India child immunisation drive gathers speed, but faces bumps

India has made good progress in the mission to save its infant and child population from preventable diseases and death through its immunisation programmes, but lack of awareness, misconceptions, lack of reach and health staff shortage remain key challenges in getting every child into the protective net, according to reports from different Indian states.

India has had a government-led Universal Immunisation Programme since 1985. It was enhanced with another programme called Mission Indradhanush (Rainbow) launched in 2014, aimed at providing full immunisation to children up to two years and pregnant women, to prevent seven vaccine-preventable diseases through more focused interventions in low performance districts.

According to results from the latest National Family Health Survey (4) conducted in 2015-16, the number of children between one and two years old who have been fully immunised has risen to 62 percent from 43.5 percent a decade earlier. See http://rchiips.org/NFHS/pdf/NFHS4/India.pdf

The NFHS definition of fully immunised is that the children have received BCG (for tuberculosis), measles and 3 doses each of polio and DPT (for diphtheria, whooping cough and tetanus) vaccines.

This has probably helped India’s mortality rate for infants under five years of age drop by more than 32 percent to 50 per 1000 live births from 74 in 2005-06, as NFHS (4) data shows.

India’s infant mortality rate, which measures the number of deaths of infants below one year of age per 1000 births, has dropped by 28 percent over the past decade, to 41 from 57. 

However, though child mortality rates are falling and immunisation rates rising, they have a long way to go towards satisfactory numbers. The United Nations’ Sustainable Development Goals state that by 2030 the world should end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.

Amar Ujala correspondent Raza Shastri, in a special report from Dehradun in the northern state of Uttarakhand for World Immunisation Week in April, said that district health officials were calling for greater awareness to improve child health through immunisation. He quoted Dr D.S. Rawat, Director General Health, Medical and Family Welfare as saying that there are still misconceptions among some parents who are unwilling to vaccinate their children. Chief among them are that vaccination led to fever, weakness, stunted growth and even death.

Rawat dispelled these notions and said initial fever and weakness was not alarming and a sign instead that the vaccine was taking effect. He said the more children were vaccinated, the less chance of community infections arose.

Hindustan Times correspondent P. Srinivasan, reported from Jaipur in the North-western state of Rajasthan that the children not in the full immunisation net included left-outs - those who did not get a single vaccine, as well as drop-outs – those who did not complete the immunisation programme. He quoted Dr V.K. Mathur, public health director, as saying the reasons for this included fear of adverse effects of immunisation, inaccessibility of many remote villages and hamlets, lack of awareness among parents, migrating population and shortage of staff to administer the vaccines.

Amar Ujala reported from  Pithoragarh in Uttarakhand that a whole tribe in the Himalayan region, the Van Rawat tribe, has absolutely no clue about vaccination. The region is so remote that the government’s programmes have not been able to reach the tribals who are so poor, uneducated and struggling to make ends meet that immunisation is anyway not a priority.

Sandeep Kumar Singh, reported for the Hindustan in Gaya district of the North-eastern state of Bihar, that 15 percent of district’s children have not been vaccinated despite constant immunisation drives. He quoted district immunisation officer Dr Surendra Chaudhary as saying again that lack of awareness and misconceptions about vaccination as chief reasons for this, especially in rural areas.

The India Saga’s Annapurna Jha quoted India’s Health Minister J.P. Nadda as saying the government was seeking the help of community leaders and non-governmental organisations to deal with misconceptions about immunisation.  The vaccine coverage under Mission Indradhanush has risen to eleven now, including those against MMR (measles, mumps, rubella), Rota virus and Japanese Encephalitis to check mortality among children Nadda said, according to Jha’s report.

India Saga’s Aarti Dhar later reported that India has also now made available the PCV vaccine (Pneumococcal Conjugate Vaccine) under its Universal Immunisation Programme to protect children against severe forms of pneumonia and meningitis, which are the leading cause of vaccine-preventable deaths in India.

With this inclusion, Indian children can be protected against 12 vaccine-preventable diseases.