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Vaccination is one of the most effective and cost-efficient public health measures, saving millions of lives. India’s Universal Immunisation Programme (UIP) is the world’s largest, and annually vaccinates 2.6 crore infants and 2.9 crore pregnant women. It contributed to a decline in under-5 mortality from 45 to 31 per 1,000 live births between 2014 and 2021, according to the Sample Registration System 2021.
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The UIP offers free immunisation against 12 diseases — 11 vaccines nationwide and one vaccine in endemic areas. In the past decade, six vaccines — Tetanus and Adult Diphtheria, Inactivated Poliovirus, Measles-Rubella, Rotavirus, Pneumococcal Conjugate, and Japanese Encephalitis — were added to the UIP across age groups.
India’s full immunisation coverage was 62% in 2014 (National Family Health Survey-4, 2015-16). To achieve 90% coverage, India launched Mission Indradhanush (MI) in 2014. In 2017, it launched the Intensified MI (IMI) programme to strategically target low-coverage areas and missed populations. By 2023, 12 phases of the MI and IMI had been completed, vaccinating 5.46 crore children and 1.32 crore pregnant women. The MI and IMI phases were integrated into campaigns such as the Gram Swaraj Abhiyan and the Extended Gram Swaraj Abhiyan to further the outreach. As a result, full immunisation coverage increased in 2024–25.
However, challenges remain in reaching remote and migratory populations, clusters with low awareness, and populations with vaccine hesitancy. Innovative strategies such as ‘zero-dose’ outreach, digital tracking, and infrastructure improvements are being used to address these gaps.
Vaccine coverage
India has maintained its polio-free status since 2011 through continued stringent surveillance. Lessons from the National Polio Programme have strengthened the UIP and vaccine-preventable disease surveillance. India also achieved maternal and neonatal tetanus elimination in 2015 and was declared Yaws-free in 2016.
Between 2017 and 2019, through the nationwide Measles-Rubella catch-up campaign, 34.8 crore children aged 9 months to 15 years were vaccinated, alongside the introduction of the rubella vaccine into the UIP. The COVID-19 pandemic disrupted routine immunisation services, causing setbacks in the gains made under UIP. Disruptive measles outbreaks between 2022 and 2024 signalled immunity gaps and affected large clusters of unimmunised children. In response, the IMI 5.0 in 2023 targeted under-five children across the country. The Zero Measles- Rubella Elimination campaign was launched in 2025 to boost public awareness about immunisation. These efforts aim to surpass 95% national Measles-Rubella coverage and build strong herd immunity.
Tech integration
India has prioritised cold chain logistics, system strengthening through the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission, and vaccine delivery and vaccination using the U-WIN platform. Building on the success of CO-WIN, U-WIN enables end-to-end digital vaccination and record keeping and tracking of vaccination for pregnant women and children up to 16 years. It enables nationwide, anytime-anywhere access for vaccination services, especially for migratory populations. Complementary digital technologies include the electronic Vaccine Intelligence Network for vaccine stock, the National Cold Chain Management Information System for real-time cold chain tracking, and the SAFE-VAC module for vaccine safety reporting.
During the COVID-19 pandemic, India was a frontrunner in vaccine development. The COVID-19 vaccination programme was launched on January 16, 2021, just weeks after the global rollout. By January 2023, over 220 crore doses had been administered, covering 97% of citizens with one dose and 90% with both doses, marking a great achievement in public health on the global stage. Despite pressure from various sectors, India relied on its domestic vaccine development and manufacturing capacity.
With proactive public-private partnerships, India not only met its national needs but also supported many low and middle-income countries through the Vaccine Maitri initiative, reflecting the spirit of Vasudhaiva Kutumbakam (the world is one family). India is now the world’s largest vaccine manufacturing hub. With the ‘Make in India’ strategy, the country has the potential to transform the future global vaccine landscape.
India’s immunisation achievements over the past decade are path-breaking and globally recognised as a model for emulation. On March 6, 2024, India received the Measles and Rubella Champion Award from the Measles and Rubella Partnership, honouring its efforts in the South-East Asia Region.
India has made remarkable strides in expanding vaccine coverage, strengthening supply chains, enhancing surveillance, and building public trust. Notwithstanding these achievements, there remains a need to closely link high-quality and sensitive disease surveillance with immunisation efforts, as well as monitoring of anti-vaccine narratives. For a country’s pandemic/epidemic preparedness, the immunisation and vaccine-preventable disease surveillance has to have a ONE-HEALTH lens. This would mean nurturing existing platforms and integrating joint surveillance of human, animal, and environmental systems.
Published – September 24, 2025 12:25 am IST
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