ROUTINE IMMUNIZATION IN INDIA

ROUTINE IMMUNIZATION IN INDIA

Immunization programs are the cornerstone of public health, world over. Vaccination was practiced in India since the early 1900s, especially against small pox, in late 1940’s. In 1962, BCG inoculation was included in the National Tuberculosis Control Program. A formal program under the name of Expanded Program of Immunization (EPI) was launched in 1978(1). This gained momentum in 1985 under Universal Immunization Program (UIP). UIP was merged in child survival and safe motherhood program (CSSM) in 1992-93. Since 1997 immunization activities are an important component of Reproductive and Child Health (RCH) program. A National Technical Advisory Group on Immunization (NTAGI) was set up in 2003, and a Midterm Strategic Plan (MTSP) developed in 2004. From April 2005,immunization is an important component of RCH II under the National Rural Health Mission(NRHM).

CURRENT SCENARIO

India has one of the lowest routine immunization (RI) rates in the world(2). Estimates from the 2005-2006 Indian National Family Health Survey (NFHS-3) indicate that only 43.5% of children age 12-23 months were fully vaccinated (received BCG, measles, and 3

doses of DPT and polio vaccines), and 5% had received no vaccinations at all(3). Given an annual birth cohort of 24 million surviving infants and under 5 year mortality rate of 74/1000(4), this results in over 12.5 million under-immunized children each year.

To improve immunization coverage in the country various initiatives have been undertaken since the inception of the programme in 1985; key inputs being strengthening and expanding the cold chain system, establishing a network of outreach immunization sites, alternate vaccine delivery model, capacity building of health functionaries and medical officers and intensified polio control measures. Introduction of new and underutilized vaccines, drafting of the national vaccine policy, tracking of beneficiaries through the Maternal and Child Tracking system are some of the recent developments. However in spite of more than 25 years since inception the programme is still adversely impacted by challenges across key thematic areas of programme management, cold chain and vaccine management, recording and reporting and injection safety. To further strengthen and improve service delivery 2012-13 has been declared as the “Year of Intensification of Routine Immunization” with the objective of improving immunization coverage rates across poor performing districts and states so as to attain Global Immunization Vision and Strategy goals of 90% coverage at national and more than 80% coverage at district level. Key activities planned during the year include sustained advocacy at all levels, improved communication and social mobilization, robust and regular program reviews, comprehensive microplanning, strengthening cold chain and vaccine logistics system, special catch up rounds through immunization weeks, piloting the teeka express, improved surveillance systems, strengthened partnerships and operational research activities. The current review pertains to the existing scenario of Universal Immunization Program in the country with impetus on the existing challenges, progress achieved till date as a result of various measures and initiatives undertaken and activities lined up as a part of year of intensification of Routine Immunization.