child-immunisation-disrupted-due-to-pandemic

Background:

  • An estimated 8.5 million third doses of DTP vaccine and 8.9 million first doses of measles vaccine were missed by children worldwide in 2020.
  • Global and regional estimates of Covid-19’s impact on routine childhood immunisation indicates unparalleled disruptions in delivery of vaccines against measles (MCV1) and diphtheria, tetanus, and pertussis (whooping cough) (DTP3).
  • Estimates suggest twice as many children may have missed doses of each vaccine than expected due to pandemic disruptions in high-income countries in Central Europe, Eastern Europe, Central Asia, and North Africa and the Middle East.
  • Although child vaccination rates improved in later months of 2020, catch-up efforts are lagging, and experts warn that the world may face a resurgence of vaccine-preventable diseases

India’s efforts to fight Malaria:

  • India’s progress in fighting malaria is an outcome of concerted efforts to ensure that its malaria programme is country-owned and country-led, even as it is in alignment with globally accepted strategies.
  • Indian government has released a National Strategic Plan (NSP) for malaria elimination for the years 2017-2022, targeting eradication by 2030.
  • This marked a shift in focus from malaria “control” to “elimination”. The plan provides a roadmap to achieve the target of ending malaria in 571 districts out of India’s 678 districts by 2022.
  • India has sustained significant decline in malaria cases, halving numbers to 5.1 million in 2018 from 9.6 million the year before. This followed a 24% decline in 2017, according to the World Malaria Report 2018.
  • Since 2000, India has reduced malaria deaths by two-thirds and halved the number of malaria cases.
  • Scaling up a diagnostic testing, treatment and surveillance
  • Ensuring an uninterrupted drug and diagnostics supply chain
  • Training community workers to test all fever cases and provide medicines, and distributing medicated bed-nets for prevention, under its ‘test-treat-track’ in the endemic north-eastern states and Odisha.

Application of DPT

As mentioned earlier, the DPT vaccine provides immunity against three infectious diseases:

  • Diphtheria: Diptheria is a disease with a high fatality chance. Symptoms include a formation of a greyish membrane covering the tonsils and upper part of the throat, making breathing a difficult task. India accounted for nearly 19%-84% of the global cases from 1998 to 2008. Although the numbers have come down in recent years, it is an uphill task to completely eradicate the disease due to shoddy immunisation drives and unsanitary conditions in urban areas.
  • Pertussis: This disease is commonly known as whooping cough, the name is derived from a typical cough which starts with a deep inhalation, followed by a series of quick, short coughs that continues until the air is expelled from the lungs, and ends with a long shrill, whooping inhalation. Being contagious, young children are the worst affected due to their still-developing immune systems.
  • Tetanus: Also known as lockjaw, this disease affects the central nervous system making motor functions difficult and causing painful muscle contractions. The disease is often fatal. MNT – Maternal and Neonatal Tetanus – is a variant that commonly occurs in newborns. Lack of access to pre and post-natal services are a major cause for the prevalence of MNT in India.

What is Intensified Mission Indradhanush?

The Intensified Mission Indradhanush (IMI) was launched in 2018 by the Central Government with the objective of covering all children under the age of two and pregnant women for immunization who were not covered under the UIP.

  • This program was to intensify the Mission Indradhanush that had been launched in 2014.

    • The objective of Mission Indradhanush was to have a 90% coverage of the UIP in India by 2020 and sustain the same.

  • IMI 2.0. was launched in December 2019 and continued up to March 2020, to further extend the reach and coverage of the mission, including tribal and hard-to-reach areas.

  • Although the scheme comes under the Ministry of Health and Family Welfare (MoHFW), it is supported by many other ministries/departments such as:

    • Ministry of Information and Broadcasting 

    • Ministry of Panchayati Raj

    • Ministry of Women & Child Development

    • Ministry of Housing and Urban Affairs

  • The diseases covered under the mission are polio, diphtheria, measles, whooping cough, hepatitis B, tetanus, meningitis, rubella, Japanese encephalitis and pneumonia.

Intensified Mission Indradhanush (IMI) 3.0

  • IMI 3.0 is aimed to accelerate the full immunization of children and pregnant women through a mission mode intervention.
  • The campaign is scheduled to have two rounds of immunisation lasting 15 days (excluding routine immunisation and holidays).
  • It is being conducted in pre-identified 250 districts/urban areas across 29 States/UTs in the country.
  • Beneficiaries from migration areas and hard to reach areas will be targeted as they may have missed their vaccine doses during the pandemic.

Aims and objectives

  • It aims to immunize all children under the age of 2 years, as well as all pregnant women, against eight vaccine-preventable diseases.
  • The diseases being targeted are diphtheria, whooping cough, tetanus, poliomyelitis, tuberculosis, measles, meningitis and Hepatitis B.
  • In 2016, four new additions were made namely Rubella, Japanese Encephalitis, Injectable Polio Vaccine Bivalent and Rotavirus.
  • In 2017, Pneumonia was added to the Mission by incorporating the Pneumococcal conjugate vaccine under Universal Immunisation Programme
Way Forward:

The following measures needs to be taken to improve India’s vaccination policy:

  1. Conducting a detailed demand-supply analysis: To conduct a calibrated expansion of the eligibility criteria India needs to conduct a detailed analysis including the vaccine manufacturers’ real-time production capability, the supply chain delays, etc.
  2. Reducing vaccine hesitancy: The only way to counter that is to be open and honest about adverse effects and make available relevant information in the public realm. So, both the state government and the centre need to be more transparent in the Universal vaccination process.
    • India can establish an independent team of experts under the aegis of the WHO to ensure adherence to recruitment standards, consent conditions, adverse event record management, and compensation standards. This will improve public confidence and provide enough data for the future policies of the government.
  3. Encourage stakeholder participation: The government has to rectify the issues with the new vaccination policy with better stakeholder participation.
    • Stakeholders should include not only state governments but also the local bodies that are struggling to control the pandemic.

Source: https://indianexpress.com/article/explained/how-pandemic-disrupted-dtp-measles-vaccination-of-kids-7406813/