There was a slight dip in childhood immunisation in 2023 compared to 2022, recently released WHO and UNICEF estimates of national immunisation coverage (WUENIC) revealed. Notably, there was a two percentage point dip (from 95% in 2022 to 93% in 2023) in the coverage of the diphtheria, pertussis, and tetanus (DPT) vaccine, used as a proxy for the number of “zero-dose” children — those who have not received any routine immunisation. This number, however, was much higher than the 87% and 88% DPT coverage seen in 2020 and 2022 respectively, and higher than the 2023 global average of 89%. WUENIC showed that immunisation stalled globally in 2023, leaving 2.7 million additional children either unvaccinated or under-vaccinated, as compared to the pre-pandemic year of 2019. DPT vaccine coverage WUENIC shows that there were 1.6 million zero-dose children in India in 2023, up from 1.1 million in 2022, but much less than 2.73 million seen in 2021. The 2023 number, however, was higher than in 2019, which saw 1.4 million zero-dose children in the country. The data also show that the coverage of the third dose of the DPT vaccine — used as a proxy for under-vaccination — stood at 91% in 2023, a two per centage point dip from the previous year, but much higher than the 2023 global average of 84%. The coverage had dropped to 85% during the first two years of the pandemic, from 91% in 2019. In absolute terms, 2.04 million children remained under-vaccinated in 2023, slightly lower than the 2.11 million children in 2019. Not cause for concern An expert who has previously worked with the government’s vaccination programme said that the “slight” drop seen in the vaccination numbers is not a cause for concern, rather a call to intensify efforts. “A programme can reach 70% coverage with minimum effort, but to go beyond 90% the strategy changes completely, with more focus on details,” the expert said. “We have to think of the migratory population — can they be immunised when they come home during the festival season? What can be done if people are travelling? What needs to be done during the summers? What can be done during floods? How to reach the last mile?” they said. They added: “There is a lot of talk about India having the second-highest zero dose children after Nigeria, but it is critical to look at the population here — even 1% translates to a huge number when it comes to India.”
