Status of immunization and need for intensification of routine immunization in India.

Vaccines have made a major contribution to public health but vaccines-preventable diseases (VPDs) are still responsible for significant deaths of under-five children. Despite Global efforts, the coverage in two WHO regions namely Africa and South-East Asia (SEA) still remain short of set targets for 2010. As a result, the SEA Regional Director has declared 2012 as the Year for Intensifying Routine Immunization (RI) in the Region. The recent immunization coverage surveys in India have shown gradual albeit a slow progress in the performance of RI in India over last few years but in some states the coverage is still quite low. Several new initiatives like introduction of Hepatitis B vaccine, second dose of Measles vaccine and pentavalent vaccine (two states), JE vaccine rounds, framing of the National Vaccine Policy, etc. are welcome steps. The challenges and barriers to achieve high immunization rates in the country are well recognized. Almost non-existence of an effective VPD surveillance system in the country has further compounded the problem. The need is to address all the barriers to achieve high RI rates, which should include induction of innovative methods, proper monitoring of the program, improving operational efficiency and reaching every community, and integrated delivery of health interventions along with immunization. The development of an efficient VPDs surveillance, adverse event following immunization (AEFI) monitoring and post-marketing surveillance systems will go a long way in ensuring satisfactory performance of the health system. The decades old Expanded Program of Immunization (EPI), which was adopted in India as universal Immunization Program (UIP) also needs a revamp with inclusion of certain new vaccines. Decisions on implementing new and underutilized vaccines require scientific evidence and data, a reliable supply of affordable vaccines, which are adapted to the country's immunization schedule, and an integrated disease monitoring and surveillance system.