This is my own presentation on immunization I expect that it will help you all.

2. PRESENTATION
ON
IMMUNIZATION
PRESENTED TO: PRESENTED BY:
Miss Manisha Sehgal
Assistant Professor
ACN
Miss Muskan Thakur
BS22MHNS007
MSc. Nursing 1st Year

3. INTRODUCTION
 Immunization is the process of artificially
inducing immunity or providing protection from
disease.
 Immunization is the artificial means by which
the state of immunity is increased.
 This is the most important invention that
conferred the highest benefit to children in the
world.
 It has helped eradicate polio and small pox for
the community.

4. DEFINITION
 “Immunization is a process of protecting an individual
from a disease through introduction of live or killed or
attenuated organisms in the individual system to create
immunity.”

5. SIGNIFICANCE
 It is most cost-effective health interventions in reduction
of communicable diseases related morbidity and mortality.
 It is a mass means of protecting the largest number of
people from various diseases.
 It gives resistance to an infectious disease by producing
or augmenting the immunity.
 Artificially acquired immunity is developed by
immunization.

6. IMMUNITY
 Immunity is the security against a particular disease and
nonsusceptibility to the invasive or pathogenic effects of
foreign microorganisms or to the toxic effect of antigenic
substances.
 Acquired immunity can be
1. Active -vaccines
2. Passive- immunoglobulins

7. TYPES OF IMMUNIZATION
 Active immunization:
 It is the process of stimulating the body to
produce antibody and other immune responses
through administration of a vaccine or toxoid.
 Passive Immunization:
 Passive immunization is provision of temporary
immunity by administration of preformed
antibodies derived from humans or animals.

8. PROCESS OF GENERATION OF IMMUNITY
AFTER VACCINATION:
1. PRIMARY RESPONSE:
 When an antigen is administered for the first time to an
animal or human who has never been exposed to it, there is
a latent period of induction of 3 to 10 days before
antibodies appear in the blood.
2. SECONDARY (BOOSTER) RESPONSE:
 The response to a booster dose differs in a number of ways
from the primary response. Production of antibody is more
rapid. Antibody response maintained at higher levels for a
longer period of time.

9. VACCINE:
 Term derived from “vaccae=cow”. So, immunization agent
is known as vaccine. Vaccine is a immuno- biological
substance designed to produce specific protection against a
given disease.

10. Types of vaccine

11. MILSTONE IN VACCINATION:
 1798 - Smallpox vaccine
 1885 - Rabies vaccine
 1921 - BCG
 1927 - Tetanus toxoid
 1954 - Salk's Polio vaccine
 1957 - Sabin live oral Polio vaccine
 1960 - Measles vaccine
 1962 - Rubella vaccine
 1980- smallpox declared eradicated from the world.

12. EXPANDED PROGRAM ON IMMUNISATION:
 WHO launch a global immunization program, known as
Expanded Program on Immunization (EPI) in May 1974.
 To protect all children of the world against six vaccine-
preventable diseases, namely - diphtheria, whooping cough,
tetanus, polio, tuberculosis and measles by the year 2000.
 EPI was launched in India in January 1978.

13. UNIVERSAL IMMUNISATION PROGRAMME:
 The Indian version, the Universal Immunization Program,
was launched on November 19, 1985.
 The National Health Policy aimed at achieving universal
immunization coverage of the eligible population by 1990.

14. NATIONAL IMMUNISATION SCHEDULE:
VACCINE WHEN TO GIVE DOSE ROUTE SITE
FOR INFANTS
BCG At birth (or as early
as possible till one
year of age)
0.05ml
(0.1ml
after 1
month
till 1
year of
age)
I/D Left upper arm
Hepatitis B At birth (or as early
as possible within 24
hours)
0.5ml I/M Antero-lateral
side of mid-
thigh
OPV-0 At birth (or as early
as possible within
the first 15 days)
2 drops Oral

15. Cont…
VACCINE WHEN TO GIVE DOSE ROUTE SITE
OPV-1,2&3 At 6 weeks, 10 weeks
&14 weeks (can be
given till 5 years of
age)
2 drops Oral
Rota Virus-
1,2&3
At 6 weeks, 10 weeks
&14 weeks (can be
given till one year of
age)
5 drops Oral
Pentavalent
1,2&3
At 6 weeks, 10 weeks
&14 weeks (can be
given till one year of
age)
0.5ml I/M Antero-lateral
aspect of mid-
thigh (LEFT)

