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Picture Courtesy: The Hindu

Context

India faces a substantial but underestimated burden from influenza, with two annual peaks in infection: winter (Jan–Mar) and post-monsoon (July–Sep). Despite this, influenza is often perceived as a mild illness, and less than 5% of Indians receive flu vaccines, which are not part of the Universal Immunisation Program (UIP).

What are Influenzas?

Influenza, commonly known as the flu, is a contagious respiratory illness caused by influenza viruses. It affects the nose, throat, and sometimes the lungs, leading to symptoms like fever, cough, sore throat, body aches, fatigue. Influenza spreads easily from person to person through droplets when an infected person coughs, sneezes, or talks. It can cause mild to severe illness and can be particularly dangerous for young children, older adults, and people with underlying health conditions.

Challenges with the Current Flu Vaccination Approach:

• Disproportionate focus on H1N1 ("swine flu") sidelines other circulating strains like H3N2 and Influenza B, both of which have caused severe outbreaks recently.
• Limited vaccine protection duration—generally lasting only 3 to 6 months—makes annual vaccination inadequate for India’s two-peak flu pattern.
• Effectiveness varies:
• By strain: Most effective for H1N1, less so for H3N2
• By age: Lower immune response in young children and older adults
• Vaccination timing: A single dose may only cover one peak, leaving individuals exposed during the other. 

Suggested Strategy

A biannual vaccination plan could offer improved protection:

• First dose in May or June, before the monsoon surge
• Second dose in November or December, ahead of the winter season

This strategy could lead to fewer infections, hospitalisations, and deaths, particularly benefiting children, who are among the most vulnerable.

Challenges in implementation

• Public misconception that flu is a mild illness
• Low awareness of vaccine benefits
• Policy limitations, as flu vaccines are not currently part of national immunisation efforts
• Operational hurdles in rolling out two vaccination rounds each year 

Way Forward

• Incorporate influenza vaccines into the UIP
• Run awareness campaigns to educate the public about the risks of flu and the benefits of vaccination
• Utilise India's vaccine production strength to ensure wide availability and affordability
• Prioritise high-risk populations such as:
• Young children
• Elderly individuals
• Those with chronic health conditions

Major Immunisation Initiatives

Universal Immunization Programme (UIP)

The Universal Immunization Programme began in 1978 as the Expanded Programme on Immunization, primarily targeting urban populations. It was renamed as UIP in 1985 when its scope expanded to include rural areas. Over time, UIP became part of broader health initiatives — first incorporated into the Child Survival and Safe Motherhood Programme in 1992, and later into the National Reproductive and Child Health Programme in 1997. Since 2005, under the National Rural Health Mission, UIP has prioritized ensuring vaccine availability and access even in the most remote regions. As of the financial year 2023-24, India’s full immunization coverage stands at approximately 93.23% nationwide.

Mission Indradhanush (MI)

Launched in December 2014, Mission Indradhanush aims to increase full immunization coverage to at least 90%. This initiative targets areas with persistently low vaccination rates, focusing on hard-to-reach populations and communities where children remain unvaccinated or partially vaccinated. MI works to bridge gaps by strengthening outreach and delivery systems in underserved regions.

U-WIN Portal

The U-WIN Portal is a digital platform designed to improve the vaccination process through streamlined delivery and record management. It offers recipients the flexibility to schedule vaccinations anytime and anywhere, enhancing accessibility. The portal generates a universal QR-coded eVaccination Certificate and supports the creation of an Ayushman Bharat Health Account (ABHA) ID, facilitating better integration of immunization records within India’s health ecosystem. 

Source: The Hindu