Notifications
Clear all
Communicable Diseases
5
Posts
5
Users
0
Reactions
449
Views
Topic starter
Over the last 50 years, vaccination against 14 diseases has directly contributed to a 40% reduction in infant mortality worldwide. "Vaccines are among the most powerful inventions in history, making once-feared diseases preventable,” said WHO Director-General. A study concluded that 10.2 billion full health years were gained over the course of five decades, or an average of 66 years, were gained for every life saved by immunization (WHO,2024).
In an Indian context though, unimpaired child rates appear to be rising in both rural and urban areas, which raises the possibility of areas that are neglected. Enhancing focus on minimizing dropouts in urban slums and implementing a targeted approach to identify and reach children in underserved pockets in both rural and urban areas would be beneficial for national policymakers eager to increase the national immunization coverage. States should make sure that boundaries are drawn between healthcare facilities, thorough headcount surveys are conducted, and micro plans are created and updated on a regular basis in order to identify underserved pockets and difficult-to-reach areas. Additionally, mobile sessions and adjustable schedules can significantly improve immunization in these regions. It would be anticipated that a robust communication intervention involving advocacy, interpersonal communication, and community engagement would significantly reduce dropout rates by fostering a cohesive environment in which women can make educated decisions about immunization (Kulkarni et al., 2021).
Kindly share your views on the gaps in Immunization in India.
References:
1. World. (2024, April 24). Global immunization efforts have saved at least 154 million lives over the past 50 years. Who.int; World Health Organization: WHO. //www.who.int/news/item/24-04-2024-global-immunization-efforts-have-saved-at-least-154-million-lives-over-the-past-50-years
Kulkarni, S., Varun Thampi, Deshmukh, D., Mangesh Gadhari, Chandrasekar, R., & Phadke, M. (2021). Trends in Urban Immunization Coverage in India: A Meta-Analysis and Meta-Regression. Indian Journal of Pediatrics/Indian Journal of Pediatrics, 90(1), 38–48. //doi.org/10.1007/s12098-021-03843-0
Posted : April 29, 2024 10:08 pm
The World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI) in 1974 to ensure that infants across the world had access to the four recommended vaccines that protect against serious childhood illnesses. These included the bacillus Calmette-Guerin (BCG), diphtheria-pertussis-tetanus vaccine (DPT) vaccine, polio vaccine, and measles vaccine. India adopted the WHO EPI in 1978.Even Though India’s full childhood vaccination was 44.7% in 2005–2006 and 60.9% in 2015–2016 the disparities exist based on sex, birth order, maternal education, and wealth status.More populous and northern Indian states showed greater vaccination disparities.There is a need to reduce inequities in childhood vaccination rates [1].
Patient and parent barriers to immunization include: parents may lack knowledge about childhood vaccinations, have unreasonable fears about vaccine safety, or lack transportation [2].
Posted : June 11, 2024 2:57 pm
In India, there are several challenges and inadequacies in the immunization system that need to be addressed to improve coverage and equity.
Health system challenge: The health system in India faces challenges like inadequate healthcare infrastructure, shortage of trained healthcare workers, and insufficient funding, which can affect immunization services. The study indicates factors contributing to wealth-related inequalities in full immunization coverage include socioeconomic status, maternal education, and antenatal care (2).
Global context: The link between poor health outcomes and low socioeconomic status, as limited access to healthcare. In India, disparities in under-five mortality by wealth are particularly high, with children living in disadvantaged households facing have higher rates of infectious diseases and lowest access to preventative services, including immunization (2).
Policy and implementation gaps: There may be gaps between immunization policies and their implementation on the ground. Ensuring that policies are effectively translated into practice is crucial for improving immunization coverage (2).
Rural-Urban Disparities: India’s least developed districts, with a population of 176 million, had received only 23 million doses, while major cities with half the population received the same number of doses (1).
Gender Inequities: Gender- based disparities also exist in immunization coverage, with girls sometimes receiving fewer vaccinations that boys due to societal biases (1).
