GS Paper II · Social Justice · Health · Welfare Schemes
Universal Immunisation Programme (UIP)
Complete UPSC notes — UIP overview, vaccine schedule, Mission Indradhanush (all phases), Measles/Mumps/Rubella, Polio eradication, cold chain, current affairs, PYQs and practice MCQs — all in one place.
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Universal Immunisation Programme (UIP) — Overview
Launch · Target groups · Scale · Key statistics · Cold chain
Definition & Launch
The Universal Immunisation Programme (UIP) is one of the largest public health initiatives globally, launched by the Government of India to provide free vaccines against preventable diseases to all children and pregnant women. Originally launched as Expanded Programme on Immunisation (EPI) in 1978, expanded to the Universal Immunisation Programme in 1985. Aim: reduce child and maternal mortality and morbidity through high immunisation coverage.
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Target Groups
Children aged 0–16 years (focus on under 5) and pregnant women. Annually targets ~26 million children and ~29 million pregnant women.
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Scale of Delivery
~12 million vaccination sessions per year. Delivered through PHCs, sub-centres, outreach sessions and urban health posts across India's vast geography.
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Coverage (2023–24)
National full immunisation coverage: 93.5% (FY 2023–24). Up from 62% (NFHS-4, 2015–16) and 77% (NFHS-5, 2021). Significant progress.
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Cold Chain System
Vaccines must be stored at specific temperatures (2–8°C for most; -15°C to -25°C for OPV). Robust cold chain = essential to maintain vaccine potency. India has one of the world's largest cold chain networks.
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Monitoring
Health Management Information System (HMIS) + periodic surveys (NFHS, DLHS, CES) track coverage. eVIN (electronic Vaccine Intelligence Network) monitors cold chain real-time.
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Diseases Covered
Currently protects against 12+ diseases including TB, Polio, Hepatitis B, Diphtheria, Pertussis, Tetanus, Measles, Rubella, Japanese Encephalitis, Rotavirus diarrhoea, Pneumonia, and more.
Simple Way to Remember — Why UIP Matters
Before UIP, vaccine-preventable diseases killed millions of Indian children every year. UIP makes vaccines FREE, UNIVERSAL (for all), and ROUTINE (at scheduled intervals). India's child mortality rate has fallen dramatically — from 126 per 1000 live births (1990) to ~32 (2020) — and UIP is a key reason. Polio eradication (2014) is UIP's biggest success story.
| Vaccine | Diseases Prevented | Given To | Key Notes |
|---|---|---|---|
| BCG (Bacillus Calmette-Guérin) | Tuberculosis (especially TB meningitis & miliary TB in children) | At birth | Oldest vaccine in UIP. Live attenuated Mycobacterium bovis. Intradermal injection. Does NOT prevent pulmonary TB in adults reliably. |
| OPV (Oral Polio Vaccine) | Poliomyelitis (all 3 serotypes) | Birth + 6, 10, 14 weeks + boosters | Live attenuated oral vaccine. Oral drops. Creates herd immunity via gut shedding. Pulse Polio Programme. India polio-free since 2014. |
| IPV (Inactivated Polio Vaccine) | Poliomyelitis | 6 weeks (one dose with Penta) | Added to UIP 2015. Killed vaccine — safer, cannot cause VAPP. Both OPV + IPV used (hybrid strategy). |
| Hepatitis B | Hepatitis B (liver disease, cirrhosis, liver cancer) | Birth dose + 3 doses in Pentavalent | Birth dose within 24 hours is critical to prevent mother-to-child transmission. |
| Pentavalent | Diphtheria, Pertussis (Whooping cough), Tetanus, Hepatitis B, Haemophilus influenzae type B (meningitis, pneumonia) | 6, 10, 14 weeks | 5-in-1 vaccine. Replaced DPT + Hib + Hep B separate injections. Major step in simplifying immunisation. UPSC Favourite |
| Rotavirus Vaccine (RVV) | Rotavirus diarrhoea (leading cause of infant diarrhoea deaths) | 6, 10, 14 weeks | Added to UIP 2016. ROTAVAC — India's indigenously developed rotavirus vaccine (Bharat Biotech). CA |
| PCV (Pneumococcal Conjugate Vaccine) | Pneumonia, meningitis caused by Streptococcus pneumoniae | 6, 14 weeks + booster at 9 months | Added 2017 (select states). Now being expanded nationally. Addresses leading cause of child pneumonia deaths. |
| MR / MMR (Measles-Rubella) | Measles, Rubella (and Mumps in MMR) | 9 months + 16–24 months | MR vaccine introduced 2017. Large-scale MR Campaign — 410 million children vaccinated. Critical for eliminating Congenital Rubella Syndrome (CRS). |
| JE Vaccine (Japanese Encephalitis) | Japanese Encephalitis (brain fever) | 9–12 months + booster (endemic areas) | Given only in JE-endemic districts (UP, Bihar, Assam, WB, Karnataka, etc.). SA-14-14-2 live attenuated vaccine. |
| Tetanus Toxoid (TT) / Td | Neonatal tetanus, Maternal tetanus | Pregnant women (2 doses) + children (booster) | Maternal TT prevents neonatal tetanus — major historical cause of newborn deaths. India eliminated neonatal tetanus in 2015 (WHO certified). |
| Vitamin A | Not a vaccine — but part of UIP supplementation | 9 months, then every 6 months till 5 yrs | Prevents Vitamin A Deficiency (VAD), night blindness, and reduces child mortality. Part of UIP delivery platform. |
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National Immunisation Schedule — Age-wise Vaccine Chart
Birth · 6 weeks · 10 weeks · 14 weeks · 9 months · 16–24 months · 5–6 years · 10 years · 16 years
How to Read This Schedule
The immunisation schedule specifies WHEN each vaccine is given. Most childhood vaccines follow the "0-6-10-14 week" primary series followed by boosters. Timing matters because the infant immune system responds best at specific developmental stages.
