Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India
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...
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BMJ Publishing Group
2025-04-01
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| Series: | BMJ Public Health |
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| author | Gunjan Taneja Pawan Kumar Disha Agarwal Ajay Kumar Verma Pritu Dhalaria Sanjay Kapur Ajeet Kumar Singh Bhupendra Tripathi |
| author_facet | Gunjan Taneja Pawan Kumar Disha Agarwal Ajay Kumar Verma Pritu Dhalaria Sanjay Kapur Ajeet Kumar Singh Bhupendra Tripathi |
| author_sort | Gunjan Taneja |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-16e263814e0b4e23a11052637ad86eeb |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-16e263814e0b4e23a11052637ad86eeb2025-08-20T03:29:34ZengBMJ Publishing GroupBMJ Public Health2753-42942025-04-013110.1136/bmjph-2024-001290Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of IndiaGunjan Taneja0Pawan Kumar1Disha Agarwal2Ajay Kumar Verma3Pritu Dhalaria4Sanjay Kapur5Ajeet Kumar Singh6Bhupendra Tripathi75 Bill & Melinda Gates Foundation, New Delhi, India2 Immunization Division, Ministry of Health & Family Welfare, Delhi, India1 Immunization Technical Support Unit, Ministry of Health & Family Welfare, Delhi, India4 Department of Economics, Banaras Hindu University, Varanasi, India1 Immunization Technical Support Unit, Ministry of Health & Family Welfare, Delhi, India3 John Snow India, Delhi, India1 Immunization Technical Support Unit, Ministry of Health & Family Welfare, Delhi, India5 Bill & Melinda Gates Foundation, New Delhi, IndiaIntroduction 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.https://bmjpublichealth.bmj.com/content/3/1/e001290.full |
| spellingShingle | Gunjan Taneja Pawan Kumar Disha Agarwal Ajay Kumar Verma Pritu Dhalaria Sanjay Kapur Ajeet Kumar Singh Bhupendra Tripathi Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India BMJ Public Health |
| title | Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India |
| title_full | Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India |
| title_fullStr | Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India |
| title_full_unstemmed | Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India |
| title_short | Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India |
| title_sort | path to full immunisation coverage role of each vaccine and their importance in the immunisation programme a cross sectional analytical study of india |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001290.full |
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