Boosting Disease Immunity in India

Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines are substances that stimulate the body's own immune system to protect the person against subsequent infection or disease.

India's immunization programme, launched in 1985, is one of the largest health programmes of its kind in the world. The programme provides vaccination against eight lifethreatening diseases (diphtheria, whooping cough, Haemophilus influenzae type B (Hib) causing pneumonia and meningitis, tetanus, polio, tuberculosis, measles and hepatitis B) in the entire country. In addition, vaccination against Japanese Encephalitis (JE) and rotavirus vaccine (RVV) has also been introduced in the country.

Evidence shows that unvaccinated and partially vaccinated children are most susceptible to childhood diseases and disability, and run a three to six times higher risk of death as compared with fully immunized children. Major reasons for inequity in immunization are lack of awareness among parents about the benefits of vaccination, fear of adverse events following immunization (AEFI) and operational reasons such as non availability of vaccines or vaccinators during vaccination sessions.

The Ministry of Health and Family Welfare (MoHFW) is committed to rapidly address the inequity in immunization coverage and consolidate the health system’s strengthening efforts. To strengthen routine immunization planning and delivery mechanisms, the MoHFW launched its flagship programme "Mission Indradhanush" in December 2014 to achieve more than 90% full immunization coverage in the country.

Did you know? The National Vaccination Day, also called the National Immunization Day, is celebrated every year on March 16 to convey the importance of vaccination to the entire nation. The day was first observed in the year 1995, the year when India started Pulse Polio Programme.

Mission Indradhanush

With a view to provide the right of immunization to every child, the Government of India launched the Universal Immunization Programme (UIP) in 1985, one of the largest health programs of its kind in the world, to cater to a birth cohort of 2.6 crore infants, and around 3 crore pregnant women every year. Despite being operational for many years, UIP was able to fully immunize only 65% children in the first year of their life.

The MoHFW launched Mission Indradhanush in December 2014 as a special drive to vaccinate all unvaccinated and partially vaccinated children under UIP. Mission Indradhanush aimed to fully immunize more than 90% of newborns by 2020 through innovative and planned approaches to reach all children. It not only aimed to rapidly increase the immunization coverage through special drives during specified months but also focused towards strengthening health systems for addressing equity issues in access to immunization.

Under Mission Indradhanush, the Government is providing vaccination free of cost against vaccine preventable diseases. The ultimate goal of Mission Indradhanush is to ensure full immunization with all available vaccines for children up to two years of age and pregnant women. Mission Indradhanush was also identified as one of the flagship schemes under Gram Swaraj Abhiyan and Extended Gram Swaraj Abhiyan.

Did you know? Immunization Programme in India was introduced in 1978 as 'Expanded Programme of Immunization' (EPI) by the Ministry of Health and Family Welfare, Government of India. In 1985, the programme was modified as 'Universal Immunization Programme' (UIP) to be implemented in a phased manner to cover all districts in the country by 1989- 90 through one of the largest health programmes in the world.

Intensified Mission Indradhanush (IMI)

                To further intensify the immunization programme, Prime Minister Shri Narendra Modi launched the Intensified Mission Indradhanush on October 8, 2017. Intensified Mission Indradhanush has covered low performing areas in the selected districts (high priority districts) and urban areas. Special attention is given to unserved/ low coverage pockets in subcentre and urban slums with migratory populations. The focus is also on the urban settlements and cities identified under National Urban Health Mission (NUHM). Intensified Mission Indradhanush strategy includes two broad interventions: Intensified Mission Indradhanush drive and Routine Immunization System Strengthening to sustain the gains. Union Minister of Health and Family Welfare launched the Intensified Mission Indradhanush (IMI) 4.0 on February 7, 2022. Intensified Mission Indradhanush 4.0 will have three rounds and will be conducted in 416 districts (including 75 districts identified for Azadi ka Amrit Mahotsav) across 33 States/UTs in the country.

The two major milestones of UIP

·         In 2014, India was officially declared polio-free, along with the rest of the SouthEast Asia Region.

·         In 2015, India achieved maternal and neonatal tetanus elimination

COVID-19

In the fight against global pandemic COVID-19, India's national COVID-19 vaccination programme has been one of the few countries producing COVID vaccines. The country started with two made-in-India COVID vaccines. In line with India's vision of Atmanirbhar Bharat, India's first domestic COVID-19 vaccine, Whole Virion Inactivated Corona Virus Vaccine (COVAXIN), was developed and manufactured by Bharat Biotech International Limited in collaboration with National Institute of Virology of Indian Council of Medical Research (ICMR). The ICMR funded the clinical trials of the COVISHIELD vaccine developed in collaboration with Oxford-AstraZeneca which is being manufactured in the country by Serum Institute of India.

Subsequently, world's first DNA-based vaccine against COVID-19, ZyCoV-D, was developed in India by pharmaceutical company Cadila Healthcare, in partnership with the Department of Biotechnology, DBT-BIRAC (Biotechnology Industry Research Assistance Council) under Mission COVID Suraksha. This is India's second indigenouslydeveloped COVID-19 vaccine. Sputnik V, developed by M/s Gamaleya Institute, Russia and imported by M/s Dr. Reddy's Laboratories Ltd., is also being used in the vaccination drive in the country.

Dr Mansukh Mandaviya, Union Minister for Health and Family Welfare in February released two reports of the Institute for Competitiveness (part of the global network of the Institute for Strategy and Competitiveness and affiliated to Harvard Business School) titled COVID19-India's Vaccine Development Story and India's COVID - 19 Vaccination Administration Journey. The reports highlight the crucial aspects that have contributed to the success of India's COVID-19 vaccine development and administration efforts, which includes manufacturing of indigenous vaccines, sturdy and timely procedures and protocols for approvals that ensured the safe administration of vaccinations.

The reports acknowledge the significant challenges faced by the Indian Government, of delivering and administering vaccines to a majority of 1.3 billion people of India who were eligible for the COVID-19 vaccines; working with the state governments to ensure free and equitable distribution and effective management of vaccine eagerness along with addressing vaccine hesitancy that was prevalent in certain pockets of the country. They also appreciate the massive efforts considering the size and heterogeneity of a country like India. The phased approach of India's vaccination programme, prioritizing populations of those who were in greatest need, including the healthcare professionals, frontline workers, elders, and those with morbidities, have been highlighted as exemplars in these reports.

The reports also identify efforts towards training and skilling of healthcare professionals to manage adverse events during vaccination; digital scheduling of vaccination sessions and certification post-vaccination through the CoWin digital platform as global best practices that other countries can learn from India.

Vaccine

Maitri Since the development of COVID-19 vaccines, the world has been looking to India to leverage its superior vaccine manufacturing capacities for the global good. The unique initiative of Vaccine Maitri which means Vaccine Friendship was launched because India's foreign policy is governed by its age-old maxim of "Vasudhaiva Kutumbakam''-The World is One Family. This historic campaign launched in January 2021 garnered us high praise from far and wide and also demonstrated what effective diplomacy in difficult times looks like. The principle 'none of us are safe until everybody is safe' is at the heart of the Vaccine Maitri programme.

As part of this humanitarian initiative, India has been supplying and donating Indiamade vaccines to countries across the globe, with our neighbours Maldives and Bhutan becoming the first recipients.

Compiled by Annesha Banerjee & Anuja Bhardwajan Source: PIB / Invest India / National Health Mission / MoHFW/NH