Age
Vaccines Given
🔴 Birth
BCG (1 dose) • OPV-0 (birth dose) • Hepatitis B-1 (within 24 hours of birth — crucial!)
🟠 6 Weeks
Pentavalent-1 (DPT+HepB+Hib) • OPV-1 • IPV-1 • Rotavirus-1 • PCV-1
🟡 10 Weeks
Pentavalent-2 • OPV-2 • Rotavirus-2
🟢 14 Weeks
Pentavalent-3 • OPV-3 • IPV-2 • Rotavirus-3 • PCV-2
🔵 9 Months
MR-1 (Measles-Rubella) • Vitamin A (1st dose) • PCV Booster • JE Vaccine-1 (endemic areas)
🟣 16–24 Months
MR-2 • DPT Booster-1 • OPV Booster • Vitamin A (2nd dose) • JE Vaccine-2 (endemic)
⭐ 5–6 Years
DPT Booster-2
⭐ 10 Years
Td (Tetanus-diphtheria booster)
⭐ 16 Years
Td (Tetanus-diphtheria booster — final UIP dose)
🤰 Pregnant Women
TT/Td — 2 doses (or 1 booster if previously immunised). Prevents neonatal and maternal tetanus.
Mnemonic — Primary Series "0-6-10-14"
Birth (0) → 6 weeks → 10 weeks → 14 weeks = Primary series for most vaccines (Pentavalent, OPV, IPV, Rotavirus, PCV)
Then: 9 months = MR-1 + Vit A | 16 months = MR-2 + DPT booster
Think: "Birth, Six, Ten, Fourteen, Nine, Sixteen"
Then: 9 months = MR-1 + Vit A | 16 months = MR-2 + DPT booster
Think: "Birth, Six, Ten, Fourteen, Nine, Sixteen"
📋 PYQ — UPSC PrelimsClassic
Which vaccine is administered to pregnant women under India's Universal Immunisation Programme to prevent neonatal tetanus?
- (a) BCG
- (b) OPV
- (c) Tetanus Toxoid (TT/Td) ✓ Correct
- (d) Hepatitis B
Explanation: Tetanus Toxoid (TT) or its combined form Td (Tetanus-diphtheria) is administered to pregnant women under UIP to protect against neonatal tetanus — a major cause of newborn deaths historically. Maternal antibodies cross the placenta and protect the newborn baby. India achieved WHO certification for elimination of maternal and neonatal tetanus in 2015 — a landmark UIP achievement. Two doses of TT are given to pregnant women (or one booster if the woman was previously immunised). BCG is given at birth. OPV is for children. Hepatitis B first dose is given at birth within 24 hours.
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Mission Indradhanush — Reaching the Unreached
Launched 2014 · 5 phases · 54.6 million children vaccinated · Zero-dose children
Why "Indradhanush" (Rainbow)?
Named after the rainbow — just as a rainbow has 7 colours, the programme aimed to protect children against (originally 7, now more) vaccine-preventable diseases. Launched on December 25, 2014 by the Ministry of Health and Family Welfare. Goal: achieve >90% full immunisation coverage in all districts by reaching unvaccinated and partially vaccinated children and pregnant women in low-coverage areas.
Phase
Year
Focus Areas
Key Achievement
Mission Indradhanush (MI)
2014
201 high-focus districts across 28 states & UTs — selected based on low immunisation coverage data
Vaccinated over 2 million children and 0.5 million pregnant women. Kick-started the intensification drive.
Intensified MI (IMI)
2017
121 districts + 17 urban areas with persistently low coverage. Focus on urban slums and tribal areas.
Achieved 6.7% increase in full immunisation coverage in targeted areas. Introduced more systematic tracking.
IMI 2.0
2019
272 districts in 27 states aiming for >90% full immunisation coverage. Focus on measles outbreak areas & low-coverage pockets.
Targeted areas with measles outbreaks. Used data analytics to identify "zero-dose" children (never received any vaccine).
IMI 3.0
2021
250 districts identified based on low routine immunisation performance. Focus on COVID-19 disrupted areas.
Emphasised reaching children and pregnant women missed due to COVID-19 pandemic. Catchup campaign post-COVID.
IMI 4.0
2022
416 districts across 33 states/UTs — largest coverage. Focus on unvaccinated and partially vaccinated children.
Aimed to mitigate pandemic disruptions and enhance coverage. Worked with ASHA workers for outreach.
IMI 5.0
2023
Special focus on improving Measles and Rubella vaccination coverage. Zero-dose children targeted.
All three rounds concluded on October 14, 2023. Targeted zero-dose children. Major push for measles elimination.
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Total Achievement (All Phases)
As of December 2024, Mission Indradhanush has vaccinated:
→ 54.6 million children
→ 13.2 million pregnant women
across all phases combined. High Yield Stat
→ 54.6 million children
→ 13.2 million pregnant women
across all phases combined. High Yield Stat
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"Zero-Dose Children" Concept
Children who have never received a single vaccine. India has one of the world's largest zero-dose child populations (~2.7 million as per UNICEF 2022). Mission Indradhanush specifically targets them. Linked to poverty, geographic remoteness, distrust of healthcare.
