Peer-reviewed article
Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India
Pritu Dhalaria, Pawan Kumar, Sanjay Kapur, Ajeet Kumar Singh, Ajay Kumar Verma et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study uses National Family Health Survey-5 data on 43,247 children in India to look at who is not vaccinated and which vaccine doses are missed. It examines children who received no vaccine at all (absolute zero dose), children who missed a specific vaccine (antigen-wise zero dose), and children who are only partly vaccinated. Zero-dose prevalence was higher among children without vaccination cards, scheduled tribes, Muslim households and the poorest wealth quintile. Among partly vaccinated children, missed measles-containing vaccine and oral polio vaccine doses were the main gaps. The authors conclude that targeted efforts are needed to reach universal coverage.
Key points
- Children without vaccination cards had a higher prevalence of absolute zero dose (21.2%).
- Prevalence of absolute zero dose was highest among scheduled tribes (4.1%), the Muslim group (5.4%) and the poorest wealth quintile (4.6%).
- Among partially vaccinated children (20%), 42.8% had zero dose for measles-containing vaccines.
- 6.7% of children failed to achieve full immunisation because of just one missed dose.
- Of the partially vaccinated subset, 7.29% missed full immunisation coverage because of oral polio vaccine dose gaps.
Limitations
This is a cross-sectional survey analysis, so it describes associations and cannot show cause and effect. The abstract gives no detail on data quality issues such as reliance on vaccination cards or caregiver recall.
Abstract
Introduction Immunisation is vital in preventing infectious diseases and promoting public health. This study examines the immunisation landscape in India, focusing on absolute zero dose (defined as a child did not receive any single dose of vaccine as per the National Immunisation Schedule), antigen-wise zero dose (defined as children who did not receive any dose of specific vaccine but received some or complete dose of other vaccines), the pattern of undervaccination (defined as children who missed any one or more than one dose of vaccine from total eight doses of vaccine (one dose-BCG, three doses-DPT, three doses-OPV and one dose-measles vaccine) and immunisation cascade. Methods Using data from the National Family Health Survey-5, we analysed the immunisation status of 43 247 children across India. The prevalence of absolute zero-dose children, antigen-wise zero dose, co-coverage rates and cascade levels for vaccine combinations are assessed. The multilevel regression model has been applied to understand the likelihood of left-out and antigen-wise zero doses by socioeconomic determinants. Results Children lacking vaccination cards experience a higher prevalence of absolute zero dose cases (21.2%). Notably, scheduled tribes (4.1%), the Muslim group (5.4%) and the poorest wealth quintile (4.6%) exhibit the highest prevalence. Remarkably, within partially vaccinated (20%) children, 42.8% show zero dose for measles-containing vaccines, while 6.7% of children failed to achieve full immunisation coverage due to just one missed dose of vaccine. Further, 20% of the partially vaccinated subset revealed that 7.29% missed full immunisation coverage due to oral polio vaccine (OPV) dose gaps. Conclusions Targeted efforts are essential to bridge immunisation gaps and achieve universal coverage in India. Focusing on antigen-specific zero dose and partially vaccinated children, particularly those missing OPV doses and measles vaccine offers the potential to improve full immunisation coverage. Therefore, to achieve the IA2030 requires an intensified target for reaching absolute zero and antigen-wise zero dose.