Dr Saurabh Kumar Banerjee outlines the impact of COVID-19 on immunisation programmes in India and how organisations can hope to mitigate the consequences of missed vaccine doses.
Immunisation is one of the most cost-effective public health interventions to date, averting an estimated two to three million deaths every year.1 To achieve full immunisation coverage of all children and pregnant women in India, the government launched “Mission Indradhanush” in December 2014. It is the world’s biggest immunisation programme in terms of number of patients, regional distribution and vaccine regimens used, with approximately 27 million newborns seeking immunisation per year.2 To dose these millions of infants, children and pregnant women, a total of nine million courses of immunisation are performed by almost 150,000 Auxiliary Nurse Midwives and assisted by approximately 27,000 cold chain points.3
Reaching out to the target beneficiary located in the remote parts of the country, carrying out the vaccinations as per immunisation protocols, community mobilisation of the society towards acceptance of vaccination and maintaining the cold chain of the vaccines in extreme hot and cold conditions, are among many of the challenges associated with immunisation coverage when the situations are favourable in the country. If the situation develops, then immunisation programmes will be an immense challenge – as it is for India currently facing COVID-19.
How will COVID-19 impact India?
Amidst the fear of COVID-19 engulfing all of India, the findings of an exploratory survey conducted in 30 villages of Rajasthan brought into light some alarming and disturbing facts; in the month of March 2020, around 250 children lost the opportunity to get vaccinated, due to various reasons. According to the 2011 census, India has around 600,000 villages. Rough calculations show that an estimated five million children may have lost the chance of vaccination in March and that these figures may bulge in April.4 The World Health Organization (WHO) has clearly indicated that when immunisation services are disrupted, even for brief periods during emergencies, the risk of vaccine-preventable disease outbreaks, such as measles and polio, increases.5
Are you looking to explore how lipid formulations in softgels can enhance drug absorption and bioavailability. Register for our upcoming webinar to find out!
3 September 2025 | 3:00 PM BST | FREE Webinar
This webinar will delve into the different types of lipid formulations, such as solutions, suspensions, emulsions, and self-(micro)emulsifying systems. Applications span diverse therapeutic areas including HIV therapy, oncology, immunosuppressants, and emerging treatments like medicinal cannabis (eg, CBD).
What You’ll Learn:
Lipid formulation development and screening tools for optimisation
Key steps in scale-up and industrialisation to ensure consistency and efficiency
Impact of lipid-based softgels on drug delivery and patient outcomes.
Missed dosing is not only a concern for India, but a global threat. According to an analysis, vaccine interruptions triggered by the COVID-19 pandemic are expected to have a far-reaching impact on the immunisation services in the least developed countries. The repercussions are evident from the fact that around 13.5 million citizens in 13 of the least developed countries in the world would not be vaccinated from diseases such as measles, polio and human papillomavirus (HPV).6 Thus, mitigation strategies should be a main point of discussion among health administrators.
Immunisation in the most remote parts of India is being carried out by the Accredited Social Health Activist (ASHA) or Community Health Workers who work under the prevue of the Ministry of Health and Family Welfare. In response to the COVID-19 outbreak, ASHA has been entrusted with many tasks pivoted around the pandemic control such as conducting door to door surveys, conducting awareness campaigns among people, overseeing the movement of migrants, sensitisation for social distancing etc. Consequently, ASHA workers are not able to provide immunisation services to pregnant women or birth control methods on account of their increased responsibilities towards the pandemic control measures. Even shortages of vaccines which were scheduled to be given during pregnancy have been experienced.7
If the situation develops, then immunisation programmes will be an immense challenge”
Many states (Uttar Pradesh, Bihar, Kerala, Karnataka and Rajasthan) in India are emphasising the necessity to take precautionary and preventative measures for controlling the infections of patients with COVID-19 and in wake of these steps have downsized the outreach services for immunisation and maternal health services such as anti-natal checkups. Outreach services include activities including organising of vaccination days or providing door-step services. Vaccination services were being provided only at the Primary Health Centers, District Hospitals, Medical colleges etc, in the present state of lockdown. A situation like this has a direct impact on lowering the immunisation coverage as people in far flung areas cannot visit the required health facilities because of lockdown. Experts have shared that such a situation could lead to increased maternal mortality and may sink the immunity level of the population in the affected states.8
In a report published in The Lancet, Niranjan Bhat, Head of Vaccine Impact Research at the Center for Vaccine Innovation and Access at PATH, US, shared that “Due to the redeployment of health personnel to COVID-19 activities, there are no routine immunisations.”9
Thus, the disruptions in outreach services and routine immunisation as well as patient inability to access health facilities in lockdown calls for innovation to bridge these challenges.