📋 PYQ — UPSC Prelims2016
"Mission Indradhanush" is related to:
- (a) Launching satellites in space
- (b) Immunisation of children and pregnant women ✓ Correct
- (c) Providing solar energy to rural households
- (d) Cleaning rivers and water bodies
Explanation: Mission Indradhanush is India's flagship immunisation drive launched on December 25, 2014 by the Ministry of Health and Family Welfare. Named after the rainbow (Indradhanush in Hindi), it aims to rapidly increase immunisation coverage by targeting unvaccinated and partially vaccinated children and pregnant women, especially in areas with persistently low coverage. As of December 2024, it has vaccinated 54.6 million children and 13.2 million pregnant women across all phases (MI through IMI 5.0). It is implemented under the Universal Immunisation Programme (UIP) and National Health Mission (NHM).
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Measles, Mumps & Rubella — The MMR Triad
Causes · Symptoms · Complications · CRS · India's MR Campaign · Elimination targets
| Feature | Measles | Mumps | Rubella |
|---|---|---|---|
| Cause | Measles virus (Paramyxovirus) | Mumps virus (Paramyxovirus) | Rubella virus (Togavirus family) |
| Transmission | Airborne via respiratory droplets. Most contagious infectious disease known (R₀ = 12–18) | Direct contact, respiratory droplets | Airborne via respiratory droplets or direct contact with infected person |
| Key Symptoms | High fever, cough, runny nose (coryza), conjunctivitis (red eyes), characteristic red rash (maculopapular — starts on face, spreads downward). Koplik's spots (white spots inside mouth — pathognomonic of measles) | Swollen salivary glands (parotitis — puffy cheeks), fever, headache, muscle aches | Mild fever, rash (lighter than measles, lasts ~3 days), swollen lymph nodes (especially behind ear). Often mild in children. |
| Key Complications | Pneumonia (leading cause of measles death), encephalitis (brain inflammation), blindness (from vitamin A deficiency + measles), hearing loss, death. "The cough of measles kills" | Orchitis (testicular inflammation, in post-pubertal males → infertility), oophoritis (in females), meningitis, encephalitis, pancreatitis | Congenital Rubella Syndrome (CRS) — if a pregnant woman is infected → baby born with heart defects, deafness, eye cataracts, intellectual disabilities. Most dangerous in 1st trimester |
| Vaccine | MR vaccine (Measles-Rubella) or MMR. 2 doses needed for full protection | MMR vaccine (Measles-Mumps-Rubella) | MR or MMR vaccine. Critical for protecting pregnant women via population immunity |
| India status | India targets measles elimination by 2023 (WHO SEARO target). Still has outbreaks in low-coverage areas. | Mumps not separately tracked; MMR given in some states/private sector | India targets rubella control by 2023. MR campaign 2017 — 410 million children vaccinated. Huge success. |
⭐ Congenital Rubella Syndrome (CRS) — High-Yield UPSC Topic
What is CRS? When a pregnant woman gets infected with rubella (especially in the first 3 months/first trimester), the virus crosses the placenta and damages the developing fetus's organs.
Defects caused by CRS:
→ Heart defects (patent ductus arteriosus, VSD, pulmonary stenosis)
→ Deafness (most common CRS manifestation)
→ Eye cataracts and glaucoma
→ Intellectual disabilities and autism-like features
→ Microcephaly, liver/spleen enlargement, low birth weight
→ Risk is highest if infection occurs in weeks 1–12 of pregnancy
Defects caused by CRS:
→ Heart defects (patent ductus arteriosus, VSD, pulmonary stenosis)
→ Deafness (most common CRS manifestation)
→ Eye cataracts and glaucoma
→ Intellectual disabilities and autism-like features
→ Microcephaly, liver/spleen enlargement, low birth weight
→ Risk is highest if infection occurs in weeks 1–12 of pregnancy
Why India focused on this: Before the 2017 MR campaign, India had ~40,000 CRS cases per year. Many children were born deaf or with heart defects because their mothers had rubella during pregnancy.
India's MR Campaign (2017): Administered MR (Measles-Rubella) vaccine to 410 million children aged 9 months to 15 years across India — one of the largest vaccination campaigns in history.
Key message: By vaccinating children, we protect pregnant women by herd immunity → no rubella in community → no CRS births. India targets rubella control (reducing CRS to near zero) as part of the UIP strategy.
India's MR Campaign (2017): Administered MR (Measles-Rubella) vaccine to 410 million children aged 9 months to 15 years across India — one of the largest vaccination campaigns in history.
Key message: By vaccinating children, we protect pregnant women by herd immunity → no rubella in community → no CRS births. India targets rubella control (reducing CRS to near zero) as part of the UIP strategy.
Measles — Key UPSC Facts
1. Measles has the highest basic reproduction number (R₀ = 12–18) of any infectious disease — one case infects 12–18 people on average in an unvaccinated population. COVID-19 had R₀ ~2–3 by comparison.
2. 2 doses of measles vaccine needed for 95–97% protection (herd immunity threshold). If coverage drops below this, outbreaks occur.
3. Measles weakens the immune system for 2–3 years post-infection (immune amnesia) — making children vulnerable to other infections.
4. Vitamin A supplementation during measles infection reduces severity and mortality — which is why Vitamin A is part of UIP.
2. 2 doses of measles vaccine needed for 95–97% protection (herd immunity threshold). If coverage drops below this, outbreaks occur.
3. Measles weakens the immune system for 2–3 years post-infection (immune amnesia) — making children vulnerable to other infections.
4. Vitamin A supplementation during measles infection reduces severity and mortality — which is why Vitamin A is part of UIP.
