Why is India not yet able to achieve 100% universal immunisation coverage despite sustained efforts? What are the key challenges, and what will it take to move from the current 93% to full coverage?
Reaching 93% immunisation coverage is a remarkable milestone for a country as vast and diverse as India. It reflects the leadership of the government and commitment of the health system in protecting millions of children and pregnant women from vaccine-preventable diseases like measles, diphtheria, polio, and tetanus. This achievement significantly reduces infant mortality and ensures a healthier and more productive population.
However, the remaining 7% of children who are not fully immunised typically belong to marginalised communities – migrant families, tribal populations, and people living in remote or hard-to-reach areas. These groups often face barriers such as vaccine hesitancy, misinformation, lack of awareness, and irregular access to health services. For example, families who frequently move for seasonal work may not know when or where vaccines are being administered or may not be able to access consistent care.
To address these challenges, the Government of India has implemented intensive outreach campaigns like Mission Indradhanush and Intensified Mission Indradhanush, both of which focus on reaching the last mile. Building on these efforts, a new initiative called the Community of Practice for Demand (CoP-D) has been launched by the Ministry of Health and Family Welfare, in collaboration with [United Nations agencies] UNDP, UNICEF, [vaccine alliance] GAVI, and other partners. CoP-D aims to engage local communities directly to raise awareness about the importance of vaccines, understand the roots of hesitancy, and develop tailored strategies to reach vulnerable populations more effectively. It will also work closely with frontline health workers like ASHAs, whose unwavering commitment has long been the backbone of India’s immunisation outreach.
Additionally, India’s adoption of digital tools such as the eVIN (Electronic Vaccine Intelligence Network) and U-WIN (Universal Immunisation Programme-WIN) is revolutionising the way vaccines are tracked and distributed. These technologies help ensure that health centres maintain adequate vaccine stocks and can monitor immunization schedules and coverage, making it easier to reach every child.
Closing the remaining gap will require sustained political commitment, community engagement, and continued innovation in both outreach and technology.
Could you elaborate on how the Community of Practice for Demand (CoP-D) will function? How do various agencies coordinate to increase awareness and drive vaccine demand?
Reaching unvaccinated or partially vaccinated children is only possible with a blend of collaboration and innovation – and that’s where the newly launched Community of Practice – Demand steps in. Led by the Ministry of Health and Family Welfare, supported by UNDP and GAVI, COP-D is a dynamic think tank that brings together government, civil society, U.N. agencies like WHO and UNICEF and community-based organisations to co-create innovative, locally relevant solutions that drive immunisation demand.
At the heart of COP-D is the goal to overcome barriers like vaccine hesitancy and lack of awareness. It works at three levels: Locally, it engages frontline workers, community-based organisations, self-help groups, women’s groups, adolescent groups, resident welfare associations and community leaders and influencers to spark behaviour change and boost vaccine uptake.
At the national and State levels, it supports strategic planning, stakeholder engagement, and implementation to tackle systemic issues and scale successful models. COP-D also taps into global best practices, adapting them to India’s diverse realities through research and grassroots testing.
Could you speak to the implementation and impact of the Electronic Vaccine Intelligence Network (eVIN)? What is the long-term vision, and what challenges remain?
eVIN was launched in 2015 by the Ministry of Health and Family Welfare with support from UNDP and GAVI. It was a response to critical gaps in the vaccine supply chain—temperature breaches, inconsistent stock levels, and lack of digital tracking—all of which affected vaccine quality and availability.
What began as a pilot in just three States has [now] transformed vaccine logistics nationwide. By using mobile and web-based tools, eVIN offers real-time data on vaccine stock levels, storage temperatures, and distribution. Its success was evident early on—by 2016 it expanded to 9 more States, and a 2018 government evaluation showed it had saved over 90 million doses and yielded a return of $2.91 for every $1 invested. Today, eVIN spans over 30,000 cold chain points across all States and Union Territories.
The next step is integration with platforms like U-WIN to create a seamless, end-to-end digital backbone to support every aspect of immunisation – from vaccine supply to beneficiary tracking to recording the final jab. India is now developing advanced dashboards and analytics tools, with UNDP’s support, to empower local programme managers – the goal is sharper monitoring, quicker decisions, and more targeted action. Globally, eVIN has already inspired similar models in Indonesia, Malawi, and Sudan. With continued investment and collaboration, it has the potential to become a gold standard for vaccine management – both in India and worldwide.
What are the immediate benefits observed from the U-WIN platform, and how does it ensure data privacy for beneficiaries?
U-WIN began as a pilot in January 2023 and was launched nationwide by Prime Minister Modi in 2024. U-WIN is a game-changing digital platform designed to make immunisation services more accessible, transparent, and efficient for the public.With U-WIN, parents can book vaccination appointments and access services anywhere in the country. It sends automated SMS reminders, issues QR-based e-vaccination certificates, and supports frontline health workers in mobilising communities and managing immunisation drives more effectively. The results have been phenomenal. In just over a year, U-WIN has registered over 69 million children and 24 million pregnant women, and digitally tracked more than 388 million vaccine doses (as of April 20). This level of uptake speaks volumes about its usability and trust among beneficiaries.
As for data privacy, safeguarding personal information is paramount. U-WIN is equipped with advanced security features to safeguard privacy and block unauthorised access. All beneficiary data is encrypted, and the platform undergoes regular security audits by government-certified agencies. These steps ensure that sensitive beneficiary data remains protected and confidential at all times.
Published – April 27, 2025 10:00 am IST