12/01/2016

MissionIndradhanushtoPutVaccinationEffortsonHighSpeed

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PressInformationBureau
GovernmentofIndia
SpecialServiceandFeatures
27March201512:18IST

MissionIndradhanushtoPutVaccinationEffortsonHighSpeed
90%ChildrentoBeCoveredinNextFiveYearsBy2020
Feature
Health
Dr.H.R.Keshavamurthy*
Vaccinationisaprovenandoneofthemostcosteffectivechildsurvivalinterventions.Allcountriesintheworldhavean
immunizationprogrammetodeliverselectedvaccinestothetargetedbeneficiaries,speciallyfocusingonpregnantwomen,
infantsandchildren,whoareatahighriskofdiseasespreventablebyvaccines.Thenumberofvaccinesintheimmunization
programmes varies from country to country however, there are a few selected vaccines against Diphtheria, Pertussis,
Tetanus,Poliomyelitis,Measles,andHepatitisBwhicharepartofimmunizationprogrammesinmostofthecountriesinthe
world.
Thoughaprovencosteffectivepreventiveintervention,thebenefitsofimmunizationisnotreachingmanychildrenwhoare
at the maximum risk of the diseases preventable by these vaccines. Majority of the children who do not receive these
vaccines live in developing countries. Studies have revealed that children are left uncovered by the routine immunisation
programmeeitherbecausetheparentsandguardiansareunawareofthedrive,orthereissomeelementofapprehensionor
fear due to vaccination. Both these can be effectively addressed through an awareness campaign which underlines the
criticalimportanceofvaccination,andremovesanyapprehensionharbouredbytheparentortheguardian.
IndianScenario
2.7CrorechildrenareborninIndiaeveryyear.Approximately18.3lakhschildrendiebeforetheirfifthbirthday.Itisthe
low income families who lose the most children to disease. India records 5 lakh child deaths annually due to vaccine
preventable diseases. Despite high childhood mortality rates due to vaccine preventable diseases, 30 percent of Indian
childrenmissthebenefitsoffullimmunizationeveryyear.Thatis,anestimated89lakhschildrenacrossthecountrythat
eithergetonlyafewvaccinesornovaccinesatall.Oneoutofevery3childreninIndiadoesnotreceiveallvaccinesthatare
availableunderUIP.Fivepercentofchildreninurbanareasand8percentinruralareasareunimmunized.
TheGovernmentofIndiarecognizesimmunizationasoneofthemostcosteffectiveinterventionstopreventchilddeaths.
IndiasUniversalImmunizationProgrammeisoneofthelargestpublichealthinterventionsinthecountrywithanextensive
vaccinedeliverysystemwith27000vaccinestorageunitsin35statesacrossthecountry.80%ofvaccinationtakesplacein
theoutreachsessions,heldinthousandseachyearinmorethan6lakhvillagesandotherurbanbelts.
UniversalImmunisationProgramme(U.I.P.)
It is one of the largest in the world in terms of quantities of vaccine used, the number of beneficiaries, the number of
Immunisation session organised, the geographical spread and diversity of areas covered. The national policy of
Immunisation of all children during the first year of life with DPT, OPV and BCG to complete the series of primary
vaccinationbeforereachingtheageofoneyearwasadoptedin1978withthelunchingofEPItoincreasetheImmunisation
coverage in infancy to 80%. Universal Immunisation programme UIP was launched in 1985 in a phased manner. The
measlesvaccinewasaddedin1985andin1990VitaminAsupplementationwasaddedtotheprogram.
TheVaccinationScheduleundertheUIP
1.BCG(BacillusCalmetteGuerin)1doseatBirth(upto1yearifnotgivenearlier)
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MissionIndradhanushtoPutVaccinationEffortsonHighSpeed

