India's efforts in childhood vaccination have shown both progress and persistent challenges, as highlighted in the latest data from the World Health Organization (WHO) and UNICEF. In 2023, India significantly improved its global ranking for zero-dose children, marking a shift from the highest number globally in 2021 to the second highest at nearly 16 lakh, behind Nigeria. This improvement underscores ongoing efforts but also reflects substantial gaps in immunization coverage across the country.

Global and Regional Rankings: 
According to the WHO-UNICEF data, Nigeria topped the list with 21 lakh zero-dose children in 2023, followed by India. Other countries with significant numbers of zero-dose children include Ethiopia, Congo, Sudan, and Indonesia. The rankings are crucial in assessing global efforts under the Immunization Agenda 2030 (IA2030), which prioritizes countries based on their immunization challenges.

Challenges in Vaccination Coverage: 
India's vaccination coverage, particularly for the measles-containing-vaccine first-dose (MCV1), saw a decline to 93% in 2023, down from 95% in 2019. This decline means approximately 16 lakh children missed out on essential immunization against measles and other preventable diseases. Meanwhile, the coverage for the second dose (MCV2) remained steady at 90%, highlighting the need for sustained efforts to bridge the immunization gap and ensure comprehensive protection for children.

Regional Call to Action: 
Ms. Saima Wazed, Regional Director of WHO South-East Asia, emphasized the urgency for enhanced efforts at all levels to identify and vaccinate unvaccinated and under-vaccinated children. The Southeast Asia region, including India, faces challenges in meeting the 2030 immunization agenda, necessitating tailored approaches and strengthened healthcare systems to achieve universal vaccine coverage and prevent vaccine-preventable diseases effectively.

Global Efforts and Immunization Trends: 
The WHO and UNICEF's latest estimates underscore the global imperative to close the immunization gap, with many countries still missing significant numbers of children despite available vaccines. UNICEF Executive Director Catherine Russell highlighted the need for global collaboration and investment in primary healthcare and community workers to ensure every child receives essential vaccinations and strengthen overall healthcare systems.

Conclusion: 
In conclusion, while India has made strides in improving its global ranking for zero-dose children, the challenges in childhood vaccination remain significant. Efforts to enhance coverage, address regional disparities, and strengthen immunization systems are critical to achieving universal vaccine access and protecting children from vaccine-preventable diseases. Continued commitment from governments, healthcare providers, and international partners is essential to closing the immunization gap and ensuring every child's right to health and protection through vaccination.

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