Zero Dose Children: Explainer: Who are ‘zero dose children’? Why were they left out of vaccination programs? | – Times of India

Who are ‘zero dose children’?

The World Health Organisation (WHO) defines: Zero-dose children are defined as those that lack access to or are never reached by routine immunization services.They are operationally measured as those who did not receive their first dose of DTP, a vaccine containing diphtheria-tetanus-pertussis.
For “zero dose” children, those who haven’t received any vaccines, the importance of timely vaccination cannot be overstated. Vaccines provide crucial immunity against diseases like measles, polio, and whooping cough, shielding infants from potentially life-threatening illnesses. Early vaccination is vital because infants’ immune systems are still developing, leaving them vulnerable to infections. Vaccines work by introducing harmless versions of viruses or bacteria to stimulate the immune system to produce antibodies. These antibodies provide protection when the child encounters the actual disease-causing pathogen. The impact of vaccines extends beyond individual protection; they contribute to community immunity, also known as herd immunity. When a significant portion of the population is vaccinated, the spread of diseases is greatly reduced, protecting even those who cannot be vaccinated due to medical reasons.

The number of zero dose children is higher than in 2019

“DTP immunization coverage is flat compared to 2022, and the number of “zero-dose” children is still higher than in 2019, before the pandemic,” says the WUENIC data or the WHO/ UNICEF estimates of national immunization coverage.

“The number of completely unvaccinated children (“zero-dose”) is slightly up from last year (by 600 thousand from 13.9m to 14.5m) and is still 1.7 m higher than in 2019,” the report gives alarming data. “The total number of un- and under-immunised children stands at 21m in 2023, 2.7m above the baseline value,” it adds.
As per the data, India is among the 10 countries that collectively account for 59% of “zero dose children”.

Indian government’s response to the WUENIC data

“As a percentage of total population, Zero Dose children account for 0.11% of the country’s total population,” the health ministry has said in response to the WUENIC data. It has said that given the large population size of India, it has the highest number of vaccinated children across the countries and the full immunization coverage of the country stands at 93.23%.

Under Mission Indradhanush, 5.46 crore children and 1.32 crore pregnant women have been vaccinated, till 2023

To reach out to zero dose and under vaccinated children, India has implemented initiatives under Mission Indradhanush and Intensified Mission Indradhanush with the support of the States. This has resulted in the reduction in the number of zero dose children by 34% between 2014-2023. Since 2014, 12 phases of Mission Indradhanush have been conducted across all districts wherein 5.46 crore children and 1.32 crore pregnant women have been vaccinated across all phases.
India provides the maximum number of WHO recommended vaccines under the Universal Immunization Programme in comparison to most of the other countries. The mean coverage for India is 83.4%, which is more than 10 percentage point of the global coverage. With high level of coverage of OPV and IPV, India has successfully maintained 13 years of polio-free status since the last polio case was detected in 2011.

Why have these kids been left out from vaccination coverage?

The rise in “zero dose” children, those who have not received any vaccinations, can be attributed to a combination of factors rooted in misinformation, access barriers, and complacency regarding the importance of vaccines.

One significant factor contributing to the rise in zero dose children is vaccine hesitancy fueled by misinformation. Misinformation spreads through social media, anti-vaccine advocacy groups, and anecdotal stories, leading parents to question the safety and efficacy of vaccines. Concerns about potential side effects, despite scientific evidence proving their safety, can deter parents from vaccinating their children.
Access to vaccines is another critical issue, particularly in underserved communities or regions with limited healthcare infrastructure. Economic barriers, lack of transportation, and inadequate healthcare facilities can prevent families from accessing vaccination services. In some cases, logistical challenges, such as vaccine shortages or inadequate healthcare provider training, further exacerbate access barriers.
In regions where vaccine-preventable diseases have been largely eradicated or are uncommon due to high vaccination rates, complacency can set in among parents. Some may underestimate the severity of diseases prevented by vaccines or believe that natural immunity is sufficient protection. Without firsthand experience of the devastating impact of these diseases, parents may not prioritize timely vaccination for their children.