Did India really lag behind vaccinating against critical diseases as claimed by PM Modi?
On June 7, Prime Minister Narendra Modi said India had to wait for decades before it could procure vaccines for smallpox, hepatitis B or Polio. "When vaccination programmes ended in other countries, it wouldn't have even begun in our country, he said. India Today TV spoke to numerous experts to understand whether India's vaccination drive has picked up post 2014, with the BJP-led central government's Mission Indradhanush, a programme launched by the BJP-led government in December 2014, to strengthen and re-energize the programme and achieve full immunisation coverage for all children and pregnant women at a rapid pace. India Today TV also analysed a paper published by the Indian Council of Medical Research to understand India's history of immunisation. ALSO READ: Online registration on CoWIN not mandatory for Covid vaccination: Health Ministry  Here is what experts have said  "While I'm not aware of any data supporting PM's claim of vaccination improving dramatically between 2014 and now, it is true that India introduced new vaccines in its vaccination programme often with long delays. This was not for lack of but despite India's remarkable vaccine production capabilities. Oommen Kurian, senior fellow, health initiative, Observer Research Foundation told India Today TV. The Prime Minister said that after 2014, the percentage of children covered under vaccination increased from from 60 per cent to 90 per cent. The last National Family health survey does not reflect this. The National Family Health Survey, 5, the report for 2019-2020, contains data for only 22 states and union territories. Of these, only 17 have been successful in achieving more than 70% vaccination coverage. GAVI LAUDS INDIA'S EFFORTS MADE BEFORE 2014  A report from Gavi Meeting of the strategic advisory group of experts on immunisation lists India, along with 15 other countries that had reached 80 per cent to 89 per cent coverage in 2014. This is for Routine immunisation coverage in Gavi countries. This was before mission Indradhanush and Intensified Mission Indradhanush  the immunisation programmes of the BJP-led government. EXPERTS SAY INDIA WAS DEPENDENT BUT THINGS CHANGED POST 1985  Experts say that while before the universal immunisation programme in 1985, Indias drive can be criticised for being sluggish, but things changed 40 years ago. Professor Giridhara Babu, while speaking to India Today TV said he agrees with the Prime Minister that before the Universal Immunisation programme that started in 1985, India had to rely on UNICEF and other agencies for vaccines. "However, with the UIP and several other supplementary programmes, India developed the capacity to manufacture several vaccines, including being self-reliant on some vaccines. Some of this were obtained in the country even before Covid-19." he said. ALSO READ | Fact Check: You can sleep through this viral claim saying anaesthetics can kill vaccinated people  "Starting 2008, India's vaccination programme has increased by leaps and bounds. Some important research on vaccines happened during this time. In 2011, India eradicated polio. Between 2008 and 2013, a number of institutional mechanisms were created, says professor Chandrakant Lahariya, author of Till We Win, and well known epidemiologist. Professor Chandrakant Lahariya, however, added that even before starting of the universal immunisation programme, 'India had evolved in its efforts'. Lahariya, in his paper, History of vaccines & vaccination in India says that India, "The science of vaccine evolved across the globe in late 19th century and India was amongst a few countries to have been involved in these efforts. The cholera and typhoid vaccine trials and research and discovery of plague vaccine took place in the country. Vaccine institutes were set up in early and whole of twentieth century. Though the pattern moved from public to private vaccine manufacturing units but the country has retained self-sufficiency through indigenous production. Smallpox has been eradicated and the country has become poliomyelitis-free since January 2011." ALSO READ: Govt confirms first death after Covid vaccination in India  ACCESS HAS NOT BEEN A PROBLEM  Lahariya in his paper, highlights other problems with India's immunization drive against diseases. "The coverage with vaccines in National Immunization Programme is suboptimal and only 3/5th children receive all due vaccines and only 3/4th receive 3 doses of DPT vaccines," he writes. He also says that apart from variations in inter and intra-state data, there are problems of lack of supervision and monitoring. Lahariya's paper highlights important milestones. https://www.ijmr.org.in/temp/IndianJMedRes1394491-5578635_152946.pdf  1893 Efficacy trials on cholera vaccine conducted in Agra, India  1897 First plague vaccine discovered by Dr Haffkine  1904/1905 First vaccine research institute established at Kasauli, Himachal Pradesh  1907 Pasteur Institute of India, Coonoor, manufactured neural tissue anti-rabies vaccine  1920-1939 DPT, DT and TT vaccine became available in the country  1940 Drug and Cosmetics Act enacted  1948 BCG vaccine laboratory set up in Guindy, near Madras (Chennai)  1951 Liquid BCG vaccine became available in India as part of mass campaigns  1965 Live attenuated freeze dried smallpox vaccine became available  1967 Freeze dried BCG vaccine became available  OPV became available in India  1970 The first time in India indigenous Oral Polio Vaccine Trivalent (Sabin) was developed and produced  1980s Indigenous measles vaccine production started  1984 Inactivated polio vaccine first produced in India (later on production stopped)  1985/1988 AEFI surveillance system established and initial guidelines were released  1989 Indian Vaccine Company Limited (IVCOL) and Bharat Immunological and Biological Limited (BIBCOL) were set up as public private joint venture companies  1997 First ever recombinant DNA hepatitis B vaccine developed in India  2006 Guidelines for clinical trials by Indian Council of Medical Research (ICMR)  2009 Three Indian manufacturers developed pandemic flu (Novel H1N1: 2009) vaccine  2010 National Pharmacovigilance Programme of India launched  Meningitis A vaccine for African Meningitis Belt licensed and successfully used in campaigns in Africa  Indigenously researched bivalent oral cholera vaccine developed and licensed in the country  2012 An indigenous inactivated JE vaccine licensed in the country. Indian manufacturer acquired capacity to produce inactivated polio vaccine  "In the post-independence period, the BCG vaccine laboratory and other national institutes were established; a number of private vaccine manufacturers came up, besides the continuation of smallpox eradication effort till the country became smallpox free in 1977," Lahariya writes in his paper. But critics argue that India still lagged if compared to developed countries like the US and that accessibility for the poor was a problem. Also Read | Covid vaccines 'superbly safe', adverse events 0.18% of total vaccinations: Centre  "It is true that India introduced new vaccines in its vaccination programme often with long delays. This was not for lack of but despite India's remarkable vaccine production capabilities. For example, between mid 1980s and the 21st century, no new vaccine was introduced to the Universal Immunisation Programme in India, though more vaccines were available for the rich" Oommen says. Vaccine researchers look at Indias immunisation drive in different stages  There were setbacks like World War-I for example and the expectation is that the pandemic will also be a roadblock but significant strides in 2011 for example when we eradicated polio. Leaving aside the change in political regimes in the last 40 years or even before, what is important is to achieve speedy vaccination against the global challenge of Covid-19. And whatever the take on the PMs statement, the consensus is that vaccinating 100% of the population should be the target. ALSO READ: Why WHO approval is not enough for Chinese Covid-19 vaccines