India’s Universal Immunization Drive Sets Global Benchmark in Child Health

India’s unwavering commitment to protecting every child and mother from vaccine-preventable diseases has resulted in remarkable strides under its Universal Immunization Programme (UIP), placing the country at the forefront of global public health initiatives. With a vast network of over 1.3 crore immunization sessions annually and the dedicated efforts of frontline health workers—ASHAs, ANMs, and other health professionals—India is rewriting the narrative on vaccine equity and access.

A Massive Scale of Protection Across the Nation

The UIP provides free immunization services annually to 2.9 crore pregnant women and 2.6 crore infants, covering one of the world’s largest birth cohorts. This population exceeds the total inhabitants of countries like New Zealand, Australia, Finland, and Switzerland, emphasizing the immense scale at which India delivers routine vaccinations.

The UIP has expanded to include 12 vaccine-preventable diseases, aligning with recommendations from the World Health Organization (WHO). Until 2013, the programme offered just six vaccines. Since 2014, the government has introduced:

• Inactivated Poliovirus Vaccine (IPV)

• Rotavirus Vaccine (RVV)

• Pneumococcal Conjugate Vaccine (PCV)

• Measles-Rubella (MR) Vaccine

• Adult Japanese Encephalitis Vaccine

• Tetanus-Diphtheria (Td) Vaccine

This comprehensive approach targets a wide spectrum of childhood illnesses, significantly reducing morbidity and mortality caused by pneumonia, diarrhea, meningitis, encephalitis, and other infectious diseases.

Zero-Dose Children on the Decline

One of the most significant indicators of UIP's success is the sharp reduction in the percentage of zero-dose children—those who have not received even a single vaccine. As per the WUNEIC 2023 report, this figure dropped from 0.11% in 2023 to 0.06% in 2024, reflecting sustained and targeted outreach.

Compared to other countries with high burdens of zero-dose children, India’s achievements are notable:

• India: 0.11% (2023)

• Pakistan: 0.16%

• Indonesia: 0.23%

• Ethiopia: 0.72%

• Nigeria: 0.98%

• Yemen: 1.68%

Given India’s large population and diverse geography, these figures highlight the effectiveness of India’s inclusive and decentralized immunization strategies.

International Recognition and Accolades

India’s achievements have not gone unnoticed on the global stage. In March 2024, India was conferred the Measles and Rubella Champion Award by the Measles and Rubella Partnership (a coalition of WHO, UNICEF, GAVI, CDC, American Red Cross, UNF, and BMGF) at a ceremony in Washington, DC. This prestigious award recognized India’s strategic elimination campaigns, rapid scale-up of MR vaccine coverage, and strong surveillance systems.

The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) also highlighted India as a global success story in its 2024 report, citing a:

• 78% decline in Under-Five Mortality Rate (U5MR) (vs 61% global decline)

• 70% reduction in Neonatal Mortality Rate (NMR) (vs 54% globally)

Additionally, the Maternal Mortality Ratio (MMR) has dropped sharply:

• 130 per lakh live births in 2014–16

• 88 per lakh in 2020–22 (SRS)

• 80 per lakh as per UN MMEIG 2023—an 86% drop since 1990, far outpacing the global reduction of 48%

Targeted Initiatives and Technological Integration

To sustain and accelerate this momentum, the Government of India has launched a series of focused campaigns and policy interventions:

• Zero Dose Implementation Plan 2024: Targeting 143 districts across 11 states with high zero-dose child burdens.

• Mission Indradhanush: Launched in 2014 and intensified in 2017, it has reached 5.46 crore children and 1.32 crore pregnant women who were previously unvaccinated or under-vaccinated.

• Pulse Polio Campaigns: Through National and Sub-National Immunization Days, India has successfully maintained its polio-free status since 2014.

• Village Health and Nutrition Days (VHNDs): These community-driven outreach platforms ensure comprehensive maternal and child care.

• Multi-tiered Task Forces: Implementation is reinforced through State, District, and Block-level Task Forces (STFI, DTFI, BTFI) for monitoring and coordination.

• Regular IEC Campaigns: Information, Education, and Communication strategies—through media, community radio, social platforms, and local folk performances—help combat misinformation and boost public trust in vaccines.

Harnessing Digital Platforms for Better Tracking

The U-WIN platform has revolutionized how India tracks immunization status. By digitally registering every child and every vaccine administered, U-WIN ensures that no child is left behind. This tech-enabled initiative strengthens accountability, data accuracy, and service delivery.

Global Comparisons Validate India’s Success

India’s immunization coverage is comparable to or better than many high-income countries:

• DTP-1 coverage: 93% (India) vs 93% (New Zealand), 91% (Germany & Finland)

• MCV-1 (Measles): 93% (India) vs 93% (Sweden), 90% (Luxembourg)

• PCV-3: 83% in Ireland

• Rota-C: 90% in the UK

The dropout rate from DTP-1 to DTP-3 has also seen a marked decline—from 7% in 2013 to 2% in 2023. Measles vaccine coverage increased from 83% to 93% during the same period.

India also surpasses global averages in antigen-wise coverage across all categories, according to Annexure 1 and 2 of the WUENIC 2023 data.

A People-Driven Mission: Frontline Warriors and Public Engagement

The success of India’s immunization program hinges largely on the unrelenting efforts of grassroots health workers—ASHAs, ANMs, and Anganwadi Workers—who walk miles to deliver vaccines, educate communities, and address vaccine hesitancy.

Their work is supplemented by community mobilizers, panchayats, NGOs, and civil society networks, all of which make India’s UIP a true Jan Andolan (people’s movement).

Looking Ahead: A Commitment to Health Equity

With the recent Measles Rubella Elimination Campaign launched in 2025, India has demonstrated its ongoing commitment to eradicating deadly diseases and achieving equitable health outcomes for all. The Government of India remains steadfast in prioritizing last-mile delivery, ensuring every eligible woman and child, regardless of geography or socio-economic status, receives life-saving vaccines.