Impact of Campaign-Style Delivery of Routine Vaccines during Intensified Mission Indradhanush in India: A Controlled Interrupted Time-Series Analysis

Journal Article
  • Emma Clarke-Deelder
  • Christian Suharlim
  • Susmita Chatterjee
  • Logan Brenzel
  • Arindam Ray
  • Jessica Cohen
  • Margaret McConnell
  • Stephen Resch
  • Nicolas Menzies
May 2020. DOI:



The world is not on track to achieve the goals for immunization coverage and equity described by the World Health Organization’s Global Vaccine Action Plan. In India, only 62% of children had received a full course of basic vaccines in 2016. We evaluated the Intensified Mission Indradhanush (IMI), a campaign-style intervention to increase routine immunization coverage and equity in India, implemented in 2017-2018.


We conducted a comparative interrupted time-series analysis using monthly district-level data on vaccine doses delivered, comparing districts participating and not participating in IMI. We estimated the impact of IMI on coverage and under-coverage (defined as the proportion of children who were unvaccinated) during the four-month implementation period and in subsequent months.


During implementation, IMI increased delivery of thirteen infant vaccines by between 1.6% (95% CI: -6.4, 10.2%) and 13.8% (3.0%, 25.7%). We did not find evidence of a sustained effect during the 8 months after implementation ended. Over the 12 months from the beginning of implementation, IMI reduced under-coverage of childhood vaccination by between 3.9% (- 6.9%, 13.7%) and 35.7% (-7.5%, 77.4%). The largest estimated effects were for the first doses of vaccines against diptheria-tetanus-pertussis and polio.


IMI had a substantial impact on infant immunization delivery during implementation, but this effect waned after implementation ended. Our findings suggest that campaign-style interventions can increase routine infant immunization coverage and reach formerly unreached children in the shorter term, but other approaches may be needed for sustained coverage improvements.