Global Vaccine Coverage and Zero-Dose Children
From 1980 to 2023, global vaccine coverage doubled for six diseases, including measles, polio, and tuberculosis. There was a notable decline in zero-dose children, who have not received the first dose of the diphtheria, tetanus, and pertussis (DTP) vaccine, by 75% globally during this period. Zero-dose children serve as a critical indicator of vaccination coverage inequities.
India's Vaccination Context
- In 2023, India had the second largest number of zero-dose children at 1.44 million, being among the eight countries with over 50% of the nearly 16 million zero-dose children globally.
- Despite not facing conflict or resource issues, India reported 23 million births in 2023, the highest globally, compared to China's 9.5 million.
- The percentage of zero-dose children in India is 6.2%, contextualized by the high number of newborns.
Trends and Challenges
- A 2021 study highlighted a reduction in zero-dose children from 33.4% in 1992 to 10.1% in 2016.
- The number fluctuated due to the COVID-19 pandemic, rising from 1.4 million in 2019 to 2.7 million in 2021, then dropping to 1.1 million in 2022 before increasing to 1.44 million in 2023.
- High concentrations of zero-dose children are found in Uttar Pradesh, Bihar, Maharashtra, Rajasthan, Madhya Pradesh, and Gujarat, with significant numbers in northeastern states like Meghalaya, Nagaland, Mizoram, and Arunachal Pradesh.
Socioeconomic Factors and Focus Areas
- The gap in zero-dose children based on gender, caste, and rural-urban living has narrowed significantly.
- High prevalence remains among impoverished groups, mothers with low education, Scheduled Tribes, and Muslim communities.
- Efforts must focus on reaching tribal areas, urban slums with large migrant populations, and addressing vaccine hesitancy among Muslim households.
Objective: WHO's Immunization Agenda 2030 (IA2030)
India aims to halve the number of zero-dose children relative to 2019 levels. With 1.44 million zero-dose children in 2023, nearly equal to the 2019 figure of 1.4 million, India requires concerted and ongoing efforts to achieve this goal within the next five years.
