50 years of immunization in India: Progress and future

Abstract

Immunization is one of the most cost effective public health interventions and largely responsible for reduction of under5 mortality rate. However, vaccine preventable diseases (VPDs) are still responsible for over 5 lakh deaths annually in India. This underlines the need of further improvement. Today, India is a leading producer and exporter of vaccines, still the country is home to one-third of the worlds unimmunized children. There are a number of reasons why India lags behind its many less developed neighbors in vaccination rates. They include huge population with relatively high growth rate, geographical diversity and some hard to reach populations, lack of awareness regarding vaccination, inadequate delivery of health services, inadequate supervision and monitoring, lack of micro-planning and general lack of inter-sectoral coordination, and weak VPD surveillance system. In this article, we discuss some of the remedial measures to remove obstacles and improve immunization status of the country. Heightened political and bureaucratic will, increasing demand for vaccination by using effective Information, education and communication (IEC), creating more delivery points for routine immunization, proper monitoring of the program, and changing overall objective of the program from merely targeting coverage to more meaningful monitoring of the VPD reduction and demand creation referred as the output of entire vaccination program. Successful AFP surveillance network should serve as platform for an efficient integrated disease surveillance system. AEFI and postmarketing surveillance systems should be urgently upgraded, and there is need of strengthening the regulatory capacity of the country. Restructuring of EPI with induction of some new vaccines, clear-cut guidelines on the policy of introduction of newer vaccines, and establishing a separate, independent department of public health are few other areas that need urgent attention.

Parents' knowledge, attitude, and practice on childhood immunization

“…1 Despite the success of Expanded Program on Immunization (EPI) many vaccinepreventable diseases are remaining prevalent in developing countries like India (more than 5 lakh death annually in our country). 2 According to the WHO, over 1.5 million children die from vaccine-preventable diseases globally and current immunization programs save more than 3.2 million lives each year and additional 1.7 million lives a year can be saved by full utilization of the existing vaccines. 3 By increasing immunization coverage to above 80%, disease transmission can be interrupted, whereby unimmunized children are also protected because of the herd immunity.…”

Awareness and Attitude Regarding Breastfeeding and Immunization Practices Among Primigravida Attending a Tertiary Care Hospital in Southern India

“…Immunization is a timely step for prevention of diseases in the 0-5 years of age group [13]. Despite India being a leading producer of vaccines, it harbors one-third of the world's unimmunized children [14]. However in the past few decades' immunization coverage rates have improved sufficiently in developed countries whereas most of the developing countries are still struggling with low rates [13].…”

Development of Knowledge, Attitude and Practice Questionnaire of Parents towards Vaccination: Process, Challenges and Solutions

“…To overcome all these barriers, it is very important to increae the awareness about the vaccination among the public and heath care professionals. 4 According to the national family health servey 4 (2015-16), the percentage of children fully vaccinated between the age group of 12 to 23 months are only 55% in Karnataka. 6 Vaccine hesitancy of the parents has been increased due to their own concerns about vaccine and AEFIs and antivaccine movement is encouraging them to refuse vaccination for their children.…”