New Delhi: With the focus having shifted on COVID-19, 23 million children globally missed out on routine immunisation last year, according to a Lancet study.
India experienced a large drop in diphtheria-tetanus-pertussis (DTP) vaccine coverage from 91 per cent to 85 per cent. According to recent data released by WHO-UNICEF, over 3 million children in India have missed out on their first dose of DTP in 2020, more than double the number of children in 2019, News18 reported.
A recent review on the impact of COVID-19 on immunisation campaigns and programmes suggests a reduction in both coverage and number of vaccines administered due to lockdown restrictions, shortage of health workers and resource diversion to address the pandemic, the report said.
Immunisation coverage data shows a plateau over decades, with global coverage of 83% and an increase in unvaccinated by 3.4 million in 2020. The recent modelling study by Lancet finds a significant gap in vaccine coverage by end of 2020, extending throughout 2021. Findings estimate a dip in coverage for diphtheria-tetanus-pertussis (DTP) 3 at 76·7% and measles vaccine at 78·9% in 2020.
Infectious diseases continue to contribute to a significant proportion of child mortality and morbidity in India despite tremendous progress in immunisation coverage through its Mission Indradhanush programme (now Intensified Mission Indradhanush-IMI) targeting 27 million newborns and 29 million pregnant women annually.
According to the Pneumonia and Diarrhea Progress report 2020, nearly half-million pneumonia and diarrhoea deaths occur in India followed by Nigeria.
The recent National Family Health Survey (NFHS-5) data (2019-20) from 22 states/UTs indicates an improvement in the full immunisation coverage in children (12-23 months). Going by the national figures from NFHS-4 (2015-16) the full immunisation rate was 62%.
To address the disruption of routine immunisation by the pandemic, the Indian Academy of Pediatrics has issued recommendations for routine immunisation of COVID-19 suspect and positive children.
During March-April 2020, an alarming 5 million children from across 600,000 villages in India may have lost the chance to routine immunisation. According to a survey of peadiatricians to understand COVID-19 related disruptions to routine vaccination services in India, there has been a 50 per cent decline in vaccination services with slow recovery. More than 75 per cent expressed concern about the gap in vaccination coverage leading to non-COVID morbidity and mortality. Essential health services have been affected across the board, according to the WHO’s Pulse survey on continuity of essential health services during the COVID-19 pandemic (figure 2). The most frequently disrupted services include routine immunisation services — outreach services (70 per cent) and facility-based services (61 per cent), the report added.
India rolled out the IMI 3.0 in February 2021, targeting children and pregnant women who missed out on routine immunisation during the pandemic. A review indicates a systematic approach to close the immunisation gap with a prepared health system for equitable rollout of vaccines.
According to the medical journal Lancet, there is an urgent need to strengthen routine immunisation and outreach to prevent the risk of vaccine-preventable disease in children and accelerate progress for more equitable vaccination coverage. Greater efforts to communicate the benefits of vaccines through health education and counselling, along with immunisation delivery approaches under safe conditions for health workers, caregivers and the community needs to be adopted, News18 reported.