2.DPT(Diphtheria,PertussisandTetanusToxoid)5dosesThreeprimarydosesat6weeks,10weeksand14weeksandtwo
boosterdosesat1624monthsand5Yearsofage
3.OPV(OralPolioVaccine)5doses0doseatbirth,threeprimarydosesat6,10and14weeksandoneboosterdoseat16
24monthsofage
4.HepatitisBvaccine4doses0dosewithin24hoursofbirthandthreedosesat6,10and14weeksofage.
5.Measles2dosesfirstdoseat912monthsandseconddoseat1624monthsofage
6.TT(TetanusToxoid)2dosesat10yearsand16yearsofage
7.TTforpregnantwomantwodosesoronedoseifpreviouslyvaccinatedwithin3Year
8.Inaddition,JapaneseEncephalitis(JEvaccine)vaccinewasintroducedin112endemicdistrictsincampaignmodein
phasedmannerfrom200610andhasnowbeenincorporatedundertheRoutineImmunisationProgramme.
Indiaexpandeditsimmunizationprogrammewiththeintroductionofthreenewvaccinesin2014.Thereisanurgentneedto
ensurethatthebenefitofcompletevaccinationisprovidedtoallchildreninthecountry.
Challenges
In spite of all positive changes, there are ongoing challenges and shortcoming in the programme. The coverage with
vaccinesinNationalImmunizationProgrammeissuboptimalandthereareinterandintrastatevariationsinthecoverage.
There are wide variations in the proportion of partially immunized and unimmunized children within states and districts.
Data recording and reporting is suboptimal and disease surveillance system desires improvement. It is critical to address
thesereasonsandidentifythedistrictswherefocusedefforts,systematicimmunizationdriveandadditionalresourceswillbe
requiredforreachingallchildrenwithallavailablelifesavingvaccines.
Thechallengesfacedindeliveringlifesavingvaccinestothetargetedbeneficiariesneedtobeaddressedfromtheexisting
knowledgeandlearningfromthepast.ThoughthepreventiveeffortsfromdiseaseswerepracticedinIndia,thereluctance,
opposition and a slow acceptance of vaccination have been the characteristic of vaccination history in the country. The
operationalchallengeskeepthecoverageinequitableinthecountry.Thelessonsfromthepasteventshavebeenanalysed
andinterpretedtoguideimmunizationefforts.
MissionIndradhanush
TheresultistheMissionIndradhanushlaunchedon25thDecember,2014withanaimtocoverallthosechildrenwhoare
partially vaccinated or unvaccinated. Mission Indradhanush is a nationwide initiative with a special focus on 201 high
focus districts. These districts account for nearly 50% of the total partially vaccinated or unvaccinated children in the
country. Mission Indradhanush will provide protection against seven lifethreatening diseases (Diphtheria, Whooping
Cough,Tetanus,Polio,Tuberculosis,MeaslesandHepatitisB).Inaddition,vaccinationagainstJapaneseEncephalitisand
Haemophilus influenza type B will be provided in selected districts of the country. Vaccination against tetanus will be
providedtothepregnantwomen.
Between20092013immunisationcoveragehasincreasedfrom61%to65%,indicatingonly1%increaseincoverageevery
year.Toacceleratetheprocessofimmunizationbycovering5%andmorechildreneveryyear,theMissionModehasbeen
adoptedtoachievetargetoffullcoverageby2020.Highfocus201districtswillbetakenupforimplementationinthefirst
phase. Of these, 82 districts are in just four states of UP, Bihar, Madhya Pradesh and Rajasthan and nearly 25% of the
unvaccinatedorpartiallyvaccinatedchildrenofIndiaareinthese82districtsoffourstates.Moreover,297willbetargeted
forthesecondphase.TheMissionfocusesoninterventionstorapidlyincreasefullimmunizationcoverageofchildrenby
approximately5%annuallyandtoexpandfullimmunizationcoveragefrom65%in2014toatleast90%childreninthenext
five years. Four special vaccination campaigns will be conducted between March and June 2015 and this will cover all
childrenlessthantwoyearsofageandpregnantwomenforTetanusToxoidvaccine.Thisimmunizationcampaignwillbe
conductedforaperiodof710dayseverymonthforfourconsecutivemonths.
MicroplansdevelopedtomaketheMissionmodesuccessfulwilldrawonthelessonslearnedfromthePolioeradication
towardssystemsstrengthening,vaccinecoldchainmanagement,regularsurveillanceandmonitoringoftheplanstoreach
eachandeveryleftoutanduncoveredchild.Thegovernmenthassoughttechnicalsupportfromvariousexternalagencies
likeWHO,UNICEFandRotarytoachievethegoalsofthisprogramme.
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Understandably,theimplementationofvaccinationprogrammeandensuringthatthebenefitsofvaccinesreachtoeachand
every possible beneficiary is a challenging task. Mission Indradhanush depicting seven colours of the rainbow, aims to
coverallthosechildrenby2020whoareeitherunvaccinatedorarepartiallyvaccinatedagainstsevenvaccinepreventable
diseases which include diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis B. The Mission
IndradhanushinitiativeisacallforactionbytheGovernmentofIndiatointensifyeffortstoexpeditethefullimmunization
coverage in the country. Full immunization will rescues lakhs of children from disease mortality and morbidity and is
essentialforsocialdevelopment.
*Dr.H.R.KeshavamurthyistheDirectorinPressInformationBureau,Kolkata.
(PIBFeatures)
Email:featuresunit@gmail.com
himalaya@nic.in
SS308/SF308/27.03.2015
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