📋 PYQ — UPSC Prelims2021
Congenital Rubella Syndrome (CRS) occurs when a pregnant woman is infected with rubella. Which of the following correctly describes CRS?
- (a) A condition in children caused by vitamin C deficiency during pregnancy
- (b) Birth defects in a newborn due to rubella virus infection during pregnancy, including heart defects, deafness, and intellectual disabilities ✓ Correct
- (c) A syndrome where the rubella virus causes encephalitis in children after vaccination
- (d) A condition where the newborn is immune to all childhood diseases due to maternal antibodies
Explanation: Congenital Rubella Syndrome (CRS) occurs when the rubella virus infects a pregnant woman — especially in the first trimester (weeks 1–12) — and crosses the placenta to infect the developing fetus. This causes a constellation of birth defects: heart defects (patent ductus arteriosus, VSD), deafness (most common), eye cataracts/glaucoma, and intellectual disabilities. India had approximately 40,000 CRS cases per year before the 2017 MR (Measles-Rubella) campaign. The MR vaccine, when given to children (achieving herd immunity), protects pregnant women from rubella exposure → prevents CRS. India's 2017 MR campaign vaccinated 410 million children aged 9 months to 15 years — one of the world's largest vaccination campaigns.
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Other Key Vaccine-Preventable Diseases
Polio · BCG/TB · Hepatitis B · Rotavirus · Japanese Encephalitis · Pneumonia
✅ Polio — India's Greatest Immunisation Achievement
Disease: Poliomyelitis — viral infection (poliovirus) causing permanent paralysis (mostly of legs) and death. Enters through contaminated food/water → multiplies in intestine → can reach spinal cord → destroys motor neurons.
Vaccines: OPV (Oral Polio Vaccine — live attenuated) + IPV (Inactivated Polio Vaccine — killed). OPV: cheap, oral, creates gut immunity. IPV: injected, safer (no VAPP risk).
VAPP: Vaccine-Associated Paralytic Polio — extremely rare complication of OPV (~1 in 2.7 million doses). This is why IPV was added in 2015.
Vaccines: OPV (Oral Polio Vaccine — live attenuated) + IPV (Inactivated Polio Vaccine — killed). OPV: cheap, oral, creates gut immunity. IPV: injected, safer (no VAPP risk).
VAPP: Vaccine-Associated Paralytic Polio — extremely rare complication of OPV (~1 in 2.7 million doses). This is why IPV was added in 2015.
Pulse Polio Programme: Launched 1994–95. National Immunisation Days (NIDs) where all children under 5 receive OPV drops simultaneously — regardless of prior vaccination status. "Do Boond Zindagi Ki" (Two drops of life) campaign.
India Polio-Free: Last polio case reported January 13, 2011 (Howrah, West Bengal). WHO certified India polio-free on March 27, 2014. The most celebrated public health success in Indian history. High Yield
Challenge: As long as polio exists anywhere in the world, IPV+OPV vaccination must continue to prevent re-importation. Pakistan and Afghanistan still have wild poliovirus.
India Polio-Free: Last polio case reported January 13, 2011 (Howrah, West Bengal). WHO certified India polio-free on March 27, 2014. The most celebrated public health success in Indian history. High Yield
Challenge: As long as polio exists anywhere in the world, IPV+OPV vaccination must continue to prevent re-importation. Pakistan and Afghanistan still have wild poliovirus.
💙 BCG Vaccine — Tuberculosis Protection in Children
Disease prevented: Severe forms of TB in children — TB meningitis (brain TB) and miliary TB (disseminated TB). Does NOT reliably prevent pulmonary (lung) TB in adults.
Vaccine: Live attenuated Mycobacterium bovis (related to TB bacteria). Intradermal injection at birth.
India: 14% of global TB burden — highest in world. BCG important but insufficient alone. India launched National Tuberculosis Elimination Programme (NTEP) targeting TB elimination by 2025 (5 years ahead of global SDG 2030 target). High Yield CA
PM TB Mukt Bharat Abhiyan: Community-driven initiative for TB elimination, launched 2022.
Vaccine: Live attenuated Mycobacterium bovis (related to TB bacteria). Intradermal injection at birth.
India: 14% of global TB burden — highest in world. BCG important but insufficient alone. India launched National Tuberculosis Elimination Programme (NTEP) targeting TB elimination by 2025 (5 years ahead of global SDG 2030 target). High Yield CA
PM TB Mukt Bharat Abhiyan: Community-driven initiative for TB elimination, launched 2022.
🟡 Rotavirus Vaccine — Fighting Infant Diarrhoea
Disease: Rotavirus gastroenteritis — most common cause of severe diarrhoea and death in children under 5 globally. Was responsible for ~87,000 child deaths per year in India.
Vaccine: Added to UIP in 2016. ROTAVAC — India's indigenously developed pentavalent rotavirus vaccine, developed by Bharat Biotech with AIIMS, NIH (USA). Cost breakthrough: ₹60 per dose vs ₹3,000 for imported vaccines. WHO pre-qualified. CA
Three oral doses at 6, 10, 14 weeks. Significant reduction in diarrhoea hospitalisations seen after introduction.
Vaccine: Added to UIP in 2016. ROTAVAC — India's indigenously developed pentavalent rotavirus vaccine, developed by Bharat Biotech with AIIMS, NIH (USA). Cost breakthrough: ₹60 per dose vs ₹3,000 for imported vaccines. WHO pre-qualified. CA
Three oral doses at 6, 10, 14 weeks. Significant reduction in diarrhoea hospitalisations seen after introduction.
