Immunization Programme is one of the key interventions for protection of children from life threatening conditions, which are preventable. It is one of the largest immunization programme in the world and a major public health intervention in the country.
Immunization Programme in India was introduced in 1978 as Expanded Programme of Immunization (EPI). The programme gained momentum in 1985 and was expanded as Universal Immunization Programme (UIP) to be implemented in phased manner to cover all districts in the country by 1989-90.
UIP become a part of Child Survival and Safe Motherhood Programme in 1992. Since, 1997, immunization activities have been an important component of National Reproductive and Child Health Programme and is currently one of the key areas under National Rural Health Mission (NHM) since 2005.
It targets to vaccinate 2.7 crore new born and 3 crore pregnant mothers annually for vaccines under UIP.
More than 90 lakh Immunization sessions are conducted annually with nearly 27,000 cold chain points across the country.
Under the Universal Immunization Programme, Government of India is providing vaccination to prevent eight vaccine preventable diseases nationally, i.e. Diphtheria, Pertussis, Tetanus, Polio, Measles, severe form of Childhood Tuberculosis and Hepatitis B and meningitis & pneumonia caused by Haemophilus influenza type B, and against Japanese Encephalitis in selected districts.
Polio: India reported its last case of polio on 13th January 2011. South East Asia Region (SEAR) has been certified Polio free on 27th March, 2014. As a part of Polio end game strategy, Injectable Polio Vaccine (IPV) vaccine has been introduced in 6 states from 30th November 2015 in Phase1. In 2016, IPV will be introduced in the remaining states.
Measles: Nationwide coverage of Measles first dose was started in 1985 in Routine immunization (RI). 2nd dose of Measles was introduced in 2010; in 22 states immediately in RI and in remaining 14 states in RI after campaign (Measles Supplementary Immunization Activity) covering ~12 crore children. As on date, the entire country is providing two dose measles vaccine schedule under routine immunization.
Hepatitis B: Hepatitis B vaccine was piloted in 2002-03 and then scaled up in entire country in 2010 to protect children from liver diseases such as Jaundice and Cancer.
Pentavalent vaccine: Pentavalent vaccine contains five antigens i.e. Hepatitis B, Diphtheria + Pertussis + Tetanus (DPT – current trivalent vaccine) and Haemohilus influenza b (Hib) vaccine. Pentavalent vaccination is provided to the children at the age of 6, 10 and 14 weeks as primary dose. The vaccine has replaced DPT and Hep B vaccine in the immunization schedule. However, birth dose of Hep B and two booster doses of DTP (at 16-24 month and 5 years of age) will continue to be given. India introduced Pentavalent vaccine initially in two states viz. Kerala and Tamil Nadu in December 2011. At present, Pentavalent vaccine has been expanded to all 36 States/UTs.
Rotavirus Vaccine: to be given under UIP as a 3 dose vaccine along with DPT 1st, 2nd and 3rd dose in a phased manner, initially in four states i.e. Andhra Pradesh, Odisha, Haryana and Himachal Pradesh in first quarter of 2016. Subsequently, the vaccine will be scaled up in entire country.
Japanese encephalitis: Japanese Encephalitis (JE) is an acute viral illness with high case fatality and long term complications. JE vaccination program started in 2006 in JE endemic areas with strategy to cover all children of 1-15 years of age in mass vaccination drive (campaign mode) and subsequent integration into routine immunization. Out of total 204 identified JE endemic districts across 21 states, campaign activity has been completed in 182 districts and JE vaccine has been introduced as a part of RI in those districts (two doses, first at 9-12 months and second at 16-24 months). In addition, there is a plan to cover remaining districts in subsequent years.
Adult JE vaccination: Recently, NVBDCP has identified 21 high burden districts from Assam, Uttar Pradesh and West Bengal for adult JE vaccination (5 districts in Assam, selected blocks of 7 districts in UP and selected blocks 9 districts in West Bengal).
MNTE validation: Maternal and Neonatal Tetanus Elimination has been validated in all 36 state/UTs of the country (2001-15) with support from partners (WHO, UNICEF). India validated MNTE by May 2015, well before the global target date set by WHO of December 2015. .
Mission Indradhanush: Launched on 25th December, 2014, this seeks to drive towards 90% full immunization coverage of India and sustain the same by year 2020. The objective of Mission Indradhanush is to fully immunize more than 89 lakh children who are either unvaccinated or partially vaccinated; those that have not been covered during the rounds of routine immunization for various reasons. Vaccination will be provided against seven vaccine preventable diseases, i.e. diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis-B. In addition, vaccination against Japanese Encephalitis and Haemophilus influenza type b will be provided in selected districts/states of the country. Pregnant women will also be immunised against tetanus. In the first phase, rounds were conducted in identified 201 high focus districts of 28 states. Four special vaccination campaigns, of more than a week, from April to July 2015 were conducted, starting from 7th of each month, with intensive planning and monitoring of these campaigns. As per the data available, during the four rounds of Mission Indradhanush, 9.4 lakh sessions were held, during which 1.89 crore vaccines were administered to the children and pregnant women. During these immunization rounds 75.5 lakh children were vaccinated and a total of 19.7 lakh children were fully vaccinated. Also, a total of 20.8 lakh pregnant women were vaccinated with tetanus toxoid vaccine, along with, a total of 16.7 lakh ORS packets and 56.8 lakh zinc tablets distributed to the children during these four rounds.
As per the data available, during the four rounds of Mission Indradhanush, 9.4 lakh sessions were held, during which 1.89 crore vaccines were administered to the children and pregnant women. During these immunization rounds 75.5 lakh children were vaccinated and a total of 19.7 lakh children were fully vaccinated. Also, a total of 20.8 lakh pregnant women were vaccinated with tetanus toxoid vaccine, along with, a total of 16.7 lakh ORS packets and 56.8 lakh zinc tablets distributed to the children during these four rounds.
The Full Immunization coverage as assessed by various surreys is as below:
Coverage Evaluation Survey (CES 2009)
Rapid Survey on Children (RSOC 2013-14)
The total financial outlay for Routine Immunization for 2014-15 was Rs 1068.10 cr as Budget Estimate and Rs. 740cr as Revised Estimate. The Budget Estimate for the year 2015-16 is Rs. 700 cr. This includes cost for vaccine, syringes, cold chain and operational cost provided to the sates/UTs under PIP.