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Immunization programmes are a key intervention for protecting children from life threatening conditions, which are preventable. India thus introduced its national immunization programme in 1978. This was later modified as the ‘Universal Immunization Programme’ (UIP) in 1985. This review article traces the history and evolution of India's vaccination programs. It also outlines the difficulties faced in recent times, which can lead to outbreaks and re-emergence of already controlled vaccine preventable diseases. It can be used by program implementers to understand such challenges and integrate plans to overcome these.