🟣 Japanese Encephalitis Vaccine
Disease: Japanese Encephalitis (JE) — mosquito-borne viral brain fever. Most important cause of viral encephalitis in Asia. 25–30% case fatality rate; 30–50% survivors have permanent neurological disability.
Transmission: Culex mosquito (from pigs and water birds) → humans. NOT person-to-person.
Endemic areas in India: UP, Bihar, Assam, West Bengal, Odisha, Karnataka — major outbreaks in Gorakhpur (UP) historically.
Vaccine: SA-14-14-2 live attenuated JE vaccine. Two doses (9–12 months + booster). Given only in JE-endemic districts under UIP.
Context: Gorakhpur encephalitis deaths (2017) — children dying of acute encephalitis syndrome (AES) — some linked to JE, others to Scrub typhus and hypoglycaemia. Highlighted need for JE vaccination + supportive care infrastructure. CA
Transmission: Culex mosquito (from pigs and water birds) → humans. NOT person-to-person.
Endemic areas in India: UP, Bihar, Assam, West Bengal, Odisha, Karnataka — major outbreaks in Gorakhpur (UP) historically.
Vaccine: SA-14-14-2 live attenuated JE vaccine. Two doses (9–12 months + booster). Given only in JE-endemic districts under UIP.
Context: Gorakhpur encephalitis deaths (2017) — children dying of acute encephalitis syndrome (AES) — some linked to JE, others to Scrub typhus and hypoglycaemia. Highlighted need for JE vaccination + supportive care infrastructure. CA
| Disease | Causative Agent | Key Feature for UPSC |
|---|---|---|
| Diphtheria | Corynebacterium diphtheriae (bacteria) | Tough membrane in throat (pseudomembrane) → airway blockage. Prevented by DPT/Pentavalent vaccine. "Bull neck" appearance. |
| Pertussis (Whooping Cough) | Bordetella pertussis (bacteria) | "100-day cough" — severe coughing fits with characteristic "whoop" sound on inhalation. Dangerous in infants. Part of Pentavalent vaccine. |
| Tetanus | Clostridium tetani (bacteria) — spore-forming | Causes muscle spasms ("lockjaw"). Enters through wounds, umbilical cord (neonatal tetanus). TT vaccine. India eliminated neonatal tetanus 2015. |
| Hepatitis B | Hepatitis B virus (HBV) | Causes liver cirrhosis and liver cancer. Birth dose prevents mother-to-child transmission. Part of Pentavalent + birth dose. |
| Haemophilus influenzae type b (Hib) | Haemophilus influenzae bacteria | Causes bacterial meningitis and pneumonia in children under 5. NOT the same as influenza (flu) — common UPSC trap. Part of Pentavalent vaccine. |
| Pneumococcal disease | Streptococcus pneumoniae | Leads cause of child pneumonia and bacterial meningitis. PCV (Pneumococcal Conjugate Vaccine) added to UIP 2017. Expanding nationally. |
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Current Affairs — UIP & Immunisation
UPSC 2025–2026 · New vaccines · India achievements · Global context
🇮🇳 India — Key Developments
93.5% full immunisation coverage (FY 2023–24): Major achievement. Up from 62% in NFHS-4. India is on track to meet global targets.
CERVAVAC (HPV vaccine, Serum Institute): Approved 2022. WHO pre-qualified 2023. Budget 2023 announced free HPV vaccination for girls 9–14 years. India plans to include in UIP. Prevents cervical cancer (HPV strains 6, 11, 16, 18). High Yield CA
Adult Immunisation — New frontier: India expanding beyond children — adult vaccination for pneumococcal disease, influenza, typhoid, Hepatitis B (for healthcare workers) being discussed under National Health Policy framework.
iNCOVACC — Intranasal COVID vaccine: India first country to approve an intranasal COVID-19 vaccine (Bharat Biotech). Nasal spray → mucosal immunity (IgA in nasal passages). CA
ZyCov-D — DNA vaccine: India approved world's first DNA vaccine (Zydus Cadila, COVID-19). Needle-free. Landmark in vaccine technology. CA
CERVAVAC (HPV vaccine, Serum Institute): Approved 2022. WHO pre-qualified 2023. Budget 2023 announced free HPV vaccination for girls 9–14 years. India plans to include in UIP. Prevents cervical cancer (HPV strains 6, 11, 16, 18). High Yield CA
Adult Immunisation — New frontier: India expanding beyond children — adult vaccination for pneumococcal disease, influenza, typhoid, Hepatitis B (for healthcare workers) being discussed under National Health Policy framework.
iNCOVACC — Intranasal COVID vaccine: India first country to approve an intranasal COVID-19 vaccine (Bharat Biotech). Nasal spray → mucosal immunity (IgA in nasal passages). CA
ZyCov-D — DNA vaccine: India approved world's first DNA vaccine (Zydus Cadila, COVID-19). Needle-free. Landmark in vaccine technology. CA
🌍 Global Context & Frameworks
WHO Agenda for Immunisation 2030 (IA2030): Global framework for immunisation to 2030. Target: 90% national immunisation coverage in all countries; reduce zero-dose children by 50%; introduce new vaccines in more countries.
India's Measles-Rubella elimination target: WHO SEARO target = measles elimination and rubella control by 2023. India missed this — outbreaks continuing in UP, Gujarat, Maharashtra due to COVID-19 disruptions. IMI 5.0 (2023) specifically addressed this gap.
