The Universal Immunization Programme: Sustained Efforts During Pandemic

India implements the largest Universal Immunization Program (UIP) in the world targeting 26.7 million newborns and 30 million pregnant women each year with 11 vaccines against 12 vaccine preventable diseases provided free of cost. India has made steadily progressed in childhood vaccination with Full Immunization Coverage (FIC) showing improvement from 62% in NFHS 4 (2015–2016) to 76.4% in NFHS 5 (2019–2021). However, it suffered setbacks during the Covid-19 pandemic due to multifarious reasons including diversion of health care resources to Covid-19 mitigation activities, the containment measures to prevent the transmission, and closure of Anganwadi centres, etc., and apprehension of the caregivers to bring their children for vaccination. The children who did not receive DPT containing vaccine (ZD children) increased from 1.4 to 3 million between 2019 and 2020 and as per HMIS. To mitigate the declining coverage, the country declared immunization as an essential service and disseminated guidelines enabling the states to deliver routine immunization services during and pandemic. The guidelines were aligned with the containment strategy wherein containment zone, buffer zone and areas beyond buffer zone were identified. The outreach sessions were discontinued in containment and buffer zones while allowed in areas beyond containment and buffer zone. The guidelines to prevent transmission were adhered to while holding the outreach sessions. During pandemic period, the country organized National Immunization Day for Polio Program and carried out regular Intensified Mission Indradhanush (IMI) every year from 2021 to 2023. The efforts made to mitigate the impact of Covid-19 pandemic resulted in the recovery of the UIP as WUENIC report 2022 indicates that India’s coverage under UIP not only recovered but exceeded that in 2019 during pre-pandemic period.