Introduction:

On March 16th every year, India observes National Vaccination day, also known as Immunization day. It was on this day in 1995 that the first dose of Oral Polio vaccine was given in India. The initiative to eradicate polio from the country came in the form of the Pulse Polio Campaign launched by the government. Under this extensive drive, 2 drops of Oral Polio Vaccine was given to all children younger than 5 years of age. The last reported case of polio in India was in West Bengal in January, 2011. In 2014, India was declared polio-free. Over the years, immunisation has proved to be the most vital tool in controlling and eliminating life-threatening infectious diseases.

• The day is celebrated on March 16 and unlike the World Immunization Week that is celebrated in the month of April (April 24 to April 30). The idea behind the observance of the day is to spread awareness about the eradication of the polio from India.
• Even still a major number of kids are immunized on this day with polio vaccine. The main reason vaccines are given to kids is to protect them from infectious disease as it has turned out to be by far the best method to help fight diseases. It has been found out that boosting immunity due to vaccination has also been responsible for control on diseases like small pox, tetanus, measles, polio, etc. not just in India but also all around the world.
• World Health Organization (WHO) reveals that immunization can work as the best prevention method as licensed vaccines can prevent twenty-five preventable infections.
• India observes the Pulse Polio Programme since 1995.
• The last case of polio was reported on 13 January 2011.
• India was certified as a polio-free country on March 27, 2012 along with 11 other countries of the World Health Organisation (WHO) such as Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Democratic People’s Republic of Korea, Nepal, Sri Lanka, Timor-Leste, and Thailand.

Polio:

• The World Health Organization (WHO) defines polio or poliomyelitis as “a highly infectious viral disease, which mainly affects young children.”
• Transmission: The virus is transmitted by person-to-person, spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
• Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio, it can only be prevented by immunization.”

Pulse Polio Programme:

• India launched the Pulse Polio immunisation programme in 1995, after a resolution for a global initiative of polio eradication was adopted by the World Health Assembly (WHA) in 1988.
• Children in the age group of 0-5 years are administered polio drops during national and sub-national immunisation rounds (in high-risk areas) every year.
• The WHO on February 24, 2012, removed India from the list of countries with active endemic wild polio virus transmission.
• Two years later, the South-East Asia Region of the WHO, of which India is a part, was certified as polio-free.
• To prevent the virus from coming to India, the government has since March 2014 made the Oral Polio Vaccination (OPV) mandatory for those travelling between India and polio-affected countries, such as Afghanistan, Nigeria, Pakistan, Ethiopia, Kenya, Somalia, Syria and Cameroon.

Progress made:

• India’s Universal Immunization Programme (UIP) is working both to increase immunization coverage and to introduce new vaccines.
• In the early 90s, India saw over two lakh cases of polio annually, but, after the polio eradication programme was launched in 1994, India attained polio-free status over the course of the next two decade due to concentrated efforts and collaboration of the Government, international partners, civil society, health workers and millions of volunteers.
• The best practices and the systems established by the Pulse Polio programme have benefitted other health programs, viz. the community mobilization, logistics management, reaching the last mile or setting up a surveillance system.
• Since 2014, five new vaccines, including against two of the leading causes of deaths in children under five in India — pneumonia and diarrhoea – were introduced under the UIP, one of the largest such programmes in the world.
• Rotavirus vaccine (RVV), which protects against a severe form of diarrhoea, was scaled up in all states last year.
• According to internal data collected by the Health Ministry, as of September 2019, almost 1.3 million children has received all three doses of PCV across 159 districts in the six states, with approximately 8.1 million children targeted for 2019-20.

Challenges:

• In 2010, 0.56 million severe pneumococcal pneumonia episodes and 105 thousand pneumococcal pneumonia deaths had occurred in children younger than 5 years of age in India.
• The annual incidence of severe pneumococcal pneumonia in India was estimated to be 4.8 episodes per 1,000 children younger than 5 years.
• Pneomococcal conjugate vaccine (PCV), the costliest vaccine in the UIP basket, currently covers only about 50 per cent of the 26 million birth cohort in Himachal Pradesh, Madhya Pradesh, Haryana, Bihar, Uttar Pradesh, and Rajasthan.
• At present, the vaccine being used in the UIP costs approximately $2.95/dose, which makes PCV costlier than other UIP vaccines such as rotavirus vaccine ($1/dose), pentavalent vaccine ($0.69/dose), and measles vaccine ($0.308-$0.318/dose).

Mission Indradhanush:

• It was launched by the Ministry of Health and Family Welfare, Government of India on December 25, 2014.
• Between 2009-2013 immunization coverage has increased from 61% to 65%, indicating only 1% increase in coverage every year.
• To accelerate the process of immunization by covering 5% and more children every year, Indradhanush mission has been adopted to achieve target of full coverage by 2020.
• The Mission Indradhanush aims to cover all those children by 2020 who are either unvaccinated, or are partially vaccinated against vaccine preventable diseases.
• India’s Universal Immunisation Programme (UIP) provide free vaccines against 12 life threatening diseases, to 26 million children annually.
• The Universal Immunization Programme provides life-saving vaccines to all children across the country free of cost to protect them against Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea. (Rubella, JE and Rotavirus vaccine in select states and districts).

Mission Indradhanush 2.0:

• The government’s flagship scheme is aimed at immunizing children under the age of 2 years and pregnant women.
• The Intensified Mission Indradhanush 2.0 has been launched to focus on 272 districts of 27 states and 652 blocks of Uttar Pradesh and Bihar among hard-to-reach and tribal populations.
• The program aims to escalate efforts to achieve the goal of attaining 90% national immunization coverage across India.
• The Intensified Mission Indradhanush immunization drive will consist of four rounds of immunization. The program will be completed by March 2020.
• The salient features of IMI 2.0 are immunization activity will be in four rounds over seven working days excluding the RI days, Sundays and holidays. Enhanced immunization session with flexible timing, mobile session and mobilization by other departments,” an official statement said.
• Mission Indradhanush 2.0 Highlights:
  • Enhanced immunization session with flexible timing, mobile session & mobilization by other departments
  • Enhanced focus on left outs, dropouts, and resistant families & hard to reach areas
  • Focus on urban, underserved population and tribal areas
  • Intensified Mission Indradhanush to be conducted till March 2020