Vaccinating India, Pg8

Context:

• Despite improved vaccination coverage globally, India still has one of the highest absolute numbers of zero-dose children, pointing to persistent socio-economic disparities and challenges in reaching marginalized communities.

Key Highlights:

• Between 1980 and 2023, global vaccine coverage for six major diseases doubled.
• Zero-dose children (those not receiving the first DTP dose) globally dropped by 75%, yet India had 1.44 million such children in 2023.
• India ranks second globally in the number of zero-dose children; part of a group of eight countries with over 50% of the global burden.
• India had 23 million births in 2023, the highest globally; the zero-dose rate stood at 6.2%.
• The number of zero-dose children fell from 2.7 million in 2021 to 1.44 million in 2023, yet remains above the pre-COVID level of 1.4 million in 2019.
• High concentrations of zero-dose children were found in Uttar Pradesh, Bihar, Maharashtra, Rajasthan, Madhya Pradesh, Gujarat, and several Northeastern States.
• Prevalence remains high among the poor, less-educated mothers, Scheduled Tribes, and Muslim communities.

Detailed Insights:

• Zero-dose children serve as a proxy indicator of vaccine access inequalities and health system reach.
• India’s large birth cohort magnifies the absolute burden, even when percentage-wise prevalence is relatively low.
• COVID-19 disrupted immunisation services, causing a surge in zero-dose children in 2021.
• Improvements have occurred, with gender, caste, and rural-urban disparities narrowing over the years.
• Persisting pockets of unvaccinated children are linked to poverty, low maternal education, marginalized communities, and vaccine hesitancy, particularly in Muslim households and tribal/urban slum areas.
• India risks missing WHO’s IA2030 target of halving the 2019 zero-dose numbers by 2030 unless focused interventions are scaled up.
• The issue demands localized outreach, community mobilisation, education, and targeted policy measures in high-burden areas.

Key Concepts Involved:

• Zero-dose children:  are those children who have not received even a single dose of any routine vaccine, typically measured as infants who have not received the first dose of the DTP vaccine. 
• DTP vaccine: A combination vaccine that protects against three life-threatening bacterial diseases — diphtheria, tetanus, and pertussis.
• WHO’s Immunization Agenda 2030 (IA2030): A global strategy aiming to halve the number of zero-dose children from 2019 baseline levels by 2030, promoting equity in vaccination access.

Mains Mock Question:

Q. The persistence of zero-dose children in India reflects deeper socio-economic inequalities and public health gaps. Critically evaluate policy measures needed to achieve equitable immunisation coverage in India by 2030.