Universal Immunisation | Mission Indradhanush, Rapid Survey of Children (RSOC), Pentavalent Vaccines, NTAGI

Why in news?

• The Women and Child Development Ministry, to whom the UN agency submitted the data of the Rapid Survey of Children (RSOC) conducted during 2012-13, has refused to accept it questioning the very basis of the survey.
• Mission Indradhanush, the new scheme launched.
• Several changes in Universal Immunisation Program recently made

What is RSOC?

The RSOC is a survey carried out by the Ministry of Women and Child Development, with the technical support from UNICEF India. 

Immunisation survey: A child is said to have received full immunisation coverage if it has been given all doses of the seven vaccines administered under the universal immunisation programme.

What do the immunisation survey results say?

• Total immunisation coverage in the country rose from 61 per cent to 65.2 per cent
• State wise variations:

Universal Immunisation Programme and Mission Indradhanush

• India’s Universal Immunization Programme (UIP) is the largest in the world. Every year around 9 MN routine immunization
• Intensification of UIP: Mission Indradhanush (launched in Dec 2014) depicting seven colours of the rainbow, aims to cover all those children by 2020 who are either unvaccinated, or are partially vaccinated against seven vaccine preventable diseases which include diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis B (covered under UIP)

Source; PIB

Why a new Mission Indradhanush, when we already have UIP?

• Immunization is the key to protect children from life threatening conditions that are preventable. As per MOHFW, immunization coverage in India has increased from 61% to only 65% , from 2009-2013. So, MOHFW has decided to intensify its efforts in immunization though this mission.      

Objectives of Mission Indradhanush

• The government intends to cover 201 high focus districts in the first phase of year 2015.  
• Furthermore, another 297 districts will be targeted in the second phase of year 2015.

Source: Times of India

Strategy of Mission Indradhanush

• The government has planned to conduct four special vaccination campaigns between January and June 2015.  
• All vaccines are already available free of cost under UIP in India. 
• Under this mission, government plans to intensify its efforts and thus increase accessibility of these vaccines to all the children of India. 
• Basically - a CATCH-UP CAMPAIGN, in POLIO MODE
• Mission mode - to be applied in the line of successful Pulse polio program
• A national-level monitor has been assigned for each of the 201 high-priority districts to ensure no children are missed because of issues like lack of access to vaccines, information or migration.
• A national control room in Delhi will coordinate with state nodal officers to get daily updates and coordinate with the national level monitors to collect, compile and analyse the data from each district
• Third-party monitoring at the vaccination site and at the community level will be done by the World Health Organization Country Office using 225 field medical officers, nearly 900 field monitors and more than 1,000 external monitors, who will be supported by partner agencies such as UNICEF and CORE.

Universal Immunization Programme: New Developments | Pentavalent, 4 new vaccines

Pentavalent:

Source: omsg.org

• Under the Universal Immunization Programme (UIP) 7 vaccines were (see below - new vaccines) administered: 
1. Diphtheria, Pertussis, Tetanus (DPT), 
2. Polio, 
3. Measles, 
4. Bacillus Calmette-Guérin (BCG) (for TB)
5. Hepatitis B, 
6. Japanese Encephalitis (JE) (in endemic districts) and 
7. Haemohilus influenzae type b (Hib) as Pentavalent vaccine combination (DPT+Hib+Hepatitis B) (in 8 states). 
1. These vaccines prevent Diphtheria, Pertussis, Tetanus, Polio, Measles, severe form of Childhood Tuberculosis, Hepatitis B, Japanese Encephalitis and disease caused by Haemohilus influenzae type b like meningitis, Pneumonia respectively. 
• Based on recommendation of National Technical Advisory Group on Immunization (NTAGI) this  new Pentavalent vaccine i.e. Haemohilus influenzae type b (Hib) vaccine as Pentavalent vaccine combination (DPT+Hib+Hepatitis B) has been included under UIP in the last 4 years. 
• National Technical Advisory Group on Immunization (NTAGI) is the apex advisory body setup by the Government of India to make recommendations on issues related to Immunization, introduction of new vaccines, etc.

New vaccines : India’s UIP will now provide free vaccines against 13 life threatening diseases

• In July 2014: decision of the Government of India to introduce four new vaccines as part of India’s Universal Immunization Programme (UIP) which will collectively expedite India’s progress on meeting the Millennium Development Goal 4 targets to reduce child mortality by two-thirds by the year 2015 and meet global polio eradication targets. 
• Rotavirus
• Diarrhoea caused by rotavirus kills nearly 80,00,000 children each year
• Results in up to 10 lakh hospitalizations, pushing many Indian families BPL
• Vaccine indigenously developed
• Rubella 
• causes severe congenital defects in newborns - like blindness, deafness and heart defects.
• Polio (injectable) 
• IPV being intriduced in 125 countries in globaly synchronised manner
• Oral - OPV will also continue
• India polio free since 2014
• Japanese encephalitis - An adult vaccine in districts with high levels of the disease. 

"Along with the recent introduction of the pentavalent vaccine, this decision represents one of the most significant policy leaps in 30 years in public health, preventing at least 1 lakh infant deaths, deaths of adults in working age group and up to 10 lakhs hospitalizations each year." 

Some Vaccine Barriers

• Gender disparities, 
• procurement and delivery challenges, 
• too few frontline health workers
• Lack of information or misinformation on the benefits of immunisation.

[Sources: The Hindu, PIB, Times of India, Indian Express]