Diphtheria, Tetanus and Pertussis (DTP3) Vaccine

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    • Recently, UNICEF in a study said that three million children in India have missed DPT doses in 2020 because of a pandemic. 

    About Diphtheria, Tetanus and Pertussis (DTP3) vaccine

    • The DPT vaccine or DTP vaccine is a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis (whooping cough), and tetanus.
    • The vaccine components include diphtheria and tetanus toxoids and either kill whole cells of the bacterium that causes pertussis or pertussis antigens.
    • Immunisation is an essential component for reducing under-five mortality: Immunisation coverage estimates are used to monitor coverage of immunisation services and to guide disease eradication and elimination efforts.
      • It is a good indicator of health system performance.

    Major findings of the study

    • The DPT vaccine is considered a marker for immunisation coverage across countries.
      • At 81 per cent now it represents the largest sustained decline in childhood vaccinations in 30 years.
    • Downfall: The percentage of children who globally received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) fell five percentage points between 2019 and 2021 owing to conflict and the pandemic.  
    • Measles vaccine: The coverage of the first dose of the measles vaccine dropped to 81 per cent in 2021, the lowest since 2008.
      • Over 24 million children missed out on their first measles vaccine dose in 2021 over five million more than in 2019.
      • A further 14.7 million did not receive their second doses.
    • Polio vaccine: compared with 2019, 6.7 million more children missed out on the third dose of the polio vaccine.
    • HPV vaccine: 3.5 million missed the first dose of the HPV vaccine which protects girls against cervical cancer later in life.
    • East Asia and Pacific region: Vaccine coverage dropped in every region, with the east Asia and Pacific region recording the steepest reversal in DTP3 coverage, falling nine percentage points in just two years.
    • Low- and middle-income countries: UNICEF said that 18 million of the 25 million children who did not receive a single DTP dose in 2021 belong to low- and middle-income countries with India, Nigeria, Indonesia, Ethiopia and the Philippines recording the highest numbers.
      • Uganda and Pakistan fared well where Uganda maintained high levels of routine coverage while rolling out targeted Covid-19 vaccination programmes.
      • Pakistan returned to pre-pandemic levels of coverage thanks to government interventions such as catch-up efforts.
    • Poorest performers: Among countries with the largest relative increases in the number of children who did not receive a single vaccine between 2019 and 2021 are Myanmar and Mozambique.
    • Globally: 25 million children missed out on one or more doses of the DTP vaccine through routine immunisation services in 2021 alone.
      • This is two million more than those who missed out on them in 2020 and six million more than in 2019.   

    Issues/ Reasons for decline in coverage

    • Conflicted area: The decline was due to many factors including an increased number of children living in conflict and fragile settings where immunisation access is often challenging.
    • Covid-19-related issues: increased misinformation and Covid-19-related issues such as service and supply chain disruptions, resource diversion to response efforts, and containment measures that limited immunisation service access and availability.
    • Malnutrition: This historic backsliding in rates of immunisation is happening against a backdrop of rapidly rising rates of severe acute malnutrition.
    • Awareness: There needs to be aware regarding immunisation and life is a precious concept, which is completely missing.
      • Giving the vaccine causes fever and the parents do not want to sit at home to take care of the children.
    • Different languages: Biggest constraint is migrants who speak different languages. It is very hard to convince them to get their kids vaccinated as immunisation is not a priority for these migrant labourers.
    • Not knowing where to go for immunisation: Rural people have no idea where to get their children vaccinated.
    • Wrong advice: By the people around or nearby, the cost of vaccination is too much and is not affordable for poor people.
    • Factory owners: don’t take responsibility or give an off as it is 24×7 work. The workers don’t wish to lose even one day’s wages to take care of the child.
    • Side-effects of the vaccine: The BCG vaccine causes swelling, while the pentavalent vaccine causes fever for a day.

    Way Forward/ Steps taken by the Government

    • Intensified Mission Indradhanush: India was quick to prevent further backslide with catchup programmes such as the Intensified Mission Indradhanush 3, which reduced the number of children who had not received the first dose from 3 million to 2.7 million in 2021.
      • In 2019, 1.4 million children in the country did not receive the first dose.
    • Indradhanush 4.0: Aiming to immunise every pregnant woman and child, India launched Intensified Mission Indradhanush 4.0 in 2022.
      • It is globally the largest vaccination drive reaching out to missed children and pregnant women.
    • Universal immunisation programme: Annually, India vaccinates more than 30 million pregnant women and 27 million children through its universal immunisation programme.
    • Covid-19 vaccination: India successfully managed to prevent a decline in coverage, while ensuring a continued focus on Covid-19 vaccination.
    • Routine immunisation services: A rapid resumption of routine immunisation services coupled with evidence-based catch-up campaigns enabled India to prevent a backslide in routine immunisation coverage.
    • Meticulous planning of campaigns at all levels: Develop special plans to reach the unreached children in more than 400,000 high-risk settlements such as urban slums, construction sites, brick kilns, nomadic sites and hard-to-reach areas.
    • Intensive training of the health officials and frontline workers: Build the capacity of health officials and workers in routine immunisation activities for quality immunisation services.

    Mission Indradhanush

    • Mission Indradhanush was launched in 2014 as a special drive to expand full immunisation coverage in India.
    • To expand immunisation coverage to all children across India. It aims to cover all those children who are either unvaccinated or partially vaccinated against vaccine-preventable diseases.
    • Children across socio-economic, cultural and geographical spectrums in India are being immunised under this program.
    • Also pregnant women are administered the tetanus vaccine, ORS packets and zinc tablets are distributed for use in the event of severe diarrhoea or dehydration and vitamin A doses are administered to boost child immunity.

    Universal Immunisation Programme (UIP)

    • India’s Universal Immunisation Programme (UIP) provides free vaccines against 12 life threatening diseases.
    • It provides life-saving vaccines to all children across the country free of cost to protect them against Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea. (Rubella, JE and Rotavirus vaccine in select states and districts)

    Intensified Mission Indradhanush (IMI)

    • The Intensified Mission Indradhanush (IMI) has been launched by the Government of India to reach each and every child under two years of age and all those pregnant women who have been left uncovered under the routine immunisation programme.
    • The special drive will focus on improving immunisation coverage in select districts and cities to ensure full immunisation to more than 90% by 2018.
    • Further, it would be reviewed by the Cabinet Secretary at the National level and will continue to be monitored at the highest level under a special initiative ‘Proactive Governance and Timely Implementation (PRAGATI)’.

    Source: IE