Covid continues to compromise India's immunisation programme

For the second consecutive year, Covid-19 impacted India’s immunisation programme in a big way with 27 lakh children not receiving the first dose of the DTP vaccine in 2021 despite the Union Health Ministry launching an intensified immunisation campaign to close the gap.

While 30 lakh children didn’t receive the first dose of an essential vaccine against diphtheria, tetanus and pertussis (DTP-1) in 2020 – the first year of the pandemic - the number rose marginally to 27 lakh a year later as the shadow of Covid-19 continued to engulf other health programmes

In comparison, only 14 lakh kids missed the shot in 2019.

In India, nearly 2.6 crore children are born each year, of which 92% received the BCG shot in 2019, but the number dropped to 85% in 2020 and 84% in 2021. Similarly, 94% of kids got the first dose of DTP in 2019, but it fell to 87% in 2020 and 88% in the following year.

Similar declines have been recorded with vaccines against measles, rubella, influenza, hepatitis-B and polio.

“There are several reasons for children to miss the vaccination. The engagement of health professionals in pandemic response and restrictions (lockdowns) due to Covid-19 kept the children away from the immunisation sessions,” Giridhara Babu, an epidemiologist at the Public Health Foundation of India, who is not associated with the exercise, told DH.

"India has repeatedly shown successful catching-up immunisation programs through Mission Indradhanush and polio eradication efforts. India can again provide leadership in covering the missed children,” he said.

The drop in immunisation numbers happened for the second successive year despite the Union Health Ministry launching Intensified Mission Indradhanush 3.0 in February, 2021 in 250 targeted districts in 29 states to bridge the gap.

Globally, 2.5 crore children missed out on one or more doses of DTP through routine immunisation services in 2021 alone, according to UN data.

Of these, 1.8 crore did not receive a single dose of DTP during the year, the vast majority of whom live in low- and middle-income countries with India, Nigeria, Indonesia, Ethiopia and the Philippines topping the list.

India recorded a drop of 5-6% in both doses of measles and 5% drop in receiving polio vaccines in the two pandemic years compared to 2019.

The coverage of the first dose of the measles shot came down to 81% worldwide in 2021, the lowest level since 2008. This means 2.47 crore children missed their first measles dose in 2021, 53 lakh more than in 2019. A further 1.47 crore did not receive their needed second dose.

Similarly, compared to 2019, 67 lakh more children missed the third dose of polio vaccine and 35 lakh missed the first dose of the HPV vaccine- which protects girls against cervical cancer later in life.

“This is a red alert for child health. We are witnessing the largest sustained drop in childhood immunisation in a generation. The consequences will be measured in lives,” Catherine Russell, UNICEF Executive Director said in a statement.

“While a pandemic hangover was expected last year as a result of Covid-19 disruptions and lockdowns, what we are seeing now is a continued decline. Covid-19 is not an excuse. We need immunisation catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems.”