Global Polio Eradication Initiative (GPEI): Led by WHO, UNICEF, Rotary International, CDC, Bill & Melinda Gates Foundation. Polio eradicated from all continents except Pakistan and Afghanistan (wild poliovirus). cVDPV (circulating Vaccine-Derived Poliovirus) now a concern in unvaccinated communities — reason why both OPV + IPV are used.
Gavi, the Vaccine Alliance: International organisation providing co-financing for vaccines in low-income countries. India "graduated" from Gavi support (no longer receives subsidies) — sign of economic progress. India now manufactures and exports vaccines through Serum Institute (world's largest vaccine manufacturer) and Bharat Biotech. CA
India's Measles-Rubella elimination target: WHO SEARO target = measles elimination and rubella control by 2023. India missed this — outbreaks continuing in UP, Gujarat, Maharashtra due to COVID-19 disruptions. IMI 5.0 (2023) specifically addressed this gap.
Global Polio Eradication Initiative (GPEI): Led by WHO, UNICEF, Rotary International, CDC, Bill & Melinda Gates Foundation. Polio eradicated from all continents except Pakistan and Afghanistan (wild poliovirus). cVDPV (circulating Vaccine-Derived Poliovirus) now a concern in unvaccinated communities — reason why both OPV + IPV are used.
Gavi, the Vaccine Alliance: International organisation providing co-financing for vaccines in low-income countries. India "graduated" from Gavi support (no longer receives subsidies) — sign of economic progress. India now manufactures and exports vaccines through Serum Institute (world's largest vaccine manufacturer) and Bharat Biotech. CA
| Programme/Initiative | Launch | Key Focus |
|---|---|---|
| eVIN (Electronic Vaccine Intelligence Network) | 2015 | Real-time tracking of cold chain status (temperature) and vaccine stock across India. Used AI/IoT to prevent vaccine wastage. Scaled up during COVID-19 vaccination drive. |
| CoWIN Portal | 2021 (COVID) | Digital platform for COVID-19 vaccine registration, scheduling, and certificate generation. Adopted for routine immunisation tracking too. Global model — shared with 50+ countries. |
| U-WIN System | 2023–24 | Universal Immunisation Programme WIN system — digital registry for all routine childhood vaccines (extending CoWIN principle to UIP). Every child gets a vaccine ID. Improves tracking of vaccine schedule completion. |
| Intensified Mission Indradhanush (IMI) 5.0 | 2023 | Specific focus on Measles-Rubella. Three rounds concluding October 14, 2023. Target: zero-dose children and catch-up for COVID-19 disruption. CA |
| HPV vaccine free launch | 2023 (Budget announcement) | Government to provide free HPV vaccination (CERVAVAC) for girls aged 9–14 years. Inclusion in UIP being phased. First state pilots underway. |
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Practice MCQs — Universal Immunisation Programme
UPSC-style · Click an option to reveal answer
💉 Click any option to check your answer
Q1. The Pentavalent vaccine given under India's UIP protects children against how many diseases and which ones?
- (a) 3 diseases — Diphtheria, Pertussis, Tetanus
- (b) 4 diseases — Diphtheria, Pertussis, Tetanus, Hepatitis B
- (c) 5 diseases — Diphtheria, Pertussis, Tetanus, Hepatitis B, Haemophilus influenzae type b
- (d) 6 diseases — Diphtheria, Pertussis, Tetanus, Hepatitis B, Hib, Polio
The Pentavalent vaccine ("Penta" = five) protects against 5 diseases: (1) Diphtheria, (2) Pertussis (Whooping Cough), (3) Tetanus, (4) Hepatitis B, (5) Haemophilus influenzae type b (Hib) — which causes bacterial meningitis and pneumonia. It replaced the older DPT vaccine (3 diseases) and the separate Hib and Hepatitis B injections, simplifying the immunisation schedule and reducing the number of injections a child needs. Given at 6, 10, and 14 weeks. It is one of the most important vaccines in UIP and a frequent UPSC question. Important: Hib is NOT the same as influenza (flu) — they are different pathogens.
Q2. India was certified "Polio-free" by the WHO in which year?
- (a) 2011
- (b) 2012
- (c) 2014
- (d) 2016
India was certified Polio-free by WHO on March 27, 2014. The last case of wild poliovirus in India was reported on January 13, 2011 in Howrah, West Bengal. A country must have zero wild poliovirus cases for 3 consecutive years to be certified polio-free by WHO — hence the 2011 last case → 2014 certification. This was achieved through the Pulse Polio Programme (launched 1994–95) with National Immunisation Days where all children under 5 received OPV drops. "Do Boond Zindagi Ki" (Two drops of life) was the campaign slogan. India's polio eradication is considered one of the greatest public health achievements in history. As of 2025, only Pakistan and Afghanistan remain endemic for wild poliovirus.
Q3. ROTAVAC, India's indigenous rotavirus vaccine, was developed by which institution?
- (a) Serum Institute of India
- (b) Bharat Biotech International Ltd (BBIL)
- (c) Indian Immunologicals Limited
- (d) Panacea Biotec
ROTAVAC was developed by Bharat Biotech International Ltd (BBIL) in collaboration with the All India Institute of Medical Sciences (AIIMS) New Delhi, National Institute of Health (NIH) USA, and the Department of Biotechnology, Government of India. ROTAVAC is a pentavalent human-bovine reassortant rotavirus vaccine. It was approved by DCGI in 2014 and introduced into UIP in 2016. The vaccine costs about ₹60 per dose (vs ₹3,000+ for imported alternatives like Rotarix or RotaTeq), making it affordable for India's immunisation programme. WHO pre-qualified ROTAVAC in 2018. This was a landmark in India's vaccine self-reliance — an example of "Make in India" in public health. Serum Institute makes CERVAVAC (HPV) and Covishield (COVID).
