India is renowned for running the world’s largest immunisation programme, covering an annual average of more than three crore pregnant women and 2.6 crore children. Amid the global health crisis brought by the Covid-19 pandemic, the country has recently introduced its latest movement called Intensified Mission Indradhanush (IMI) 4.0. Launched virtually by the Ministry of Health, this initiative aims to uphold public health through extensive vaccination.
Intensified Mission Indradhanush 4.0
IMI 4.0 focuses on providing Routine Immunization (RI) services to unvaccinated and partially vaccinated children and pregnant women, especially those up to two years of age. Though regular immunisation progress has decelerated due to the pandemic, IMI 4.0 is committed to narrowing the gaps and ensuring universal immunisation. The plan includes conducting three rounds of immunisation in 416 districts spanning 33 States/Union Territories, targeting those identified based on vaccination coverage, Health Management Information System (HMIS) data, and prevalence of vaccine-preventable diseases.
The Universal Immunisation Programme
India’s vaccination initiative dates back to 1978 when the Ministry of Health and Family Welfare introduced the Expanded Programme of Immunization (EPI). This effort was revitalized in 1985 as the Universal Immunization Programme (UIP), designed to prevent mortality and morbidity among children and pregnant women from 12 vaccine-preventable diseases. However, during 2009-2013, the increase in immunisation coverage slowed down, progressing at a rate of only 1% per year. This led to the birth of Mission Indradhanush in 2015.
Mission Indradhanush
Mission Indradhanush was launched with the aim of rapidly boosting full immunisation coverage to 90% by providing vaccinations against 12 Vaccine-Preventable Diseases (VPD). These include diseases such as diphtheria, whooping cough, tetanus, polio, tuberculosis, hepatitis B, meningitis and pneumonia, among others. Some vaccines, like those for Japanese Encephalitis and Haemophilus influenzae type B, are administered in select districts only.
Intensified Mission Indradhanush
An intensified version of Mission Indradhanush, abbreviated as IMI, was launched in October 2017. This initiative particularly targeted urban areas, aiming to improve immunisation coverage in select districts and cities. The goal was a full immunisation rate of more than 90% by December 2018, two years ahead of the original 2020 goal.
Second and Third Phases of Intensified Mission Indradhanush
The subsequent phase, known as Intensified Mission Indradhanush 2.0, was a nationwide immunisation drive launched to celebrate 25 years of the Pulse polio programme. It aimed to achieve at least 90% immunisation coverage across India by 2022. Building on this, IMI 3.0 was launched in 2021. Its main focus was on children and pregnant women who had missed their vaccine doses due to the Covid-19 pandemic.
Achievements of India’s Immunisation Programmes
As of April 2021, various phases of Mission Indradhanush have succeeded in vaccinating a total of 3.86 crore children and 96.8 lakh pregnant women. The first two phases alone resulted in a 6.7% increase in full immunisation coverage within a year. Survey results show an 18.5% increase in full immunisation coverage in districts covered by Intensified Mission Indradhanush compared to the National Family Health Survey (NFHS)-4 data. Recent reports reveal an increase in Full Immunisation Coverage among children aged 12-23 months from 62% as per NFHS-4 data to 76.4% according to the NFHS-5.