Immunization Ecosystem

This book critically analyses various policies and perspectives relating to immunization over the last half a century and reflects on the lessons and best practices. It explores the political economy of immunization in the wake of the COVID-19 pandemic, a mass reckoning on the preparedness for a health emergency, based on planning and strategy of allocating resources- monetary, infrastructure, and manpower. This transdisciplinary volume is framed through a large gamut of immunization perspectives, including the importance of policy formulation, and programme implementation. It illuminates the role of social and behaviour change communication in demand generation and the importance of mainstreaming vaccine hesitant families and communities. Supply chain management, logistics, and the role and scope of digital technology are other areas of discussion. It also addresses human rights issues in war zones and the need for equity in immunization to reach out to vulnerable communities, especially women and children. This book will be useful to students and faculty of public health schools, people engaged in public health programme implementation, especially in immunization across the globe encompassing policy-makers, programme implementers, monitoring and evaluation personnel, behaviour change professionals, frontline workers, UN organizations like WHO, UNICEF, World Bank, donor organizations among others including CSOs and NGOs.

Professor Jaishri Jethwaney did her PhD in media and elections from JNU, her MA in political science from Delhi University, and professional education in mass communication and journalism both in India and abroad. After her long innings at IIMC spanning over 25 years as a professor and programme director, she did a two-year senior research fellowship at ICSSR, which led to a seminal study of the Indian news media industry. Professor Jethwaney has contributed to various public health communication strategies, both in the government and NGO campaigns over her long career. Among her many books that she has authored, the latest ones include Wages and Related Issues-A Critical Appraisal of News Media Industry in India (ICSSR-AF, 2025), The Beauty Paradigm: Gender Discourse in Indian Advertising (Sage, 2022), When India Votes (Rupa, 2019) and Social Sector Communication (Sage, 2016, Routledge 2024). Dr. Pritu M. Dhalaria, a public health specialist, has over 30 years of extensive experience in public health, particularly in maternal and child health, communicable and non-communicable diseases, immunization, programme implementation, and partnerships. With an MBBS, DCM, and MD in community medicine, his foundational studies and varied experiences have given him a robust understanding of medical sciences and public health principles, which he has applied throughout his career to address critical health challenges. During his long and illustrious career, Dr. Dhalaria has worked across all the levels of the public health system, from grassroots implementation to the involvement in decision-making processes across South Asia. In retrospect, he began his professional journey in public health in 1996 after completing his education, beginning as a research medical officer on malaria research and intervention on sexual health. He has served in various prestigious public health organization, including WHO, PATH, IAVI, and JSI. He has published more than 25 research papers in national and international journals and contributed to many technical reports, which have helped in shaping the public health policy.

List of Figures x List of Tables xi Foreword xii PART A Immunization: Evolution, Present State, Challenges, and Opportunities 1 1 Immunization in a Global Context: Tracing 50 Years of Growth, Challenges, Opportunities, and Public Health Impact 3 2 Diseases Eradication, Elimination, and Control: The Success Story of Smallpox Eradication 33 3 Partners in Setting Joint Agendas in Synergizing Immunization Efforts: The Role of the UN, Donors, and Governments 51 4 The India Story on Immunization 69 5 Routine Immunization-Various Phases and Campaigns Including IMI 01-05-The Indian Experience 83 6 New Vaccines and Life-Course Vaccination-The Way Forward 102 7 Technological Forays into Digital Management of Immunization 113 PART B Issues That Need Addressing 127 8 Vaccine Hesitancy-Reality or Myth? Lessons Learnt, Case Studies, and Way Forward 129 9 Understanding Anti-Vaccine Discourse-Its Evolution, Issues, and Varying Perspectives 147 10 AEFI Situations: The Current Scenario and Strategies for Strengthening Pharmacovigilance Systems 171 PART C Demand Generation 189 11 Advocacy, Communication, and Social Mobilization- At the Heart of a Successful Immunization Programme 191 12 IEC and Social Behaviour Change Communication- Conceptual Framework, Best Practices, and Case Studies 217 13 Social Marketing Approach in Health Sector-Brand Positioning of Immunization 235 14 Risk Communication-An Interdisciplinary Approach to Handling Crisis in the Immunization Domain 255 15 Emerging Role and Scope for Social Influencers in Building Demand Generation 275 PART D The Way Forward 295 16 Capacity Building of Frontline Workers and IEC/ SBCC Teams-Imperatives for Continual Training and Development 297 17 Agenda for Tomorrow 320 Index 333