Q4. What is the significance of the Hepatitis B "birth dose" being given within 24 hours of birth?
- (a) Hepatitis B is more effective when given before the child is exposed to any other vaccines
- (b) The birth dose protects against Hepatitis C which is common in newborns
- (c) Newborns have higher immune response in the first 24 hours
- (d) It prevents mother-to-child (vertical) transmission — if the mother is a Hepatitis B carrier, the baby is at high risk during delivery and needs immediate protection
The Hepatitis B birth dose (given within 24 hours) is specifically designed to prevent mother-to-child (vertical) transmission of Hepatitis B virus. During childbirth (delivery), a Hepatitis B-infected mother can transmit the virus to the newborn. If infected at birth, infants have a ~90% chance of developing chronic Hepatitis B infection, which can lead to cirrhosis and liver cancer decades later. The birth dose given within 24 hours, along with Hepatitis B Immunoglobulin (HBIG) in high-risk cases, provides immediate passive-active protection. The subsequent doses in the Pentavalent vaccine (at 6, 10, 14 weeks) complete the primary series. This is why delaying the birth dose even by a few days significantly reduces its effectiveness in preventing vertical transmission.
Q5. As of December 2024, how many children have been vaccinated through all phases of Mission Indradhanush?
- (a) 32 million (3.2 crore)
- (b) 40 million (4 crore)
- (c) 54.6 million (5.46 crore)
- (d) 100 million (10 crore)
As of December 2024, Mission Indradhanush has vaccinated 54.6 million (5.46 crore) children and 13.2 million (1.32 crore) pregnant women across all phases (from the original Mission Indradhanush launched December 25, 2014, through IMI, IMI 2.0, IMI 3.0, IMI 4.0, and IMI 5.0 in 2023). Mission Indradhanush specifically targets unvaccinated and partially vaccinated individuals in low-coverage areas — particularly zero-dose children (who have never received any vaccine). IMI 5.0 (2023) specifically focused on Measles and Rubella coverage and concluded all three rounds by October 14, 2023. The programme is implemented under the National Health Mission (NHM).
Q6. Which of the following statements about the BCG vaccine is CORRECT?
- (a) BCG vaccine prevents all forms of tuberculosis including pulmonary TB in adults
- (b) BCG vaccine is effective primarily against severe childhood TB — TB meningitis and miliary TB — but does not reliably prevent pulmonary TB in adults
- (c) BCG is an inactivated (killed) bacterial vaccine given orally
- (d) BCG vaccine was developed in India and introduced globally
Statement (b) is correct. The BCG (Bacillus Calmette-Guérin) vaccine is a live attenuated vaccine made from a weakened strain of Mycobacterium bovis (related to TB bacteria). It is given as an intradermal injection at birth. BCG is highly effective (~80%) against the most severe forms of childhood TB — TB meningitis (brain TB) and miliary TB (disseminated TB spreading through blood). However, its efficacy against pulmonary (lung) TB in adults is variable and generally low (~0–80% in different studies). This is a critical limitation — India bears 14% of global TB burden despite universal BCG vaccination, because BCG doesn't reliably prevent the most common (pulmonary) form. BCG was developed by French scientists Albert Calmette and Camille Guérin (hence the name), not in India. It was first used in humans in 1921.
⚡ Quick Revision — Universal Immunisation Programme
| Topic | Key Facts for UPSC |
|---|---|
| UIP Launch | EPI 1978 → expanded to UIP 1985. Free vaccines for all children (0–16 yrs) and pregnant women. One of largest public health programmes globally. |
| Scale | ~26 million children + ~29 million pregnant women targeted annually. ~12 million vaccination sessions. National coverage: 93.5% (FY 2023–24). |
| Vaccine Schedule Key Points | Birth: BCG + OPV-0 + Hep B-1. 6-10-14 weeks: Pentavalent + OPV + IPV + Rotavirus + PCV. 9 months: MR-1 + Vit A + PCV booster. 16–24 months: MR-2 + DPT booster. Pregnant women: TT/Td (2 doses). |
| Pentavalent Vaccine | 5-in-1: DPT (Diphtheria + Pertussis + Tetanus) + Hepatitis B + Hib. Given at 6, 10, 14 weeks. Most important UIP vaccine for UPSC. |
| Polio (OPV + IPV) | India polio-free since 2014 (WHO certified March 27, 2014). Last case Jan 13, 2011 (Howrah, WB). Pulse Polio Programme since 1994–95. "Do Boond Zindagi Ki." IPV added 2015 (prevents VAPP). |
| Rotavirus (ROTAVAC) | Added to UIP 2016. Made by Bharat Biotech + AIIMS + NIH. ₹60/dose. WHO pre-qualified 2018. Three oral doses at 6, 10, 14 weeks. |
| Mission Indradhanush | Launched Dec 25, 2014. Reaches unvaccinated/partially vaccinated. 5 phases: MI (2014) → IMI (2017) → IMI 2.0 (2019) → IMI 3.0 (2021, COVID) → IMI 4.0 (2022, 416 districts) → IMI 5.0 (2023, MR focus). Total: 54.6M children + 13.2M pregnant women vaccinated (Dec 2024). |
| Measles | Paramyxovirus. Most contagious (R₀=12–18). Koplik's spots (pathognomonic). Complications: pneumonia, encephalitis, blindness. 2 doses MR vaccine needed (95% herd immunity threshold). India targets elimination. |
| Rubella / CRS | Togavirus. Mild in children. Dangerous if pregnant woman infected → Congenital Rubella Syndrome (CRS): heart defects, deafness, intellectual disability. MR Campaign 2017 — 410 million children vaccinated. India targets rubella control. |
| BCG vaccine | Live attenuated Mycobacterium bovis. Intradermal at birth. Protects against TB meningitis + miliary TB in children. Does NOT reliably prevent pulmonary TB in adults. India has 14% global TB burden. |
| Cold chain | Vaccines stored at 2–8°C (OPV at -15°C to -25°C). eVIN monitors real-time. Vaccine potency lost if cold chain broken — wastage and ineffective vaccination result. |
| Current Affairs | CERVAVAC (India's HPV vaccine, SII, 2022; free for girls 9–14 from Budget 2023). U-WIN digital immunisation registry. CoWIN expanded beyond COVID. iNCOVACC (intranasal COVID vaccine). ZyCov-D (world's first DNA vaccine). NTEP (TB elimination by 2025). IMI 5.0 (2023, MR focus, zero-dose children). 93.5% UIP coverage 2023–24. |
🚨 5 UPSC TRAPS — Universal Immunisation Programme:
Trap 1 — "Hib vaccine protects against influenza (flu)" → WRONG! Haemophilus influenzae type b (Hib) is a bacterium — it is NOT the influenza (flu) virus. The name is confusingly similar. Hib causes bacterial meningitis and pneumonia in children under 5. The influenza (flu) vaccine is a separate vaccine (not in UIP, though sometimes given privately). Pentavalent vaccine protects against Hib bacteria — not influenza virus. This confusion is very common and UPSC may exploit it.