Getting vaccines to patients
One of the crucial elements affecting immunisation is the supply chain of the vaccine which is responsible for delivering the product from the site of manufacturing to the target beneficiary.
India fulfills nearly half or 1.25 billion requirements of doses out of 2.4 billion doses of vaccines required by UNICEF. Lockdown has not only impacted the export from major manufacturers of vaccines like India but has also jeopardised the import to many countries which are also confronted with nationwide lockdown or import restrictions, preventing them from receiving the vaccine. The damage caused by COVID-19 over the last three months may therefore result in outbreaks of alarming diseases worldwide due to significant issues with the manufacture and delivery of the vaccines required.10
Thus, revisiting export and import policies for prophylactics during the pandemic outbreak should be a point of concern and strategic decision for the manufacturers, exporters and importers of vaccines.
…disruptions in outreach services and routine immunisation as well as patient inability to access health facilities in lockdown calls for innovation”
In one of its briefs, UNICEF shared that although governments will have to temporarily delay mass vaccination initiatives to ensure that immunisation distribution does not lead to COVID-19 transmission, UNICEF “strongly suggests” that policymakers start “rigorous preparations now” to improve immunisation efforts once the pandemic is under control.11 The report further suggested that the vaccination efforts should concentrate on children who will skip doses of vaccines during the COVID-19 interruption period and should give priority to the poorest and most vulnerable children.
The points below should therefore be the point and concern, discussion and future planning to counter the deficiencies faced in immunisation services during COVID-19:
Causes of missed schedule of vaccination should be investigated from the community and mitigation strategies should be framed
Logistics management of vaccines during the outbreak should be a point of concern and strategic decision and critical thinking should be undertaken by manufacturers, exporters and importers of vaccines, United Nations (UN) agencies and government authorities
As suggested by UNICEF, the government should focus on “rigorous preparations now” to improve immunisation efforts once the pandemic is under control.
About the author
Dr Saurabh Kumar Banerjee is passionate academician in the sphere of Pharmaceutical Management. He is working as Dean & Associate Professor in School of Pharmaceutical Management, IIHMR University, Jaipur, India. He has more than 15 years of experience in academics, research, and industry cumulatively.
Roxanne Nelson , (The Lancet , April 17, 2020), Volume 20, Issue 5, P546, COVID-19 disrupts vaccine delivery The impact of the ongoing pandemic of coronavirus 2019 on immunisation campaigns in low- and middle-income countries is concerning, Retrieved from https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820%2930304-2
This website uses cookies to enable, optimise and analyse site operations, as well as to provide personalised content and allow you to connect to social media. By clicking "I agree" you consent to the use of cookies for non-essential functions and the related processing of personal data. You can adjust your cookie and associated data processing preferences at any time via our "Cookie Settings". Please view our Cookie Policy to learn more about the use of cookies on our website.
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorised as ”Necessary” are stored on your browser as they are as essential for the working of basic functionalities of the website. For our other types of cookies “Advertising & Targeting”, “Analytics” and “Performance”, these help us analyse and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these different types of cookies. But opting out of some of these cookies may have an effect on your browsing experience. You can adjust the available sliders to ‘Enabled’ or ‘Disabled’, then click ‘Save and Accept’. View our Cookie Policy page.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Cookie
Description
cookielawinfo-checkbox-advertising-targeting
The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Advertising & Targeting".
cookielawinfo-checkbox-analytics
This cookie is set by GDPR Cookie Consent WordPress Plugin. The cookie is used to remember the user consent for the cookies under the category "Analytics".
cookielawinfo-checkbox-necessary
This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-performance
This cookie is set by GDPR Cookie Consent WordPress Plugin. The cookie is used to remember the user consent for the cookies under the category "Performance".