16. Cont…
VACCINE WHEN TO GIVE DOSE ROUTE SITE
IPV Two fractional
doses at 6 weeks
&14 weeks
0.1ml I/D Right upper arm
Measles and
Rubella-1
9 completed months
– 12 months (given
up to 5 years if not
received at 9-
12month age)
0.5ml S/C Right upper arm
Japanese
Encephalitis-1
9 completed months
-12months
0.5ml S/C Left upper arm
Vitamin A (1st
dose)
At 9 months with
measles - Rubella
1ml Oral

17. Cont…
FOR CHILDREN
VACCINE WHEN TO GIVE DOSE ROUTE SITE
DPT booster-
1
16-24 month 0.5 ml I/M Anterolateral
aspect of mid-
thigh
Measles and
Rubella-2
16-24 month 0.5 ml S/C Right upper arm
OPV booster 16-24 month 2 drops Oral
Japanese
Encephalitis-
2
16-24 month 0.5 ml S/C Left upper arm

18. Cont…
VACCINE WHEN TO GIVE DOSE ROUTE SITE
Vitamin A
(2nd to 9th
dose)
16 months with
DPT/OPV booster.
Then one dose every
6 month up to the
age of 5 years
2 ml Oral
DPT
booster-2
5-6 years 0.5 ml I/M Upper Arm
TT 10 years & 16 years 0.5 ml I/M Upper Arm

19. Cont…
FOR PREGNANT WOMEN
VACCINE WHEN TO GIVE DOSE ROUTE SITE
TT-1 Early in pregnancy 0.5ml I/M Upper Arm
TT-2 4 weeks after TT-1 0.5ml I/M Upper Arm
TT-booster If received 2 TT
doses in a pregnancy
within the last 3 years
0.5ml I/M Upper Arm

20. IAP SCHEDULE:
AGE VACCINE
Birth BCG
OPV (zero dose)
Hep B-1
6 weeks Hep B-2
IPV-1
DPT-1
Hib-1
PCV (Pneumococcal conjugate)-1
Rotavirus-1
10 weeks Hep B-3
IPV-2
DPT-2
Hib-2
PCV-2
Rotavirus-2

21. Cont…
AGE VACCINE
14 weeks Hep B-4
IPV-3
DPT-3
Hib-3
PCV-3
Rotavirus-3
6 months Influenza-1
7 months Influenza-2
6-9 months TCV (Typhoid Conjugate
Vaccine)
9 months MMR-1,

22. Cont…
AGE VACCINE
15 months MMR-2
Varicella-1
PCV booster
16-18 months IPV booster-1
DPT booster-1
Hib booster-1
18-24 months Hep A-2
Varicella-2
4-6 years IPV booster-1
DPT booster-2
MMR-3
9-14 years Tdap
HPV-1&2
15-18 years HPV-1,2&3

23. Passive immunization in VPD:
Passive immunization is applied in following vaccine
preventable disease:
 Diphtheria,
 Tetanus,
 Hepatitis B
 Rabies &
 Measles.

24. Vaccine Preventable diseases:
According to CDC:
 Chickenpox
 Diphtheria
 Flu
 Hepatitis A
 Hepatitis B
 Hib
 Measles
 Meningococcal
 Mumps
 Polio
 Pneumococcal
 Rotavirus
 Rubella
 Tetanus
 Whooping Cough

25. DIPTHERIAANTITIOXIN:
DOSE:
 Prophylactic: 500 to 2000 units by S/C or I/M injection;
 Therapeutic: 10,000 to 30,000 units by I/M injection or
40,000 to 100,000 units by I/V injection in 2 divided doses
with an interval of 12 to 24 hours.

26. MEASLES IMMUNOGLOBULIN (HUMAN):
DOSE-
 Recommended by WHO is 0.25 ml per kg of body weight.
It should be given within 3-4 days of exposure.
 The person passively immunized should be given live
measles vaccine 8-12 weeks later.

27. HEPATITIS B IMMUNOGLOBIN:
 The recommended dose is 0.05 to 0.07 ml/kg of body
weight;
 two doses should be given 30 days apart.
 HBIG provides short-term passive protection which lasts
approximately 3 months.

28. TETANUS IMMUNOGLOBIN:
Dose –
 250 unit for prophylaxis
 3000-6000 for therapeutic

29. HOW TO DESCRIBE A VACCINE:
Whenever one describes a vaccine, it must be done under the
following heads:
 Type
 Content
 Dose
 Time of administration
 No of doses including boosters.

