Routine childhood vaccination in India from 2005-2006 to 2015-2016: Temporal trends and geographic variation

Area of Science:

• Public Health
• Epidemiology
• Immunization Programs

Background:

• Routine childhood vaccination coverage in India has increased, but timely vaccine delivery remains a challenge.
• Significant disparities in vaccination coverage and timeliness exist across Indian states.

Purpose of the Study:

• To quantify changes in childhood vaccination coverage and timeliness in India from 2005-06 to 2015-16.
• To analyze variations in coverage and timeliness across states and over time.

Main Methods:

• Utilized data from India's National Family Health Surveys (NFHS-3 and NFHS-4).
• Employed the Turnbull estimator to calculate cumulative distribution functions for vaccine administration ages, accounting for censored data.
• Estimated national and state-level vaccination coverage and timeliness for BCG, DPT (3 doses), and MCV.

Main Results:

• Both national vaccination coverage and timeliness improved between NFHS-3 and NFHS-4 for all analyzed vaccines.
• Increases in timeliness (27.3%–74.0%) were lower than increases in coverage (75.3%–74.0%).
• Cross-state variation in timeliness was greater than in coverage, but both decreased from NFHS-3 to NFHS-4, with a more significant reduction in timeliness variation.

Conclusions:

• A substantial proportion of children in India receive vaccines after the recommended age, increasing vulnerability to preventable diseases.
• Interventions focusing on improving timely vaccine delivery are crucial for enhancing the effectiveness of India's routine immunization program.