PHPSESSID
This cookie is native to PHP applications. The cookie is used to store and identify a users' unique session ID for the purpose of managing user session on the website. The cookie is a session cookies and is deleted when all the browser windows are closed.
viewed_cookie_policy
The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.
zmember_logged
This session cookie is served by our membership/subscription system and controls whether you are able to see content which is only available to logged in users.
Performance cookies are includes cookies that deliver enhanced functionalities of the website, such as caching. These cookies do not store any personal information.
Cookie
Description
cf_ob_info
This cookie is set by Cloudflare content delivery network and, in conjunction with the cookie 'cf_use_ob', is used to determine whether it should continue serving “Always Online” until the cookie expires.
cf_use_ob
This cookie is set by Cloudflare content delivery network and is used to determine whether it should continue serving “Always Online” until the cookie expires.
free_subscription_only
This session cookie is served by our membership/subscription system and controls which types of content you are able to access.
ls_smartpush
This cookie is set by Litespeed Server and allows the server to store settings to help improve performance of the site.
one_signal_sdk_db
This cookie is set by OneSignal push notifications and is used for storing user preferences in connection with their notification permission status.
YSC
This cookie is set by Youtube and is used to track the views of embedded videos.
Analytics cookies collect information about your use of the content, and in combination with previously collected information, are used to measure, understand, and report on your usage of this website.
Cookie
Description
bcookie
This cookie is set by LinkedIn. The purpose of the cookie is to enable LinkedIn functionalities on the page.
GPS
This cookie is set by YouTube and registers a unique ID for tracking users based on their geographical location
lang
This cookie is set by LinkedIn and is used to store the language preferences of a user to serve up content in that stored language the next time user visit the website.
lidc
This cookie is set by LinkedIn and used for routing.
lissc
This cookie is set by LinkedIn share Buttons and ad tags.
vuid
We embed videos from our official Vimeo channel. When you press play, Vimeo will drop third party cookies to enable the video to play and to see how long a viewer has watched the video. This cookie does not track individuals.
wow.anonymousId
This cookie is set by Spotler and tracks an anonymous visitor ID.
wow.schedule
This cookie is set by Spotler and enables it to track the Load Balance Session Queue.
wow.session
This cookie is set by Spotler to track the Internet Information Services (IIS) session state.
wow.utmvalues
This cookie is set by Spotler and stores the UTM values for the session. UTM values are specific text strings that are appended to URLs that allow Communigator to track the URLs and the UTM values when they get clicked on.
_ga
This cookie is set by Google Analytics and is used to calculate visitor, session, campaign data and keep track of site usage for the site's analytics report. It stores information anonymously and assign a randomly generated number to identify unique visitors.
_gat
This cookies is set by Google Universal Analytics to throttle the request rate to limit the collection of data on high traffic sites.
_gid
This cookie is set by Google Analytics and is used to store information of how visitors use a website and helps in creating an analytics report of how the website is doing. The data collected including the number visitors, the source where they have come from, and the pages visited in an anonymous form.
Advertising and targeting cookies help us provide our visitors with relevant ads and marketing campaigns.
Cookie
Description
advanced_ads_browser_width
This cookie is set by Advanced Ads and measures the browser width.
advanced_ads_page_impressions
This cookie is set by Advanced Ads and measures the number of previous page impressions.
advanced_ads_pro_server_info
This cookie is set by Advanced Ads and sets geo-location, user role and user capabilities. It is used by cache busting in Advanced Ads Pro when the appropriate visitor conditions are used.
advanced_ads_pro_visitor_referrer
This cookie is set by Advanced Ads and sets the referrer URL.
bscookie
This cookie is a browser ID cookie set by LinkedIn share Buttons and ad tags.
IDE
This cookie is set by Google DoubleClick and stores information about how the user uses the website and any other advertisement before visiting the website. This is used to present users with ads that are relevant to them according to the user profile.
li_sugr
This cookie is set by LinkedIn and is used for tracking.
UserMatchHistory
This cookie is set by Linkedin and is used to track visitors on multiple websites, in order to present relevant advertisement based on the visitor's preferences.
VISITOR_INFO1_LIVE
This cookie is set by YouTube. Used to track the information of the embedded YouTube videos on a website.
Nice piece of information.
Thanks
Knowledgeable.
Helpful insights!!
Congratulations sir!!