India would reach 90 per cent immunization coverage by 2020 and the mission Indradhanush would help to achieve this target, informs Dr M K Aggarwal, Deputy Commissioner (UIP), Ministry of Family Health Welfare, to Prathiba Raju of Elets News Network (ENN)
Can you give us an outline of the current immunisation level in India ?
As per the latest estimate and various survey points, currently, 65 per cent of the children in India receive all vaccines during the first year of their life. We want to increase this data rapidly, as this data was available at 2009, it stood upto 61 per cent and since 2012 it is at 65 per cent. It has increased in a very slow pace. We need to rapidly increase the immunisation coverage. The public should also understand that if it is full immunisation coverage the child has to get one shot of BCG (Bacillus Calmette Guerin), three shots of DPT (Diphtheria, Pertussis and Tetanus Toxoid DPT 1,2,3) or pentavalent. And, one shot of measles vaccine and three drops of OPV (Oral Polio Vaccine). If these are completed at the age of one year we can then call it full immunisation.
After implementation of “Mission Indradhanush” is there any change in the reach of the immunisation?
Mission Indradhanush flagship programme was launched in December, 2014. It has strengthened the routine immunisation program and focuses on all those who are left out from the benefits of the vaccination cycle thereby providing complete immunisation and taking it to the grass root level across the country. The first round of the mission, conducted about four months ago, was a huge success. We were able to cover about two million people who were partially immunised and left with full immunisation. This meant that we have achieved more than the 50 per cent of our target in 201 districts. Phase II will be starting in October 2015 and continue upto February 2016 for few other medium priority districts. It will be an ongoing process. Our aim is to provide complete immunisation to 90 per cent of the children by 2020.
We had focused on 201 districts, out of which, 82 districts were from four states of Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan. As nearly 25 per cent of the unvaccinated or partially vaccinated children of India are in these districts from four states. In the second phase 297 districts will be targeted.
Definitely it is achievable. Mission Indradhanush is not just a campaign but the program also simultaneously strengthens the immunisation program in the rural areas. We are also conducting campaigns for system strengthening like capacity building of the doctors and health workers. The health workers are identifying the area were children are partially immunised and include them in the micro plan of immunisation. Everytime we do not have to conduct a campaign to cover those children but we have to just have follow-up with the parernts for the second round of vaccination. So these efforts would reflect in the national average.
If we can able to eradicate polio we can achieve full immunisation too. Polio eradication campaign had very positive impact. We expect the same from the media for the routine immunisation programme. We are expecting an unbiased story because public perception usually changes by media views and media should be very accurate as far as possible in reporting on immunisation.
At times there are issues were children die of vaccine as well. Your comments.
All the vaccines are licensed by Drug Control General Of India (DGCI) after being screened through all the protocols and scientific evidence. Vaccines are time tested and tried. Before being introduced, these vaccines undergo a scientific and a step-by-step method. World over this is the practice. We have a national technical advisory group which has got experts across the fields like community medicine, virologist, epidemiologist, pediatrician, pathologist and the committee examines the issue from aspects like burden of disease, economic viablity, safety of the vaccines and then put up a recommendation, which goes to a larger organisation. It is a pool of experts who see to it.
Yet, there are deaths because vaccine is a biological product, like any drug, it can have some consequences. If you see our infant mortality rate is 42 at present. This means 42 children are dying in the first year of their life. This might occur due to different causes like diarrhoea, fever, pneumonia or at times they are ascribed to vaccine. But we are not sitting silent on the issue. We have a National Adverse Event Following Programme , where we follow adverse cases that detect the cause of the death and investigate it. After investigation we find that very few cases are ascribed to vaccine. It might be coincidental or a program error and we take the corrective action accordingly. So far, we have done causalty survey of about 663 cases and they are uploaded in the health ministry’s website.
What are the IT advancements made in the routine immunisation sector?
We have got national cold chain and vaccine logistics management information system, where we have 26,000 cold chain points across the country. At every cold chain point we have different types of freezers, temperature monitoring to keep the vaccine safe. All these cold chain points are mapped and we have detailed information of the cold chain technician who monitors it in the district, state and centre level.We also have national Mother and Child Tracking System (MCTS), where we have a call centre established to the care givers like Auxiliary Nurse Midwives (ANMs) and Asha workers so that they can directly interact with the parents.