Continuous pulse polio rounds is one of the reasons contributing to poor coverage under other immunization drives in the city, the Brihanmumbai Municipal Corporation (BMC) has admitted after a first ever random sample study on such drives. It has also stressed on improved coverage of immunization in the slums, where nearly 60 per cent of the city's population lives. The study points out that 21 per cent children are not fully protected with vitamin A supplements and 487 children out of 40,250 between 12-36 months in the slum areas are unimmunized. Another worrying indicator in the study is that as many as 8,412 drop out of immunization. "The rationale for the study was that decline in routine immunization coverage in recent years was due to frequent pulse polio drive. Administration of vitamin A supplementation was poor on account of irregular and erratic supply,' says Dr A A Bandiwadikar, Deputy Health Officer at BMC's Health department handling the project. The findings were released at a joint meeting of officials of the state, BMC, UNICEF and WHO, and doctors from the Preventive Social Medicine departments of individual medical colleges on Wednesday. BMC officials agree that the pulse polio immunization programme has overshadowed routine immunization. Dr Jairaj Thanekar, Executive Health Officer at BMC, says: "Ten to twelve rounds of pulse polio drives every year keep health workers engaged for 15 days a month. This has seriously compromised the routine immunization. Also repeated immunization has left citizens apprehensive.' Another factor that has led to the stagnating routine immunization is, unlike in other districts, only doctors administer dosages in camps arranged in slum areas. Migration, apprehension of adverse effect and unawareness are the other factors. "The adherence rate (to vitamin A) falls drastically as the number of doses increases. As high as 81.65 per cent children are given vitamin A initial supplementation, however by the third dose, the number falls to 15 per cent and by the fifth dose it reaches one per cent,' said Dr A A Bandiwadikar, Deputy Health Officer at BMC. He attributes it to irregular supply of the vitamin A supplementation. However, BMC officials are hopeful that the vitamin A drive scheduled next month will boost the coverage. Some of the suggestions that came out of the meeting on Wednesday were to create strong information education and communication material to penetrate the gray areas, coupling vitamin A with other immunization and also convergence of anganwadis and public health system.