India has launched a massive drive to locate, identify, and inoculate an estimated one million children who have not received a single vaccine, as the world’s most-populous nation seeks to reduce disease burden.

Under the programme spearheaded by the Union ministry of health and family welfare to cover these unvaccinated children, also known as zero-dose children, ASHA (accredited social health activist) workers are going door-to-door to identify such kids and mobilizing them for immunization.

“The government is accelerating its efforts to identify zero-dose children. A micro plan has been developed and ASHA workers are travelling door-to-door to search for zero-dose children. The plan aims to reach the missed communities and ensure vaccination of every child with all due vaccines under the UIP within the one year of life. They are preparing list and mobilizing the parents of such kids to get vaccination in the next scheduled session,” an official aware of the matter said.

These kids mainly reside in the Northeastern states, Uttar Pradesh and Bihar.

India runs the world’s largest universal immunization programme (UIP) targeting a cohort of 2.6 crore children and 2.9 crore pregnant women annually under which vaccines are provided free of cost to eligible beneficiaries.

Zero-dose children are those who have not received any basic vaccine. For operational and reporting purposes, “zero dose children” are children who have not received the first dose of pentavalent vaccine till the age of one year.

A pentavalent vaccine is a cocktail of five vaccines that protects against five illnesses—diphtheria, tetanus, whooping cough, hepatitis B, and haemophilus influenzae type B.

Queries sent to the Union health ministry remained unanswered.

At a time when antimicrobial resistance (AMR) has been identified as one of the biggest threats to global health, the importance of vaccination in preventing AMR cannot be disregarded.

Immunization not only protects people against drug-resistant infections but also reduces their spread as well as the need for and use of antibiotics, thereby contributing to the battle against antimicrobial resistance. Therefore, it becomes important to reach out to those children designated as zero dose.

The health ministry’s strategy for implementing the zero-dose plan includes a nationwide roll-out of the country’s electronic immunization registry U-WIN, strengthening service delivery, enhanced monitoring and mentoring, capacity building by strengthening training under routine immunization, and mobilizer incentivization among others.

India has 1 million zero-dose children

“This year, India has around one million zero-dose children. However, this is considered an achievement as during covid-19 pandemic the number of zero-dose children exceeded around 3 million, after which the government made huge efforts to bring this number down,” the official cited earlier said, adding that India’s immunization coverage for FY24 stands at 93.23% of the total population.

Under the flagship Intensified Mission Indradhanush (IMI 5.0), the government carries out routine immunization campaign to ensures that immunization services reach the missed-out and dropped-out children and pregnant women across the country. In 2023-24, the Centre had allocated 89,155 crore for UIP. This is an increase of 13% over revised estimates for 2022-23.

The World Health Organization’s Immunization Agenda 2030 aims to reduce the number of zero-dose children by 50% by 2030 globally.

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