The purpose of this paper is to critically evaluate the immunisation programme in a broad macro-perspective on demographic trends and child health. We have collated data on 15 major states starting from the beginning of the 1980s to mid-1990s, though observation on all variables uniformly over the period could not be secured. Our analysis suggests that there has been a slackening of the initial thrust (1990-91) of the EPI, which is of some concern from the point of vaccine preventable diseases (VPDs). Since the population of net infants is in the increasing phase in almost all states, the task of providing full coverage appears to be daunting given the present performance level in the underperforming states. Although the notion of 'herd immunity' is controversial, we may not be totally on the wrong track in concluding that though at the aggregate level VPD occurrence will go down, the incidence of local 'epidemic' in some states cannot be ruled out. It is evident from our studies on immunisation, that the programme lacks on both aspects of incentive and management and this is not due to any shortage in the financial and physical resources devoted to it. This is also corroborated by the better performances of politically better managed states as compared to states which suffered from inept political management and instability.