This review assesses India’s progress toward the Immunization Agenda 2030 (IA2030). It centers on several interlinked themes: the development of the Universal Immunization Program (UIP), immunization coverage and zero-dose children, catch-up campaigns, data-driven decision-making, urbanization, climate-related disruptions, and immunization financing. Drawing together programme data, policy documents, and the published literature, the review outlines both the country’s key achievements and the challenges that remain.
Key findings
India’s zero-dose children rose from about 1.4 million in 2019 to 2.9 million in 2020 before falling to about 0.9 million in 2024, while DTP1 coverage increased from 93% in 2023 to 96% in 2024.
Intensified Mission Indradhanush catch-up campaigns have been central to recovering missed children in urban slums, tribal and hard-to-reach areas and among migrants, with IMI 4.0 vaccinating nearly 6 million children and 1.5 million pregnant women and IMI 5.0 extending the approach nationwide.
Digital systems such as U-WIN for registration, tracking and follow-up and eVIN for real-time vaccine stock and cold-chain monitoring are increasingly used in District Task Force reviews and microplanning to identify and reach missed children.
Urbanization and mobility leave migrants, informal workers and slum and peri-urban populations outside registries and facility catchments, which the paper addresses through urban primary health centres, GIS-supported microplanning, outreach sessions, flexible hours and intersectoral coordination.
UIP expenditure grew from INR 22.59 billion in 2020 to INR 43.88 billion in 2024, but substantial gaps between allocations and actual spending, including at state level, mean sustained financing must be matched by stronger financial management and implementation capacity.
How can the findings be used?
The review provides a useful framework for considering immunization investment as a combination of coverage recovery, health-system strengthening and equity-oriented last-mile delivery, rather than relying on individual interventions alone. For policymakers and programme managers, the experience described in India highlights the importance of linking predictable financing with high-quality data, targeted outreach, digital beneficiary tracking and approaches adapted to mobile and underserved populations.
Thumbnail image credit: GAVI
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