NEW DELHI — The coverage of childhood immunization programs declined globally in 2020, and India was no exception. However, the country prioritized its childhood immunization program by giving it an “essential service” designation.

“As a result, India achieved an all-time high of 99 percent reported coverage with DPT3 [diphtheria-tetanus-pertussis] vaccine in the first quarter of 2021,” Poonam Khetrapal Singh, Regional Director, World Health Organization South-East Asia Region, said on Aug. 13.

“For a program that caters to 30 million pregnant women and the world’s largest birth cohort of 26 million, this is unprecedented and commendable. Globally DTP3 is a proxy indicator for immunization coverage,” she said.

“In India, DTP3 coverage is equivalent to three doses of pentavalent vaccine that protects against diphtheria, pertussis, tetanus, and hepatitis B, and Haemophilus influenzae type b [Hib].”

Additionally, India has expanded the use of the Pneumococcal vaccine despite the Covid-19 pandemic. Singh said the vaccine is now being administered in 24 states as part of a nationwide scale-up by the end of the year. 

The United Nations Children’s Emergency Fund (UNICEF) had said in July that India had the highest number of under-vaccinated or unvaccinated children worldwide, 3.5 million to be precise and that over three million were “zero-dose children” in 2020. 

The Ministry of Health then busted the claims with figures from the first quarter.

Speaking about the reasons behind the initial decline in the childhood immunization program at the start of the pandemic, Singh said: “There have been multiple challenges to the childhood immunization program: vaccinators were redirected towards Covid-19 pandemic response; restrictions on movement occurred due to lockdowns; vaccinators fell sick or were in quarantine, there was fear of Covid-19 among the community. All these contributed to a temporary decline in childhood immunization coverage in the country.”

India took strong measures to overcome the challenges and revive the vaccination of children and declared immunization as an essential health service, according to Singh.

“Micro-plans were modified to identify immunization sites beyond containment zones and Covid-19 care centers. Guidelines were issued for safe vaccination during the pandemic. Staggered vaccination was undertaken to maintain social distancing, and Covid-19 appropriate behavior(s) were reinforced,” she said.

The World Health Organization supported health authorities in training nearly 1.6 million Auxiliary Nurse-Midwives (ANMs) and Accredited Social Health Activists (ASHAs) on Covid infection prevention and control, which helped resume safe immunization during the pandemic in India. 

Singh—who is currently serving in her second five-year term as Regional Manager—noted that community mobilization efforts were reinforced with a special focus on assuring people of safety measures at the vaccination sites and the continued need for people to provide life-saving vaccines to their children during the pandemic.

“And this process is ongoing. WHO continues to work with the health authorities at all levels to support a better understanding of impediments to immunization services and measures to expand coverage,” Singh said.

“Recently, the WHO supported a deep dive exercise to review immunization program performance in 14 districts of seven states. Results of such focused approach will help further guide and improvise efforts.”

(With inputs from ANI)

Edited by Amrita Das and Krishna Kakani

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