WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) 2023

Global Findings:

• Stalled Immunization Coverage: In 2023, childhood immunization coverage stagnated, leaving 2.7 million children either unvaccinated or under-vaccinated.
• Conflict-Affected Countries: Over 50% of these unvaccinated children live in 31 conflict-affected countries, highlighting a significant challenge in regions experiencing instability.

Findings Specific to India:

• Missed Vaccinations:
• In 2023, approximately 1.6 million children in India missed essential vaccinations, including Diphtheria, Pertussis, and Tetanus (DPT) and measles.
• HPV Vaccination: India does not include the human papillomavirus (HPV) vaccine in its national immunization program, despite cervical cancer being the second-most common cancer among women (18% of female cancers).
• Zero-Dose Children: India accounted for 2 million zero-dose children—those who have not received routine immunization services.

Immunization Programs in India:

• Universal Immunization Programme (UIP):
• Operational Since: 1985
• Target Population: Close to 2.67 crore newborns and 2.9 crore pregnant women annually.
• Key Achievements: UIP is credited with significant reductions in vaccine-preventable under-5 mortality rates and has achieved major milestones such as the elimination of polio in 2014 and maternal and neonatal tetanus elimination in 2015.
• Vaccines Covered: UIP provides free vaccinations against 12 diseases:
• Nationally: Diphtheria, Pertussis, Tetanus, Polio, Measles, Rubella, severe Childhood Tuberculosis, Hepatitis B, Meningitis, Pneumonia caused by Hemophilus Influenza type B.
• Sub-Nationally: Rotavirus diarrhea, Pneumococcal Pneumonia, Japanese Encephalitis.
• Mission Indradhanush:
• Launched: 2014
• Objective: A special drive to vaccinate all unvaccinated and partially vaccinated children and pregnant women under UIP.
• Achievements: As of now, 5.46 crore children and 1.32 crore pregnant women have been vaccinated.
• Intensified Mission Indradhanush (IMI) 5.0, 2023:
• Focus: A catch-up vaccination campaign for children up to 5 years of age and pregnant women who missed out.
• Diseases Covered: Diphtheria, Whooping Cough, Tetanus, Polio, Tuberculosis, Measles, Hepatitis B, Pertussis, Meningitis, Pneumonia, Japanese Encephalitis, and Measles-Rubella.

Current Status of Childhood Immunization in India:

• DPT Vaccine Coverage: In 2023, there was a slight decline in the coverage of the DPT vaccine from 95% in 2022 to 93%. The global average for 2023 was 89%.
• Zero-Dose Children: The number of zero-dose children increased to 1.6 million in 2023, up from 1.1 million in 2022.
• Under-Vaccination: The coverage of the third dose of the DPT vaccine, used as a proxy for under-vaccination, was 91% in 2023, a two-percentage point dip from the previous year but still higher than the 2023 global average of 84%.
• Under-Vaccinated Children: In absolute terms, 2.04 million children remained under-vaccinated in 2023, a slight decrease from 2.11 million in 2019.

Key Takeaways and Recommendations:

• Increased Efforts Needed: The slight dip in vaccination coverage indicates the need for enhanced efforts in routine immunization campaigns and targeted interventions to reach zero-dose and under-vaccinated children.
• Inclusion of HPV Vaccine: Consider integrating the HPV vaccine into the national immunization program to address cervical cancer.
• Strengthening Immunization Programs: Continued focus on programs like Mission Indradhanush and Intensified Mission Indradhanush is essential to increase vaccination rates and cover gaps in immunization.
• Addressing Conflict Zones: Special strategies may be needed to ensure vaccination coverage in conflict-affected regions, where access to healthcare services is limited.

By addressing these areas, India can improve its immunization coverage and ensure better protection for its children against vaccine-preventable diseases.