How India’s routine immunisation bounced back from disruptions of COVID pandemic

Vaccination of a child during a campaign led by the World Health Organization (WHO). (Photo by nik wheeler/Sygma via Getty Images)

When the pandemic hit India and the lockdown was imposed, routine immunisation coverage took a hit by 20-50 percent in April and May 2020.

But, two weeks into the lockdown, the Ministry of Home Affairs issued an advisory stating immunisation falls under essential services. This led to a recovery in the immunisation coverage.

By the end of third and beginning of fourth quarter of 2020, India had almost achieved pre-pandemic coverage status in routine immunisation of children and women.

According to a top official involved in the programme for children, routine immunisation was again adversely affected by the deadly second wave of COVID-19 between February and June, 2021.

India’s immunisation programme for children is one of the largest health programmes, catering to a birth cohort of 2.7 crore children annually. The programme provides vaccination against eight life‐threatening diseases (diphtheria, whooping cough, haemophilus influenzae type B (Hib) causing pneumonia and meningitis, tetanus, polio, tuberculosis, measles and hepatitis B).

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“A synchronised effort across states was adopted to monitor the immunisation drive for children alongside COVID-19 vaccination. The officials involved in district administration were directed to form a dedicated task force for immunisation of children,” the official said, asking not to be identified.

“The district officials were tasked with additional responsibility of children immunisation and to hold monthly meetings to review the progress,” he added.

Recently, vaccination against Japanese encephalitis (JE) was provided in selected endemic districts/states.

“The rotavirus vaccine (RVV) was introduced long ago and in the second half of 2021, pneumococcal vaccine, for pneumonia in children, which was initially given to only 20 percent of the birth cohort, has now been expanded to the whole country,” another official said, also seeking anonymity.

“Earlier, the pneumococcal vaccine was given to children below 1 year of age, but only to 20 percent of the cohort. Now it has been expanded for everyone since the Serum Institute of India (SII) will provide the indigenously developed pneumococcal conjugate vaccine,” the official said.

The states like Assam, Tamil Nadu and Maharashtra also organised catch-up campaigns at regular intervals at the state level for improving immunisation.

A health ministry official said that India’s improved coverage of children’s vaccination during the pandemic is also due to the concurrent monitoring of the programme. “Our current immunisation coverage is between 86 percent and 90 percent and the accountability is at both the district and state level,” the official said.

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During the first half of 2021, Mission Indradhanush 3.0 was launched and again a catch-up campaign was launched between February and April 2022 to maximise vaccination coverage.

“Thereafter, there has been a consistent effort at the state and national level to push immunisation, to track un-immunised and partially immunised children so that they are fully immunised,” the health ministry official said.

“If you look at the last 2.5 years, the number of disease surveillance labs for measles and rubella have doubled; earlier there were 14 labs and now India has 27 labs,” he added.

According to a health ministry official, by the end of this year, all the data related to vaccination of children would be available on the CoWIN platform.

“It would make it easier for us to track children who have either been partially immunised or have not been immunised at all,” the official said.