19.
Inadequate Infrastructure: Rural areas often lack functional cold chain systems. Only 60% of Primary Health Centers (PHCs) are equipped with adequate cold chain infrastructure.
Migrant Populations: High mobility among migrant workers and urban slum dwellers leads to gaps in routine immunization.
Awareness Deficits: A UNICEF study revealed that over 25% of rural families were unaware of newer vaccines like the rotavirus vaccine.
Resource Constraints: India spends $9 per child on immunization, far below the global middle-income average of $58.
Vaccine Wastage: Poor storage and distribution practices contribute to wastage rates of 15–30%.
Workforce Shortages: A 30% shortfall in Auxiliary Nurse Midwives (ANMs) hampers vaccine delivery in underserved regions.
Pandemic-related Strains: The diversion of resources to manage COVID-19 disrupted routine immunization, reducing DPT3 coverage by 12% during the pandemic.

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Strengthen Infrastructure: Improve cold chain systems and healthcare facilities, especially in rural and underserved areas.
Target Vulnerable Populations: Implement focused strategies for regions and communities with low coverage rates.
Boost Awareness Campaigns: Address vaccine hesitancy through community outreach and education programs.
Leverage Digital Tools: Expand the use of technologies like eVIN to monitor vaccine stock and distribution in real time.
Integrate Immunization Programs: Link vaccination efforts with other health and welfare schemes under a one-health approach.
Increase Funding: Enhance financial allocations to match global standards, ensuring wider vaccine coverage.
Strengthen Workforce: Recruit and train more healthcare workers to improve vaccine delivery.