Vaccination Success and Justice Gap

• Mass COVID-19 vaccination in India became a social contract, but the absence of compensation for vaccine injuries exposes a critical vaccine justice gap.

India’s Vaccination Journey

• India’s vaccination journey reflects a steady evolution from basic disease control to a comprehensive, technology-driven public health immunisation system.

Early Phase (1948–1962)

• 1948: India began mass immunisation with the International Tuberculosis Campaign to control TB.
• 1962: National Tuberculosis Programme launched; Bacille Calmette-Guérin (BCG) integrated into routine disease prevention.

Institutionalisation Phase (1978–1985)

• 1978: The government introduced the Expanded Programme on Immunisation to provide basic vaccines like BCG and Diphtheria, Pertussis, and Tetanus (DPT).
• 1985: Universal Immunisation Programme expanded vaccination across the country, focusing on children and pregnant women.

Expansion & Milestones (1995–2017)

• 1995: Pulse Polio Campaign ensured every child under 5 received polio drops to eliminate the disease.
• 2014: India became polio-free (WHO officially certified); Mission Indradhanush launched to improve full immunisation coverage.
• 2015–17: New vaccines like Rotavirus, Measles-Rubella, and Pneumococcal were added to protect against more diseases.

Digital & Modern Phase (2015–Present)

• 2015 onwards: eVIN system improved vaccine storage and supply tracking using digital tools.
• 2021–23: COVID-19 vaccination drive became the world’s largest, supported by the CoWIN platform.
• 2024–26: U-WIN platform & HPV vaccine rollout strengthened digital tracking & prevention of cervical cancer.

Major Achievements

• Polio: free since 2011, maternal and neonatal tetanus eliminated in 2015, and Yaws-free in 2016.
• Mass Campaigns: Measles-Rubella drive vaccinated 34.8 crore children between 2017-19.
• COVID-19 Vaccination: Over 220 crore doses administered by January 2023; 97% first dose and 90% double dose coverage.
• Global Award: India received the Measles & Rubella Champion Award (2024) for regional efforts.
• Vaccine Maitri Initiative: Supplied vaccines to several low and middle-income countries, reinforcing Vasudhaiva Kutumbakam.

Vaccine Risks and Responsibility

• Rare Risks: Vaccines are highly safe but not risk-free; adverse events like anaphylaxis and thrombosis with thrombocytopenia syndrome (TTS) occur rarely despite large-scale use.
• AEFI Data: The government reported 92,114 Adverse Events Following Immunisation (AEFI) cases, including 2,782 serious cases and 1,171 deaths, showing measurable risk.
• Social Contract: Over 220 crore doses administered; citizens accepted small risks for collective immunity and public health protection.
• State Duty: Under Article 21, the State must safeguard health and compensate individuals harmed during public vaccination drives.
• Equity Concern: Vulnerable groups lack access to legal remedies, making the absence of compensation a serious issue of social justice.

Weaknesses in the Vaccine Justice Framework

• Tort Law Limitation: Requires proof of fault or negligence, making it ineffective where vaccine injuries arise from individual immune responses rather than any error.
• Consumer Law Gap: Free vaccination weakens the “consumer” relationship under the Consumer Protection Act, 2019, limiting legal recourse for affected individuals.
• Technical Constraints: Consumer forums lack specialised medical expertise to evaluate complex pharmacovigilance data and establish causality in AEFI cases.
• PIL Limitation: Public Interest Litigations can guide policy directions, but cannot ensure individual compensation or create a structured redressal mechanism.

Way Forward for Vaccine Justice

• Dedicated Law: Enact a Vaccine Injury Compensation Act to provide statutory backing and ensure continuity beyond executive decisions.
• No-Fault Mechanism: Create a Vaccine Injury Table for presumptive causation, reducing the burden of proof on affected individuals.
• Independent Tribunal: Establish a specialised quasi-judicial body with medical and legal experts for speedy, accessible claims resolution.
• Compensation Fund: Set up a shared fund (government + manufacturers’ levy) to ensure timely and fair compensation.
• Transparent Surveillance: Strengthen AEFI reporting, audits, and public dashboards to build trust and improve accountability.

India’s vaccination success must evolve into a justice-driven public health model ensuring dignity and accountability, where compensation and transparency bridge gaps, transforming public trust into true immunity for society.

Reference: The Hindu

PMF IAS Pathfinder for Mains – Question 636

Q. Despite being one of the most effective public health interventions, vaccines occasionally lead to adverse events that raise concerns of justice and state responsibility. Critically analyse the gaps in India’s vaccine injury compensation framework and propose a robust mechanism for ensuring vaccine justice. (250 Words) (15 Marks)

Approach

• Introduction: Write a contextual introduction about vaccination in India.
• Body: Write the gaps in India’s vaccine injury compensation framework, key challenges in vaccine justice and propose a robust mechanism for ensuring vaccine justice.
• Conclusion: Emphasis on a no-fault vaccine compensation law to ensure vaccine justice.