The number of children in India who were unvaccinated or missed their first dose of diphtheria-tetanus-pertussis (DTP) combined vaccine doubled due to the pandemic, rising from 1.4 million in 2019 to 2.7 million in 2021, as the world recorded the largest sustained decline in childhood vaccinations in approximately 30 years, according to official data published by the WHO and UNICEF.
The increase in zero dose, or those who missed their first dose of diphtheria-tetanus-pertussis, between 2019 and 2021 is the “first time ever there has been a decline in evaluated coverage in immunisation for India as a whole,” Dr Mainak Chatterjee, Health Specialist at UNICEF India, told The Hindu.
Though immunisation coverage continues to decline the world over, India was able to arrest the trend between 2020 and 2021. The number of children with zero dose rose sharply to three million in 2020. But a further backsliding was prevented and the number dropped to 2.7 million in 2021 due to catchup programmes such as the third Intensified Mission Indradhanush (IMI), notes the WHO-UNICEF report.
There are nearly 25 million children born every year in the country.
Steady improvement
Until the pandemic, India steadily improved immunisation coverage from 43% during the National Family Health Survey (NFHS) -3 (2005-2006), to 62% in the (NFHS) -4 between 2015 and 2016 and the (NFHS)-5 between 2019 and 2021.
India started the fourth round of IMI from February, which is expected to further reduce the number of unvaccinated children in the next round of WHO and UNICEF estimates of national immunisation coverage (WUENIC) in 2023, adds Dr. Chatterjee. Annually, India vaccinates more than 30 million pregnant women and 27 million children through the Universal Immunisation Programme.
Globally, the percentage of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) — a marker for immunisation coverage within and across countries — fell five percentage points between 2019 and 2021 to 81%.
As a result, 25 million children missed out on one or more doses of DTP through routine immunisation services in 2021 alone. This is two million more than those who missed out in 2020 and six million more than in 2019, highlighting the growing number of children at risk from devastating but preventable diseases.
Red alert
“This is a red alert for child health. We are witnessing the largest sustained drop in childhood immunisation in a generation. The consequences will be measured in lives,” said Catherine Russell, UNICEF Executive Director.
The fall in immunisation coverage is especially worrying as it is being accompanied by a rapidly rising rate of severe acute malnutrition due to a fall in income levels during the pandemic.
“A malnourished child already has weakened immunity and missed vaccinations can mean common childhood illnesses quickly become lethal to them. The convergence of a hunger crisis with a growing immunisation gap threatens to create the conditions for a child survival crisis,” the WHO-UNICEF joint statement warned.