References:
1. Dasgupta, R. (2021, July 30). India’s vaccine rollout is ignoring the many inequities in its society. The Conversation. //theconversation.com/indias-vaccine-rollout-is-ignoringthe many-inequities-in-its-society-165080
2. Kumar, N., Pinki Allyhan, & Aggarwal, A. (2024). Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study. Journal of Health, Population and Nutrition, 43(1). //doi.org/10.1186/s41043-023-00494-z
Posted : June 12, 2024 11:21 am
Each year, around 7.6 million children worldwide lose their lives before reaching the age of five, with India having the highest child mortality rate. The World Health Organization (WHO) estimates that 1.5 million of these deaths could be prevented through immunization. In 1974, WHO launched the Expanded Programme on Immunization to prevent six diseases by 2000, inspired by the successful eradication of smallpox. Recent policy efforts, such as India's Mission Indradhanush, have increased full immunization coverage to approximately 76%. However, disparities in coverage persist due to supply and demand factors. Rural areas still lag behind urban regions, even though 94% of children receive most vaccines from public health facilities. The National Family Health Survey (2015-2016) reported that only 63% of Indian children had received all recommended vaccines.
Improving child mortality rates in India and other low- and middle-income countries (LMICs) requires understanding local immunization barriers, including parental awareness, cultural attitudes, household income, and social status. Research in India indicates that the presence of health facilities and frontline health workers does not significantly reduce dropout rates for certain vaccinations. Despite free immunization programs for children aged 0-6 years, many from lower socioeconomic backgrounds, specific populations, and rural areas do not follow the immunization schedule due to poor healthcare infrastructure, lack of resources, and inadequate oversight. Major obstacles include time constraints, transportation costs, and lack of awareness about vaccination benefits. Studies in various countries have highlighted the impact of socioeconomic and demographic factors on child immunization. In India, factors such as religion, caste, birth order, place of delivery, antenatal care visits, and maternal tetanus vaccination status significantly influence vaccination rates. Currently, outreach and sensitization programs are conducted by ANMs, Anganwadi workers, and community health workers to promote immunization within communities.
Reference:
Sharma K, Kumar N, Kshatriya GK, Deb R. Socio-demographic variables for child immunisation among Khatik population of Delhi. Current medicine research and practice. 2024;14(1):22-29. doi: //doi.org/10.4103/cmrp.cmrp_222_23
This post was modified 2 years ago by shravani.R
Posted : June 15, 2024 3:07 pm
The issue of immunising children around the time of congenital heart surgery is complex and controversial. When immunisations are delayed, children can be left vulnerable to diseases that vaccines are designed to prevent, and this can also lead to incomplete vaccination schedules. For children with congenital heart disease (CHD), who are often already medically fragile, these vaccine-preventable illnesses can be especially harmful. Although limited, some existing research indicates that giving immunisations around the time of surgery might be both safe and effective.
A recent study explored the immunisation practices of member centres within the Pediatric Acute Care Cardiology Collaborative. The study gathered and analysed survey responses from these centres to understand their current practices better. Of the 46 centres approached, 35 (76%) responded completely. The study found that 23 centres (66%) delay immunisations before surgery, and 31 centres (89%) do so after surgery. Notably, among those that delay post-surgery immunisations, 20 centres (65%) apply this only to patients whose surgeries involved cardiopulmonary bypass. The length of these delays varied widely between centres. Despite these delays, nearly all centres (34, 97%) ensure that children who stay in the hospital for long periods receive their routine childhood immunisations.
This study revealed that most centres choose to delay routine childhood immunisations for some time before and after congenital heart surgery, although the specific practices differ significantly from one centre to another. Such deferrals pose risks to patients and might not be necessary for this group. More research is needed to understand the effects of these deferrals on the immune system and to help develop more consistent guidelines.
References:
Gal, D. B., Cleveland, J. D., Vergales, J. E., & Kipps, A. K. (2024). Immunisation deferral practices surrounding congenital heart surgery. Cardiology in the Young, 1–4. //doi.org/10.1017/s1047951124000507
Posted : June 17, 2024 10:45 pm