Despite progress in vaccinating children against preventable diseases, a new Lancet study has revealed that there are many gaps in vaccination coverage at the local level in India.

This means that while millions of children are being vaccinated, small areas of districts are still struggling. Due to this, many children are falling prey to diseases like measles and polio.

The research was conducted by experts from Harvard University, Flamen University and the University of Montreal, analyzing data from more than 87,000 children ages one to three, representing approximately 46 million children in 36 states and union territories. represents the population.

The study used data from the most recent National Family Health Survey 2019-21 (NFHS-5) to understand where vaccine coverage is falling.

The findings highlight a troubling trend: Small areas within districts show huge differences in vaccination rates. These “low-coverage clusters” are often hidden within states that appear to be performing well overall.

This unequal distribution is a major hurdle in achieving India’s vaccination targets.

Key findings from the study

The researchers found that more than 50% of the variations in vaccination rates occur within small local areas rather than within districts or states. This means that while one village may have a high vaccination rate, a neighboring village may have very low coverage.

The rates of undervaccination of vaccines administered during the first year of life were highest in the Northeastern states and Uttar Pradesh.

However, areas of low vaccination were identified in most states, even in areas where healthcare systems are strong.

Districts where more children have not been vaccinated often have greater disparities within their boundaries. This suggests that certain communities or areas in these districts face greater barriers to accessing vaccines.

Despite India’s overall high vaccination rates, many areas are vulnerable to the spread of diseases such as measles, diphtheria, pertussis and polio due to gaps in coverage.

For example, while official estimates suggest that more than 90% of children received polio and measles vaccines, the study found that only in some states, such as Odisha and Tamil Nadu, vaccination rates were high enough to prevent outbreaks.

The study found several reasons for these disparities:

• Logistical problems are often encountered in delivering vaccines to remote and inaccessible areas.
• In some communities, acceptance is low due to lack of information about the importance of vaccines.
• The lack of proper infrastructure and staff shortage in some areas further compounds the problem.

In light of these findings, the authors suggest a different approach to overcome these shortcomings.

Instead of focusing on entire districts, health programs should target specific low-coverage areas within districts to expand and spread vaccination to children, he said.

By addressing issues at the grassroots level, resources can be used more effectively to ensure the safety of all children, the authors wrote.

The authors suggested, “India’s recently created ‘Ayushman Arogya Mandir’ (health and wellness centres), with regional responsibility for providing primary health care, may provide a natural venue for a localized approach.”

The study suggests that the overall numbers may be misleading. While the country appears to be on track nationally, local disparities reveal a different story.

The study authors said child vaccination omissions in India are due to a variety of factors, including supply (not enough vaccine available) and demand (parents not bringing children for vaccination).

Additionally, other challenges such as poverty and lack of resources may lead to low vaccination of children in India. To understand the complexity of resources and geographic areas, researchers suggested the need to study social scientific research to better understand these issues.

These differences are not just statistics, they represent children who remain at increased risk of fatal but preventable diseases.