Table 1: Basic information ,000, (per 1,000 LB) 34.6 (per 1,000 LB) 174 (per 100,000 LB) District 712.

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1 EPI history EPI launched in 978 with DPT, OPV, BCG and typhoid vaccines TT immunization of pregnant women introduced in 983 MCV introduced in 985 HepB piloted in 00 and made universal in 0 MCV introduced 00 onward Pentavalent (introduced in two states in 0 and gradually expanded to all states by 05 First dose of JE vaccine at 9 to months introduced in 006 and second dose at 6 to 4 months introduced in 03 in JE endemic districts Multi-dose vial policy for vaccines introduced in 03 IPV introduced in six states in 05 and being expanded to all states in 06 Rotavirus vaccine introduced in four states in 06, now expanded to 9 states topv to bopv switched on 5 April 06 Rubella vaccine introduced at subnational level from February 07 PCV introduced in 3 states in 07 (selected districts in Bihar and Uttar Pradesh and entire state of Himachal Pradesh). Now expanded to entire state of Madhya Pradesh and selected districts in Rajasthan (subnational) Source: cmyp and EPI/MoHFW Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Table : Basic information 07 Total population,338,773,78 Live births 7,073,305 Children < year 5,900,000 Children <5 years 6,000,000 Children <5 years 438,393,89 Pregnant women 9,500,000 Women of child bearing age (5-49 years) Neonatal mortality rate Infant mortality rate 47,000, (per,000 LB) 34.6 (per,000 LB) Under-five mortality rate 43 (per,000 LB) Maternal mortality ratio Division/Province/State/ Region 74 (per 00,000 LB) District 7 Block 6,058 Population density (per sq. km) Population living in urban areas % Population using improved 94% drinking-water sources Population using improved 40% sanitation Total expenditure on health 3.8% as % of GDP Births attended by skilled 85.7% health personnel Neonates protected at 87% birth NT SEAR annual EPI reporting form, 07 WHO, Global Health Observatory (GHO) data apps.who.int/gho/data accessed on 3 May 08 Table : Immunization schedule, 07 Vaccine Age of administration BCG Birth HepB Birth OPV Birth, 6 weeks, 0 weeks, 4 weeks and 6 to 4 months IPV 6 weeks and 4 weeks DTP-Hib-HepB 6 weeks, 0 weeks and 4 weeks DTP 6 to 4 months and 5 years Measles 9 to months and 6 to 4 months MR 9 to months and 6 to 4 months (sub national) JE_live_Atd 9 to months and 6 to 4 months (JE endemic districts) TT 0 years, 6 years and doses/booster for pregnant women Vitamin A 9 months, 8 months and 6 months interval till age 5 years Pneumococcal 6 weeks, 0 weeks and 9 months (sub national) conjugate vaccine Rotavirus 6 weeks, 0 weeks and 4 weeks (sub national) Source: JRF 07 Table 3: Immunization system highlights cmyp for immunization NTAGI fully functional Spending on vaccines financed by the government % Spending on routine immunization programme financed by the government 36% Updated micro-plans that include activities to improve immunization coverage 676 districts (97%) National policy for health care waste management including waste from immunization activities in place National system to monitor AEFI in place Most recent EPI CES National Family Health Survey-4 05 >80% coverage for DTP-Hib-HepB3 45 districts (6%) >90% coverage for MCV 7 districts (39%) >0% drop-out rate for DTP-Hib-HepB to DTP-Hib- HepB3 44 districts (6%) Polio vaccination policy for travellers to and from polio endemic/infected countries introduced 04 Mission Indradhanush to immunize all children against seven VPDs ongoing since Dec 04 Source: WHO/UNICEF JRF, 07 Figure : National immunization coverage, BCG DTP OPV MCV Source: WHO and UNICEF estimates of national immunization coverage, July 08 World Health Organization SEARO/FGL/IVD 3 July 08

2 Figure : DTP3 coverage, diphtheria and pertussis cases, Figure 3: TT+ coverage and NT cases, WHO and UNICEF estimates of national immunization coverage, July 08 WHO vaccine-preventable diseases: monitoring system 08 Country official estimates, WHO vaccine-preventable diseases: monitoring system 08 DTP-Hib-HepB3 coverage by state Figure 4: 06 Figure 5: 07 National: 87.6% National: 89.3% Source: SEAR annual EPI reporting form, 06 (administrative data) Source: SEAR annual EPI reporting form, 07 (administrative data) <70% 70% - 79% 80% - 89% >90% Table 4: Reported cases of vaccine preventable diseases, 0-07 Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 0 0 a,55 44, (4%) 8,668,3 ND ND ND 03 0 b 3,33 3, (5%) 3,8 3,698 ND,078 ND 04 0 c 6,094 46,706 49(0%) 4,977 4,870 ND,657 ND 05 0 d,365 5,06 49 (%) 5,488 3,5 ND,60 ND 06 0 e 3,380 37,74 7 (6%) 8,663,07 ND, ,93 3, (6%) 3,40,856 ND, Source: Source: WHO/UNICEF JRF (multiple years) and EPI/MOHFW a Excludes one type VDPV b Excludes five type VDPV c Excludes three type VDPV d Excludes two type VDPV e Excludes one type VDPV ND=No data

