Giving immunisation a shot in the arm

A shot in the arm is all it takes to protect our children from numerous life-threatening diseases. Five lakh children die every year due to vaccine-preventable diseases; 95 lakh are at risk because they are unimmunised or partially immunised. The figures are unacceptable for an immunisation programme which has been operational for more than 30 years. Between 2009 and 2013, immunisation coverage increased by just 1 per cent a year. At that rate, we will get to the 90 per cent coverage rate prevailing in Nepal or Bangladesh only in 2040.

Earlier this year, Health Minister JP Nadda flagged off Mission Indradhanush to immunise every Indian child by 2020.

Immunisation is the one of the most cost-effective public health interventions to prevent child mortality and morbidity. Under routine immunisation certain gaps were identified; Mission Indradhanush caters to fill those gaps. To begin with, it identified 201 high-focus districts in the first phase across 28 States. Eighty-two districts are located in high-focus States, namely, Uttar Pradesh, Bihar, Rajasthan and Madhya Pradesh; these account for the highest number of unimmunised and partially immunised children. Targeted efforts to intensify routine immunisation in these districts were made, including four special vaccination drives conducted this April, May, June and July.

Mission Indradhanush has been envisaged to supplement and strengthen the existing routine immunisation programme which offers vaccines against diphtheria, hepatitis B, measles, pertussis or whooping cough, polio, tetanus and tuberculosis. Just like a rainbow, Mission Indradhanush depicts protection against these seven diseases. The initiative also ensures equitable access to these vaccines for all children, irrespective of region, gender or socio-economic status. To expand immunisation coverage across the country, it is essential that health workers such as accredited social health activists (ASHAs) and anganwadi workers (AWWs) are able to reach and map even the remotest locations in India. Through meticulous planning and incorporating lessons learned from polio immunisation drives, the vaccinators can now reach all high-risk areas and populations.

Often, it is some hesitancy or lack of understanding about the benefits of a vaccine that holds parents back. Vaccines are the most effective way of preventing infections; this has been proved the world over by numerous studies. By preventing infections, vaccines prevent long-term complications in the vaccinated and provide herd immunity to the community. When a significant proportion of children within a community are protected against a disease through immunisation, the entire community is protected. For example, in the case of a highly contagious disease such as measles, more than 95 per cent of the children must be vaccinated to achieve sufficient herd immunity to prevent its spread. This is why it is important to ensure that all children are fully immunised. The benefits of these vaccines are also far-reaching as healthier children miss fewer days at school and grow into healthy, productive adults.

Vaccines have helped dramatically reduce the burden of several common childhood diseases in the country. In the past, India has been a shining example by eradicating deadly diseases such as small pox and polio. Recently, India also eliminated maternal and neonatal tetanus. Similarly, 100 per cent immunization coverage is also an achievable goal. We need a similar reinvigoration of spirit to tackle the diseases that plague our children today. Mission Indradhanush has proven to be a clarion call to bring the parents of the country together towards achieving full coverage.

The writer is vice-president for research and policy at the Public Health Foundation of India

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