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Historian, Michael Bennett in his book, ‘War Against Smallpox: Edward Jenner and the global spread of vaccination’, states that the introduction of vaccination in India was associated with war and imperial expansion of Great Britain. He articulates the many reasons British authorities were interested in vaccinating Indians, one of which was ensuring vaccine supply (which depended on vaccinating a larger number of children than were available to the expatriate community) by inoculating a large number of Indian children. Many of these vaccinations were on coercion and not of their own accord.
Mahatma Gandhi did not encourage vaccination, since it violated his ideas of religion, vegetarianism and notions of purity. In an article penned down by Gandhi in 1913, he says, “Vaccine from an infected cow is introduced into our bodies; more, even vaccine from an infected human being is used… I personally feel that in taking this vaccine we are guilty of a sacrilege.”
With the passing of the Government of India Act (1919), self-governments were given the responsibility of providing vaccination. Even though the Act was introduced with good intentions, the state governments were unable to fund their respective vaccination drives to the full extent. With the beginning of the Second World War in 1939, the vaccination efforts went down further, and the number of smallpox cases started rising again.
Anna Dusthall, born to the female help of a British officer in Mumbai, became the first child in India to successfully receive the world’s first vaccine, on June 14, 1802. It was then that the pus formed from her skin was used to inoculate five more children against small pox, after which the vaccine was sent to different parts of the subcontinent. However, common people were hesitant to take the vaccine due to several reasons, including the need to pay a small fee for vaccination, as well as believing that vaccination would be ineffective since the disease was the wrath of goddesses. Another major factor was organized oppositions by erstwhile ‘Tikadaars’ (who were involved in variolation) to smallpox vaccination fearing that they might lose their jobs. However, about one and a half centuries later from the first case of vaccination, India and the world were declared free of smallpox. Post-Independence smallpox vaccine production was facilitated by Nehru and India’s first health minister, Rajkumari Amrit Kaur.
At a time when the cholera epidemic in India was at its zenith, the Government of India accepted a request from Dr. Haffkine to come and conduct a Cholera vaccine trial in the country. In 1893, Dr Haffkine conducted vaccine trials in Agra, Uttar Pradesh, and showed the efficacy of his vaccine in the effective control of the disease. The Government of India further provided him with a laboratory in Grant Medical College, Mumbai, in order to encourage and help him with his research. Dr Haffkine developed the cholera vaccine in 1897.
In 1978 the country decided to launch the National Immunisation Programme with the introduction of BCG vaccine for Tuberculosis, the Oral Polio Vaccine, the Diphtheria, Pertussis (Whooping cough) and Tetanus (DPT) vaccine and the vaccine against typhoid-paratyphoid. In the mid-1980s a nation-wide public health effort began to eradicate Polio, a disease which affects the central nervous system, leading to flaccid paralysis. State-specific efforts to immunise people against polio included the ‘Polio Plus’ programme in Tamil Nadu (1985) and the ‘Pulse Polio’ initiative in Tamil Nadu, Kerala and Delhi. The targeted demographic for the vaccination programme included children of up to 5 years of age. After massive efforts at immunistaion, on March 27, 2014, the WHO declared India a polio-free country.
In 1985, the UIP started with six antigens (BCG, OPV, DPT and measles) in the programme. No new antigen was added to the programme for the next 16 years. During this period, globally and in India, a number of new vaccines became licensed and available in the market. The first new antigen added since the beginning of UIP was hepatitis B vaccine in the year 2002/2003. In 2011, Hepatitis B vaccine became the seventh antigen to be introduced in the UIP across the country. Haemophilus influenzae type b (Hib) vaccine were introduced in Kerala and Tamil Nadu on December 2011. In 2010, India became the last country in the world to introduce the second dose of measles vaccine in the National Immunization Programme. The UIP also facilitated the production of the Pentavalent Vaccine, the Rotavirus Vaccine, the PCV (Pneumococcal Conjugate Vaccine), the fIPV (Fractional Inactivated Poliomylitis Vaccine) and the Tetanus and Adult Diptheria Vaccine.
India began administering COVID-19 vaccines on 16 January 2021. As of 11 May 2021, India has administered 175,235,991 doses overall, including first and second doses of the currently-approved vaccines.
Two vaccines received approval for emergency use in India at the onset of the programme, including Covishield (a version of the Oxford–AstraZeneca vaccine manufactured by the Serum Institute of India), and Covaxin (developed by Bharat Biotech). In April 2021, Sputnik V was approved as a third vaccine, with deployment expected to begin by late May 2021.
The first COVID immunization drive started on January 16 with priority given to an estimated three crore healthcare workers and the frontline workers. It was followed by voluntary vaccination of those above 50 years of age and the under-50 population groups with co-morbidities. Off late, the government officially made the vaccine available to people above 18 years of age as well.
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