3 Table 5: AFP surveillance performance indicators, 0-07 The last polio case due to WPV was reported on 3 January 0 from West Bengal. Indicator AFP cases 60,9 54,63 53,933 46,970 46,499 39,30 Wild poliovirus confirmed cases Compatible cases Non-polio AFP rate Adequate stool specimen collection percentage 87% 86% 87% 86% 87% 86% Total stool samples collected 9,39 0,40 05,939 9,868 9, 76,7 % NPEV isolation % Timeliness of primary result reported Number of discarded AFP cases per 00,000 children under 5 years of age. Percent with specimens, 4 hours apart and within 4 days of paralysis onset. 3 Results reported within 4 days of sample received at laboratory. Non-polio AFP rate by district Adequate stool specimen collection % by district Figure 6: 06 Figure 8: 06 Figure 7: 07 Figure 9: 07 < -.99 > No non-polio AFP case <60% 60% - 79% >80% No AFP case Table 6: OPV SIAs Year Antigen Geographic coverage Target age Target population Coverage (%) Round Round Round Round 04 OPV NID <5 years 67,89,448 68,408, OPV SNID <5 years 46,879,086 70,8, OPV NID <5 years 67,393,5 68,04, OPV SNID <5 years 7,49,633 49,8, OPV SNID <5 years,48,343,594, topv NID <5 years 66,95,895 66,70, topv Mop up and SNID <5 years,868,674 45,348, bopv SNID <5 years 70,836,03 6,9849, bopv NID <5 years 70,000,000 70,000, bopv SNID <5 years 70,600,000 70,600, Source: WHO/UNICEF JRF (multiple years) and EPI/MOHFW Figure 0 : Environmental surveillance sites for polio detection Delhi- 7 sites Maharashtra- 6 sites Bihar 3 sites West Bengal- 5 sites Punjab- 4 sites Gujarat - sites Telangana 4 sites Uttar Pradesh 0 sites

4 Figure : MCV & MCV coverage and measles cases, WHO and UNICEF estimates of national immunization coverage, July 08 WHO vaccine-preventable diseases: monitoring system 08 MCV coverage by state MCV coverage by state Figure : 06 Figure 4: 06 National: 87.5% National: 73.5% Source: SEAR annual EPI reporting form, 06 (administrative data) Figure 3: 07 Figure 5: 07 National: 89.6% National: 79.6% Source: SEAR annual EPI reporting form, 06 (administrative data) Source: SEAR annual EPI reporting form, 07(administrative data) Source: SEAR annual EPI reporting form, 07(administrative data) Table 7: MCV SIAs Year Antigen Geographic Target group Target Coverage Coverage 00 MCV subnational 9 months to 3,845,686 87% 0 years 0 MCV subnational 9 months to 40,67,580 90% 0 years 0 MCV subnational 9 months to 76,730,639 9% 0 years 05* MCV subnational to 5 years 890, MCV subnational 9 months to 5 years 60,3,836 98% *as a part of emergency health response to floods in Tamil Nadu Source: Source: WHO/UNICEF JRF (multiple years) <80% 80% - 89% 90% - 94% >95% Figure 6: Sub-national risk assessment - measles and rubella Very High Risk High Risk Medium Low Not Available World Health Organization SEARO/FGL/IVD 3 July 08

5 Figure 7: Immunity against measles - immunity profile by age in 07* *Modeled using MSP tool ver Figure 8: Sporadic and outbreak associated measles cases* by month 0-07 *Includes laboratory confirmed and epidemiologically linked cases Source: SEAR Monthly VPD reports Figure 9: Immunization status of confirmed (laboratory and Epi linked) measles outbreak associated cases, by age, 0-07 Source: SEAR annual EPI reporting form (multiple years)

6 Table 8: Surveillance performance indicator for measles and rubella, 0-07 Case classification (number) Indicators Year No. of Suspected Measles Lab-confirmed Measles Epi-Linked Clinically-confirmed Rubella Lab-confirmed Epi-Linked Discarded non-measles non-rubella cases Annual incidence of confirmed Measles cases per million total population Annual incidence of confirmed Rubella cases per million total population Proportion of all suspected measles and rubella cases that have had an adequate investigation initiated within 48 hours of notification Discarded non-measles non-rubella incidence per 00,000 total population Proportion of provinces reporting at least two discarded non-measles non-rubella cases per 00,000 total population Proportion of sub-national surveillance units reporting to the national level on time Target 80% 80% 80% 0 9, ,00 0 4,087,98.7 ND 0. ND , , ,96, ND 0. ND ,970 3,408 3, ,59 3, ND 0.3 ND ,75 4,808 4, ,35 5, ND 0.5 ND ,447 3,476 3, ,35 8,960 4, ND 0.5 ND ,773 3,467 9, ,03, ND 9.6 Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Table 9: Performance of laboratory surveillance, 0-07 Year Serum specimen collected from suspected measles cases Serum specimen received in laboratory within 5 days of collection Specimen positive for measles IgM Specimen positive for rubella IgM % Results within 4 days of receipt Genotypes detected No (%) No (%) No. % No. % Measles Rubella (3.) 794 (00) D8 ND 03,564 (4.6),564 (00) D8 B 04 4,748 (7.0) 4,748 (00) 3, D4,D8,B3 ND 05 7,7 (9.0) 7,7 (00) 4, D4,D8,B3 ND 06 7,763 (.) 7,763 (00) 3, , D4,D8,B3 B 07 6,483 (4.) 6,483 (00) 3, D4,D8 B Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Figure 0: Network of WHO supported surveillance medical officers and laboratories Surveillance medical officers Laboratories: Polio Measles/rubella Polio and measles/rubella Japanese encephalitis IBD and Rotavirus reference Lab For contact or feedback: Immunization Division Ministry of Health and Family Welfare (MOHFW), New Delhi, India Tel/Fax : , pradeephaldar@yahoo.co.in Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 000, India Tel: , Fax: SearEpidata@who.int,