India’s been free of polio since January 13, 2011, and here’s why: each one of the country’s 27 million newborns got vaccinated against the paralysing infection not once but repeatedly for the first five years of their lives.Giving polio drops to 800 million children each year is a spectacular feat by any standards, but India has failed to piggyback on its success.
About 3,000 children under 5 years die each day — 16 lakh each year — but more than half of these deaths can be prevented if routine vaccines given free under the Centre’s universal immunisation programme (UIP) reach them. Full immunisation coverage still hovers at a low 61%, with children living in slums and backward areas falling out of the vaccination safety net.
The more, the better
Vaccines work and there are numbers to prove it. Measles deaths worldwide dropped by 75% between 2000 and 2010, said the World Health Organisation this week, with most of the 9.6 million lives saved being in India and Africa because of increased vaccination against the disease. Measles causes fever, cough and a rash and kills one of every 1,000 children it infects.
“The catch-up campaign to target 135 million children with the second dose of measles vaccine is expected to prevent 1 lakh deaths,” says Dr Ajay Khera, deputy commissioner, Ministry of Health and Family Welfare.
Another new addition is the pentavalent vaccine, which was introduced in Tamil Nadu and Kerala in mid-December 2011, protects against five diseases: Hib, diphtheria, pertussis, tetanus and hepatitis B. “It ensures better compliance as it is given in a single shot and children don’t have to be taken for the usual five injections,” says a WHO technical expert, who did not wish to be named. Worldwide, over 130 countries use pentavalent vaccines.
Can’t you hear me knocking?
The biggest challenge, says Dr Henri van den Hombergh, chief of health, UNICEF, is that routine immunisation is everything but routine in India. “Coverage still hovers around 61% because it is not routine for people to go for a service, just as it is not routine for a lot of providers to be there at work,” says Dr van den Hombergh. “Most often, when you ask people why they did not get their child vaccinated, the answer is, ‘we did not know’,” he says.
To improve compliance, the Centre’s introduced a name and cellphone-based tracking system of pregnant mothers and children through a web-enabled system with a database of more than 10 million children. “Parents are sent reminder SMSes before the due vaccination date. Health workers, too, are sent the list of children due for vaccination through SMS. This system will help us track each child,” says Dr Khera.
If the government is as effective in ensuring that health providers are physically present with the vaccines needed, vaccine-preventable diseases will soon become an anomaly in India as they are in developed countries.