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Bcg opv ipv vaccines and catchup vaccination (immunization)

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BCG OPV and IPV

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Bcg opv ipv vaccines and catchup vaccination (immunization)

  1. 1. BCG, OPV, IPV & CATCH-UP VACCINATION PRAVEEN RK NO: 75
  2. 2. BCG VACCINE
  3. 3. BCG • Bacillus Calmette Guerin • Live attenuated vaccine against Tuberculosis • Protects against TB Meningitis, Miliary TB • Common strains used- Copenhagen(Danish1331), Pasteur , Glaxo • Danish 1331- Produced at Guindy, Tamil Nadu, India • Available as lyophilised (freeze dried) powder • Reconstituted with sterile normal saline
  4. 4. • Induces Cell mediated immunity • Primary infection is not prevented • Protects against severe form of TB – miliary TB, TB meningitis • Protective efficacy – 80% • Duration of protection – 15 to 20 years • Maternal antibodies do not interfere as CMI do not transfer transplacentally • Administration at birth provides – early protection ensures compliance convenient to implement
  5. 5. • Dose – 0.05ml (neonates) , 0.1ml (infants and children) • Route of administration – intradermal (26G needle) • Site – left upper arm at insertion of deltoid
  6. 6. PHENOMENA AFTER VACCINATION Permanent tiny round scar 4-8mm diameter Healing occurs (6-12 weeks) Breaks into shallow ulcer with crust Increases size with diameter of 4-8mm (5-6 weeks) Papule at site of injection (2-3 weeks)
  7. 7. SCHEDULE • National Immunization Program • At birth • Catch up till 1 yr • IAP 2016 • At birth • Catch up till 5 yr
  8. 8. ADVERSE REACTIONS • Persistent ulceration at injection site • Discharging sinus • Ipsilateral axillary or cervical lymphadenopathy • Disseminated infection • Osteomyelitis • Scrofuloderma (immunodeficient persons)
  9. 9. CONTRAINDICATION • Immunodeficiency (HIV, leukemia, lymphoma) • Generalized eczema • Infective dermatosis • Hypogammaglobinemia
  10. 10. STORAGE • 2-8oC • Sensitive to heat and light • Discard unused vaccine after 4h
  11. 11. ORAL POLIO VACCINE
  12. 12. OPV • Live attenuated polioviruses (types 1, 2, 3) • Developed by Sabin • Each dose (2drops) contain 105 to 106 median cell culture doses of each serotypes • Stabilizing agent – Magnesium chloride • Multiple doses are needed to ensure take • Vaccine of choice for eradication of poliovirus where wild poliovirus is still circulating • Given as bivalent OPV (serotypes 1&3)
  13. 13. • Included in • Pulse Polio Immunization • Supplementary immunization activities • National Polio Surveillance Project • National Immunization program
  14. 14. DEVELOPMENT OF IMMUNITY Administration of vaccine Infect intestinal mucosa Multiplication in mucosal cells (take) Provides local as well as systemic immunity
  15. 15. • Dose – 2 drops • Route of administration – Oral • Method of administration – Tilt the child’s back and gently squeeze the cheeks or pinch the nose to make the mouth open. Let the drops fall from the dropper onto the child’s tongue. Repeat the process if child spits out the vaccine
  16. 16. SCHEDULE • National Immunization Program • OPV0 at birth or within 15 days • OPV1 at 6th week • OPV2 at 10th week • OPV3 at 14th week • OPVb at 15-18 months and 5yr
  17. 17. • IAP 2016 • OPV at birth, 6mo, 9mo and 5yr (In case of sequential IPV- OPV Schedule) • Same as in National Program (IPV not available)
  18. 18. ADVANTAGES • Easy to administer • Induces both humoral and intestinal immunity • Antibody is quickly produced • Vaccinee excretes the virus and infects others who are also immunized thereby • Useful in controlling epidemics • Relatively inexpensive
  19. 19. ADVERSE REACTIONS • Vaccine associated paralytic polio( type 3 mutation) • Vaccine derived poliovirus (type 2)
  20. 20. CONTRAINDICATIONS • Immunocompromised individuals (symptomatic HIV, leukemia, malignancy, those under corticosteroids) • Active viral infections • Breast feeding and mild diarrhoea are not contraindications
  21. 21. STORAGE • Stable at 4-80C for 3-4 months • -20oC for a year • Potency drops rapidly with temperature fluctuations • Potency monitored using Vaccine Vial Monitor (VVM) • Vaccine discarded if color of inner square in vvm is as dark as or darker than color of outer circle
  22. 22. INACTIVATED POLIO VACCINE
  23. 23. IPV • Developed by Salk • Suspension of formaldehyde killed poliovirus grown in monkey kidney, human diploid or vero cell culture • Induces humoral immune response and gives protection from paralysis • Does not induce local immunity • Vaccine potency measured by ‘D’ antigen • Currently used Enhanced potency IPV (eIPV) contain 40D, 8D, 32D units of types 1, 2, 3 polioviruses.
  24. 24. • Highly immunogenic • Seroconversion – 90-95% in infants beyond 8 weeks age administered of two doses of IPV 2months apart 99% of those given 3 doses 4 weeks apart
  25. 25. • Dose – 0.5ml • Route of administration – intramuscular or subcutaneous
  26. 26. SCHEDULE • National Immunization Program • At 14 weeks • IAP 2016 • Sequential IPV-OPV schedule • 3 doses IPV at 6, 10 and 14 weeks , or • 2 doses IPV at 8 and 16 weeks (primary) and 1 dose IPV at 15-18 months (booster) • Also give OPV at 6mo, 9mo, and 5yr and on NIDs and SIAs • Catchup upto 5yr; 3 doses at 0, 2 and 6months
  27. 27. ADVANTAGES • Efficacy of IPV in preventing poliomyelitis is excellent • Does not cause Vaccine associated paralytic poliomyelitis • Vaccine of choice in patients with immunodeficiency • Can be administered to pregnant women
  28. 28. DISADVANTAGE • Immunity not rapidly achieved • Injections during epidemic can precipitate paralysis • Does not produce local immunity , virus can multiply in gut and can be a source of infection to others
  29. 29. ADVERSE REACTIONS • No serious adverse reactions • Minor local erythema, induration, swelling and tenderness
  30. 30. CONTRAINDICATIONS • Any known allergy
  31. 31. STORAGE • 2-8oC • Sensitive to light
  32. 32. CATCH UP VACCINATION
  33. 33. CATCH UP VACCINATION • Not infrequently, children who present for immunization have missed out on previously scheduled vaccines • To ensure that these ‘overdue’ children can be protected as quickly as possible, ‘catch-up’ vaccination schedules are available • Every opportunity should be taken to check vaccination status and to provide missing doses. • When infants and children have missed scheduled vaccine doses, a catch-up schedule should be commenced • Missed immunization does not require restarting of the entire series or addition of doses to the series for any vaccine in the recommended schedule
  34. 34. • Two or more inactivated vaccines can be given simultaneously or at any interval between doses without affecting the immune response • An inactive vaccine can similarly be given simultaneously or at any interval with a live vaccine • 2 live (intranasal/injectable) vaccines should either be given simultaneously or at least 4 weeks apart • If a dose of DTP, IPV, Hib, pneumococcal conjugate, hepatitis A, hepatitis B, HPV, MMR, or varicella vaccine is missed, subsequent immunization should be given at the next visit as if the usual interval had elapsed
  35. 35. • For rotavaccine same principle can be followed, though upper age limit of last dose should be maintained • Minimal interval recommendation should be followed for administration of all doses.
  36. 36. THANK YOU

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