Trap 2 — "BCG vaccine prevents all forms of TB including lung TB in adults" → WRONG! BCG vaccine is effective against severe childhood TB (TB meningitis and miliary TB) but has variable and generally low efficacy against pulmonary (lung) TB in adults — which is the most common form. This is why India still has the world's highest TB burden despite universal BCG vaccination. BCG is given at birth and does NOT provide lifelong protection against all TB forms.
Trap 3 — "India received WHO polio-free certification in 2011" → WRONG! India's last polio case was January 13, 2011. But WHO certified India polio-free on March 27, 2014 (3 years after the last case = WHO's requirement). These are two different events — last case date vs certification date. UPSC sometimes tests this distinction.
Trap 4 — "Mission Indradhanush was launched to provide new vaccines not in UIP" → WRONG! Mission Indradhanush does NOT introduce new vaccines. It delivers the EXISTING UIP vaccines to children who were missed — unvaccinated or partially vaccinated children in hard-to-reach areas. It is an intensification/catchup campaign, not a new vaccine introduction programme. The programme specifically focuses on "zero-dose children" and areas with persistently low coverage.
Trap 5 — "OPV is safer than IPV because it is given orally (not by injection)" → WRONG! OPV (Oral Polio Vaccine) is live attenuated — and very rarely (1 in 2.7 million doses), it can cause Vaccine-Associated Paralytic Polio (VAPP) in the vaccinated child or their close contacts. IPV (Inactivated Polio Vaccine — killed) is actually SAFER because it cannot cause VAPP. This is why IPV was added to UIP in 2015 and why some countries have shifted entirely to IPV. India uses BOTH (hybrid schedule) because OPV creates gut immunity and herd immunity via shedding, while IPV provides systemic protection without VAPP risk.
Trap 1 — "Hib vaccine protects against influenza (flu)" → WRONG! Haemophilus influenzae type b (Hib) is a bacterium — it is NOT the influenza (flu) virus. The name is confusingly similar. Hib causes bacterial meningitis and pneumonia in children under 5. The influenza (flu) vaccine is a separate vaccine (not in UIP, though sometimes given privately). Pentavalent vaccine protects against Hib bacteria — not influenza virus. This confusion is very common and UPSC may exploit it.
Trap 2 — "BCG vaccine prevents all forms of TB including lung TB in adults" → WRONG! BCG vaccine is effective against severe childhood TB (TB meningitis and miliary TB) but has variable and generally low efficacy against pulmonary (lung) TB in adults — which is the most common form. This is why India still has the world's highest TB burden despite universal BCG vaccination. BCG is given at birth and does NOT provide lifelong protection against all TB forms.
Trap 3 — "India received WHO polio-free certification in 2011" → WRONG! India's last polio case was January 13, 2011. But WHO certified India polio-free on March 27, 2014 (3 years after the last case = WHO's requirement). These are two different events — last case date vs certification date. UPSC sometimes tests this distinction.
Trap 4 — "Mission Indradhanush was launched to provide new vaccines not in UIP" → WRONG! Mission Indradhanush does NOT introduce new vaccines. It delivers the EXISTING UIP vaccines to children who were missed — unvaccinated or partially vaccinated children in hard-to-reach areas. It is an intensification/catchup campaign, not a new vaccine introduction programme. The programme specifically focuses on "zero-dose children" and areas with persistently low coverage.
Trap 5 — "OPV is safer than IPV because it is given orally (not by injection)" → WRONG! OPV (Oral Polio Vaccine) is live attenuated — and very rarely (1 in 2.7 million doses), it can cause Vaccine-Associated Paralytic Polio (VAPP) in the vaccinated child or their close contacts. IPV (Inactivated Polio Vaccine — killed) is actually SAFER because it cannot cause VAPP. This is why IPV was added to UIP in 2015 and why some countries have shifted entirely to IPV. India uses BOTH (hybrid schedule) because OPV creates gut immunity and herd immunity via shedding, while IPV provides systemic protection without VAPP risk.