30. Cont…
 Diluent if any
 Time after reconstitution
 Efficacy
 Storage
 Side effects
 contraindications

31. FOR EXAMPLE:
Measles vaccine:
 1. Type- Freeze dried vaccine contains live attenuated
virus; Stored at 2-8 degree C.
 2. Dose- 0.5 ml;
 3. Route- Subcutaneous.
 4. Time of administration- 9 months in India.
 According to W.H.O if child is malnourished,
 1st dose is b/w 6-8 months;
 2nd dose after 1 year.

32. Cont…
 5. Efficacy of Vaccine-
 95%if given after one year.
 At nine months -85%
 6. Duration of immunity– Lifelong.
 7. It is freeze dried vaccine
 8. Has to be reconstituted with distilled water
 9. Reconstituted vaccine must be used as early as possible
 10. It has shell life for 2 years
 11. Must be stored between 2-8 degree centigrade

33. Recent W.H.O. recommendation –
 1st dose of measles at 9 months.
 2nd dose of M.M.R. – 15 months.
 This vaccine may also be given to contacting person.

34. Complications of vaccine:
 1. Fever
 2. Rash
 4. T.S.S

35. Contraindications of Measles vaccine:
 1. Impaired cell-mediated immunity.
 2. Convulsions.
 3. Patient on steroids.
 4. Pregnancy
 5. Active T.B.
 6. Acute infectious disease.
 7. Generalized allergy.

36. How to calculate vaccine requirement:
There are two ways to calculate vaccine requirement—
 1. Based on real number of beneficiaries in community.
 2. Based on, Birth Rate and IMR.

37. Based on real number of beneficiaries in community.
 Count the total number of beneficiaries, like infant,
pregnant mother etc.
 Multiply it with total number of doses of vaccine to be
given.
 Now multiply it with wastage factor for different vaccines
 E.g.- If there are 100 infants. Number of doses of BCG
require will be:
 100× 1 × 1.33= 133 doses
 Since vial of BCG come in doses of 10.
 So needed vial will be= 133/10= 13.3 i.e., 14

38. RESEARCH ARTICLE
 Telemedicine in the National Immunization
Program (Brazil): A promising tool
 The objective of this study was to evaluate the acceptance and
impact of telemedicine at a Reference Center for Special
Immunobiological (CRIE). Patients aged 18 years or older who had
a medical referral to CRIE and agreed to have a telemedicine
consultation were included. From April 2021 to February 2022,
702 telemedicine consultation were conducted. Over 3,380
vaccines were prescribed via telemedicine. Of all the participants
who answered the satisfaction questionnaire, 99.8% stated that they
would recommend the service to other people.

39. SUMMARY
 In this topic I have explained about introduction, definition
& significance of immunization. Immunity and types of
immunity and immunization also explained. Process of
generation of immunity after vaccination, vaccine & types
of vaccine, milestones in immunization, expanded program
on immunization, universal immunization program,
national and IAP immunization schedule also discussed.
Passive immunization in VPD & how to describe a vaccine.

40. CONCLUSION
 Vaccines for contagious diseases have strong spillover
effects, given that immunization interrupts the disease
transmission process and reduces the likelihood that an
infection will harm others. Immunization helps protect
future generations by eradicating diseases.
 It is the process of the production of antibodies against
diseases. These are mainly used against bacterial and viral
diseases in both humans and cattle.

42. RECAPITULATION
 Define immunization?
 What is immunity?
 What are the types of immunization?
 Explain about national immunization program?
 What is passive immunization in VPD?
 How to describe a vaccine?

43. MCQ-
 1. Name the vaccine which was first discovered in the
world
 a) Rabies
 b) Plaque
 c) Small pox
 d) Chicken pox

44. Cont…
 2. In which year small pox vaccine was
discovered
 a) 1798
 b) 1898
 c) 1998
 d) 1800

45. Cont…
 3. The dose of immunoglobulin in the
prevention of measles is
 a) 1 ml/kg
 b) 1.5ml/kg
 c) 0.5ml/kg
 d) 0.25ml/kg

46. Cont…
4. Universal Immunization programme started in
India
a. 1974
b. 1978
c. 1985
d. 1995

47. Cont…
 5. Sabin is type of vaccine
a. Live
b. Killed
c. Toxoid
d. Killed

48. Cont…
 6. BCG vaccine must be used after dilution/
reconstitution within
a. 24 hours
b. 12 hours
c. 6 hours
d. 4 hours

49. ASSIGNMENT
 Make assignment on immunization schedule.