Leaving No One Behind: Progress in Child Immunization Among the Disadvantaged Populations in India, 1992–93 to 2020–21

Immunization is a protective health intervention that reduces the risk of various childhood illness to support health and cognitive development of children. Coverage of all basic vaccines is a key priority for immunization programs to achieve the sustainable development goals in health and well-being. While India’s success is critical for achievement of global targets, but this cannot be viewed in isolation with the promise of leaving no one behind. In India, immunization coverage has gained momentum with huge reductions in geographical, socioeconomic, and group inequalities as the most notable success stories of the immunization program. The average annualized rate of progress (AARP) in immunization coverage has accelerated since the launch of the NRHM (3.5% per annum during 2006–2016) and has further accelerated in the Intensified Mission Indradhanush (IMI) phase (4.1% per annum during 2016–21). The variations across income, education, and religious background have substantially shrunk in the last few years. However, a high prevalence of zero-dose amidst such rapid improvements is deplorable. The geography of vulnerability in immunization coverage is gradually shifting toward the urban areas with greater concentration of the problem in the slum areas and among the urban poor. Overall, the goal of universal coverage by 2030 critically hinges upon policy efforts to re-design immunization services in urban areas and reach the vulnerable populations in the underserved areas.