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  1. 1. A presentation by Dr. Surbhi Vaish Mittal,Aarogyam Healthcare & Healing Foundation
  2. 2. VACCINATION PROGRAM IN INDIA WHO launched EPI-1974, against- Diphtheria, Pertussis, Tetanus, Polio, T.B., Measles. EPI launched in India- 1978. Became Universal Immunization Programme -1985. Ministry of Health & Family Welfare – 90% vaccination coverage (public sector) Less than 10 % coverage of EPI vaccines- private sector –urban areas.
  3. 3. AIM OF IMMUNIZATIONSCHEDULES Reduction of Infant Mortality Prevention of serious disability & morbidityWHO recommends- Schedules which are, Epidemiologically relevant Immunologically effective Operationally feasible Socially acceptablePriority Target age groups – Infants- Primary Immunization series Newborns & Pregnant women- TetanusEPI recommends giving more than 1 vaccine, on the same day- better coverage, reduce no. of contacts
  4. 4. National Immunization ScheduleAge VaccineAt birth BCG, OPV 06 weeks DPT1, OPV1, HB110 weeks DPT2, OPV2, HB214 weeks DPT3, OPV3, HB39 months Measles16-18 months DPT (Booster), OPV45 years DT10 years TT16 years TTPregnant women TT( 2 doses at 1 month interval)
  5. 5. IAP Immunization ScheduleVaccine Recommended AgeBCG Birth to 2 weeksOPV Birth, 6, 10, 14 weeks, 16-18 months, 5 yrs & additional pulse polio dosesDPT 6, 10, 14 weeks, 16-18 months, 5 yrsHepatitis B At birth, 6, 10, 14 weeksHiB Conjugate 6, 10, 14 weeks, 16-18 monthsMeasles 9 monthsMMR 15 monthsTyphoid 2 yearsTT/Td 10, 16 yearsTT (2 doses) Pregnant Women Optional vaccines , Varicella- Above 15 months, Hepatitis A- Above 18 months, Pneumococcal >6 weeks
  6. 6. Vaccination Schedule for theunimmunized child-Age Less than 7 years More than 7 yearsFirst Visit BCG, DPT, OPV, HB, Hib BCG, TT/Td, HB2nd visit ( 1 month later ) DPT, OPV, MMR, HB, TT/Td Measles/MMR, HB3rd Visit ( 1 month later ) DPT, OPV, Typhoid (if Typhoid, TT/Td >2yrs of age)Fourth Visit ( 1 year later ) DPT, OPV, HB TT/Td, HB
  7. 7. Vaccination Schedule inAdolescentsVaccine AgeTT/Td Booster at 10, 16 yrs, & every 10 yrsRubella/ MMR 1 dose at 12-13 yrs( Monovalent or as MMR (if not given earlier)Hepatitis B 3 doses (0, 1, 6 months) if not given earlierTyphoid TA, Vi, or Oral Typhoid vaccine every 3 yearsVaricella 1 dose upto 12-13 yrs & 2 doses at 1 month interval after 13 yrs if not given earlier, or did not suffer from chicken poxHepatitis A 2 doses ( 0 & 6 months )if not given earlier
  8. 8. Tetanus Prophylaxis in WoundManagementHistory of prior Clean, minor wounds All other woundsTT/DPT/DT/Td doses TT*, TIG** TT, TIGUnknown or <3 doses Yes, No Yes, Yes3 or more doses No ***, No No ****, No *TT-Tetanus Toxoid **TIG-Tetanus Immunoglobulin 250 IU/IM injection *** Yes, If more than 10 years since last dose **** Yes, if more than 5 years since last dose
  9. 9. Key Points - Vaccines stored at +2 to +8 degrees C, except OPV- stored at -20 degrees C or below. Lapsed Immunizations Minor Illnesses- Fever, diarrhoea, respiratory infections & malnutrition Both killed & live vaccines- simultaneous administration , at different sites, using separate needles for each component. Avoid giving injections-Skin infections, Skin lesion or weeping dermatitis. Prepare skin with disinfectant. Sterile needles & syringes- For reconstitution/administration
  10. 10. VACCINE GUIDELINES-Vaccine Diluent Dose, Route & Contra- Adverse Site indications EffectsBCG (freeze Normal Saline 0.1ml intra Immuno Axillary lymphdried) dermal left deficiency adenitis deltoidDTP (whole cell None 0.5ml IM, Progressive Fever, local painvaccine ) antero-lateral neurological & induration aspect thigh diseaseOPV None 2 drops orally Immuno VAPP rarely deficiency, HIV (Vaccine associated paralytic polio)HB 10 mcg of None 0.5ml IM, None Local pain,purified HBsAg antero-lateral erythema aspect thighMeasles Sterile water 0.5 ml None Mild fever, mild(lyophilized) SC/Deltoid/thig rash after 7 days hMMR Sterile water 0.5 ml Systemic Mild fever, mild(lyophilized) SC/Deltoid/ hypersensitivity rash after 7 days
  11. 11. VACCINE GUIDELINES CONTINUEDVaccine Diluent Dose, Rate & Contra Adverse Effects Site indicationsVaricella Sterile water 0.5 ml SC Systemic Milder Varicella(Lyophilized) deltoid hypersensitivity type rash to neomycinHepatitis A None 0.5 ml IM thigh None Local pain, erythemaTyphoid Vi None 0.5 ml IM None Mild localantigen vaccine deltoid reactionMeningococcal Sterile water 0.5 ml IM or SC None Mild fever, localvaccine(2 yrs & Deltoid/ Thigh reactionabove, duringepidemics)Pneumococcal None 0.5 ml IM or SC None Local Reaction23 Valent anterolateralvaccine aspect of thigh/ deltoid
  12. 12. Thank You