Universal Immunisation Programme (UIP)

The Universal Immunisation Programme (UIP) is the Government of India's free vaccination programme for children and pregnant women. Through it, every newborn in India can get free vaccines at government health centres against 12 vaccine-preventable diseases. It is one of the largest public health programmes in the world, reaching about 2.6 crore newborns and about 2.9 crore pregnant women every year. It is run by the Ministry of Health and Family Welfare (MoHFW).

Why does India need it?

Many childhood diseases, such as measles, polio, diphtheria and tetanus, can kill or disable children. Vaccines can prevent them cheaply. But families, especially poor and rural ones, may not afford vaccines or may not know when to give them. A free, nationwide programme with a fixed schedule makes sure every child gets protected, whatever the family's income. When most people in a community are vaccinated, even those who cannot be vaccinated are protected, because the disease cannot spread easily. This is called herd immunity.

Where did it come from?

• 1978: India started the Expanded Programme on Immunization (EPI), following WHO's global EPI launched in 1974. It mainly covered urban areas.
• 1985: EPI was renamed and widened into the Universal Immunisation Programme, to reach rural areas too, in phases.
• 1992: UIP became part of the Child Survival and Safe Motherhood (CSSM) Programme.
• 1997: It became part of the Reproductive and Child Health (RCH) Programme.
• 2005 onwards: It runs under the National Rural Health Mission, now the National Health Mission (NHM).

Which diseases does it cover?

The UIP protects against 12 diseases. Eleven are covered across the country:

• Diphtheria, pertussis (whooping cough) and tetanus
• Polio
• Measles and rubella
• Severe childhood tuberculosis (TB)
• Hepatitis B
• Pneumonia and meningitis caused by Haemophilus influenzae type b (Hib)
• Pneumonia caused by pneumococcus
• Rotavirus diarrhoea

The twelfth, Japanese Encephalitis (JE), a brain infection spread by mosquitoes, is covered only in the districts where it is common (endemic districts).

How has the vaccine list grown?

Over the last 15 years, India added several new vaccines:

• Pentavalent vaccine (one shot against five diseases: diphtheria, pertussis, tetanus, hepatitis B and Hib): started in Kerala and Tamil Nadu in December 2011, then expanded nationwide.
• Inactivated Polio Vaccine (IPV): from November 2015, as part of the global plan to end polio.
• Rotavirus vaccine: from 26 March 2016, against severe diarrhoea.
• Measles-Rubella (MR) vaccine: through a national campaign from 2017.
• Pneumococcal Conjugate Vaccine (PCV): from May 2017, starting in some states.
• Td (Tetanus and adult diphtheria): replaced the TT (tetanus toxoid) vaccine for adolescents and pregnant women, scaled up nationwide in 2019.
• HPV vaccine: a national drive for 14-year-old girls began on 28 February 2026.

How does it work on the ground?

A child gets vaccines at fixed ages: at birth (BCG, oral polio and hepatitis B), at 6, 10 and 14 weeks (pentavalent, polio, rotavirus and others), at 9 to 12 months (MR, and JE where needed), and boosters at 16 to 24 months and 5 to 6 years. Adolescents get Td at 10 and 16 years, and pregnant women get Td too.

Vaccines are given at sub-centres, primary health centres and outreach sessions in villages, often on fixed "immunisation days". ASHA workers (village health workers) bring families in, and ANMs (Auxiliary Nurse Midwives) give the shots. The Centre buys the vaccines and supplies them to states.

The supporting systems

• Cold chain: Most vaccines spoil if they get too warm, so they are kept at about 2°C to 8°C from factory to village using ice-lined refrigerators and cool boxes.
• eVIN (Electronic Vaccine Intelligence Network): A digital system started in 2015 that tracks vaccine stock and temperature in real time at cold chain points.
• U-WIN: A digital registry, modelled on Co-WIN (used for COVID-19 vaccines), launched nationally on 29 October 2024. It records every vaccination of pregnant women and children (birth to 16 years), sends reminders and gives digital certificates.
• NTAGI (National Technical Advisory Group on Immunisation): India's top expert body on vaccines, set up in 2001. It advises the government on which vaccines to add and on schedules.

Mission Indradhanush: filling the gaps

Even with a free programme, many children were missing vaccines. In 2014, only about 65% of children were fully immunised. So the government launched Mission Indradhanush on 25 December 2014. It is a "catch-up" campaign that goes to districts and areas with low coverage to vaccinate children and pregnant women who were left out or dropped out.

"Indradhanush" means rainbow, a reference to the seven diseases it first targeted. Intensified Mission Indradhanush (IMI) followed in October 2017, and later rounds continued (IMI 5.0 in 2023, which extended the age range to children up to 5 years). The goal is at least 90% full immunisation coverage.

What has it achieved?

• Polio: India's last wild polio case was in January 2011 (Howrah, West Bengal). WHO certified the South-East Asia Region, including India, polio-free on 27 March 2014.
• Maternal and neonatal tetanus: India was validated as having eliminated it in 2015.
• Coverage: Full immunisation among children aged 12 to 23 months rose from about 62% (NFHS-4, 2015-16) to 76.4% (NFHS-5, 2019-21).

Commonly confused concepts

• UIP vs Mission Indradhanush: UIP is the permanent, routine programme for everyone. Mission Indradhanush is a time-bound catch-up drive under UIP for children left out.
• EPI vs UIP: EPI (1978) was the earlier, mainly urban programme. UIP (1985) widened it to the whole country.
• eVIN vs U-WIN vs Co-WIN: eVIN tracks vaccine stock and temperature. U-WIN records each person's routine vaccinations. Co-WIN was built for COVID-19 vaccination.
• OPV vs IPV: Oral Polio Vaccine (OPV) is given as drops and uses a weakened live virus. Inactivated Polio Vaccine (IPV) is an injection with a killed virus, and it cannot cause vaccine-derived polio.
• Elimination vs eradication: Elimination means bringing a disease down to zero or a very low level in one region (like maternal and neonatal tetanus in India). Eradication means removing it from the whole world forever (only smallpox so far).

Issues, criticism and the way forward

• Zero-dose children: Some children still get no vaccines at all. India had about 1.6 million zero-dose children in 2023, according to WHO-UNICEF estimates, though the government says the share has been falling.
• Uneven coverage: Coverage is lower in some states, urban slums, remote tribal areas and among migrant families.
• Vaccine hesitancy: Rumours and fear of side effects keep some families away. Clear communication through ASHAs and local leaders is key.
• Cold chain and data gaps: Power cuts and weak storage in remote areas can spoil vaccines; U-WIN and eVIN aim to close tracking gaps.
• Adding new vaccines: Each new vaccine raises costs and needs strong evidence. Using affordable Indian-made vaccines, such as CERVAVAC, can help the programme add vaccines without huge expense.
• Way forward: Full rollout of U-WIN, targeted campaigns for zero-dose children, better urban immunisation and strong community outreach can help India reach the 90% coverage goal.

Concepts to Know

• Vaccine: A preparation that teaches the body's defence system to recognise a germ, so it can fight the real germ quickly later.
• Herd immunity: When enough people in a community are immune, a disease cannot spread easily, so even unvaccinated people are protected.
• Cold chain: The chain of fridges and cool boxes that keeps vaccines at the right temperature from the factory to the child.
• Booster dose: An extra dose given later to "remind" the body and keep protection strong.
• Endemic: A disease that is regularly found in a particular area.
• NFHS (National Family Health Survey): A large national survey on health and family welfare, used to measure things like vaccine coverage.