Immunization Coverage among Children Under Five in India: A Meta-Analysis

Immunization is one of the most effective public health interventions for preventing vaccine-preventable diseases and reducing childhood morbidity and mortality. Despite substantial improvements in vaccination programs over the past decades, disparities in immunization coverage continue to exist in many parts of India. The present meta-analysis aimed to estimate the pooled prevalence of immunization coverage among children under five years of age in India and to examine regional variations in vaccination uptake. A comprehensive literature search was conducted using electronic databases including PubMed, Scopus, Web of Science, and Google Scholar to identify relevant studies published between January 2000 and December 2025. Observational studies reporting immunization coverage among children under five years in India were included. Data extraction and quality assessment were performed using standardized criteria, and pooled prevalence estimates were calculated using a random-effects meta-analysis model. A total of 26 studies involving approximately 138,450 children were included in the analysis. The pooled prevalence of full immunization coverage among children under five in India was estimated to be 72.4% (95% CI: 68.3–76.5). Subgroup analysis indicated higher coverage in urban areas compared to rural settings, and southern regions reported higher vaccination coverage compared to northern and eastern regions. Significant heterogeneity was observed among the included studies, reflecting regional and socioeconomic differences in immunization uptake. Funnel plot analysis suggested minimal publication bias. Although immunization coverage in India has improved considerably due to national initiatives such as the Universal Immunization Programme and Mission Indradhanush, substantial disparities remain across geographic and socioeconomic groups. Strengthening routine immunization services, improving healthcare accessibility, and increasing community awareness are essential to achieve equitable vaccination coverage and reduce preventable childhood diseases