Monday, July 6, 2020

Article by Dr Nadeera Nilupamali, co-founder and Vice President (Product), ImmunifyMe "How early child health immunization is important in India"

India, the largest democracy of the world and highly populated country topping the list in terms of population density recorded nearly 67,385 births in 2020 on New Year's Day. Country, home to the highest number of unvaccinated children, has embarked upon an intensified journey to increase the vaccination coverage with mission Indradanush 2.0.

Vaccines play a key role in defending most vulnerable: Children and infants.  However, one in every five children remains un-immunized in the world. And as a result, over 3 million children die every year due to diseases which can be easily prevented by proper vaccination. Routine childhood vaccines are among the most cost-effective life-saving interventions. Thanks to vaccines, countless cases of disease such as polio, measles, diphtheria, pertussis (whooping cough), rubella, mumps, tetanus, rotavirus and hepatitis etc have been prevented and saved millions of lives.

According to recent data released by the Indian National Statistical Office (NSO) 97% of the children aged between 0-5 years in the rural setting receive at least one vaccine, but, when it comes to those children being fully immunized, the percentage drops to 58%. Urban setting is not better in any way, 98% of the children receive at least one vaccine but only 60% of the children aged between 0-5 years are fully immunized. Many people working in public health have admitted that even this figure seems to be inflated and the situation could be worse on the ground and a large percentage of children dropping out of immunization programs.
Especially in India in recent times, routine vaccination has been intensified with additional efforts to optimize community coverage. Government has started putting extra efforts with the Mission Indradhanush programme which was launched in December 2014, aiming  to ensure 90% of infants would be vaccinated by the year 2020. Furthermore, under Intensified Mission Indradhanush 2.0, which is the second phase of the initiative launched on October 31, 2019, with a plan to cover 271 districts across India where fewer than 70% infants are currently vaccinated.
The success of Government Intervention
Despite the government spending billions of dollars in programs like Mission Indra Dhanush, the country's immunization rate remains one of the lowest in the world. Immunization amongst children here in India is a big challenge and there many factors to it
  1. Access to vaccines
  2. Religious beliefs
  3. Inter-state, Inter-City Migration
  4. Anti-Vaccine mentality and in some cases
  5. Not being aware about the vaccination process at all
  6. Misplaced priorities in parent front
  7. Parents busy lifestyle and forgetfulness
  8. Proper monitoring of vaccination
  9. Management of vaccine coverage data
  10. Real time monitoring of vaccination and lack of digital interventions
Why does immunisation make financial sense for the country?
Healthcare for young children eventually determines the country's  economic productivity , because vaccine-preventable diseases are known to cause stunting in childhood, which can lead to poor growth, poor adult health, and diminished learning capacity of the children. Prevention always costs less than treatment . For an example if a child ends up with any disability from the illness  like paralysis from polio which could have easily prevented by a vaccine, or neurologic problems from encephalitis caused by measles  etc will result in huge costs for the  treatments and also for providing special school services and other requirement for that particular child.
Morbidity, mortality, and the economic cost of treatment for vaccine preventable diseases are undoubtedly  going to add a huge burden to a country's economy.
If we do a benefit-cost analysis of vaccines there's  no doubt a full range of benefits as measured by gains in economic productivity compared to catastrophic medical expenses which can occur due to our simple ignorance of not vaccinating the children.

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