Dr. Navneet Kumar Dhamija Assistant Commissioner - Immunization Ministry of Health & FW, Govt. of India Mobiles : 88267725...
Introduction of JE Vaccination <ul><li>In 2005, a massive outbreak hit several districts in many parts of the country and ...
Criteria to identify JE endemic districts <ul><ul><li>Case load of JE- Total number of cases reported (AES/ suspected JE/ ...
JE Vaccination Program Strategy One time campaign covering children aged 1-15 years followed by integration of JE vaccine ...
Vaccine availability <ul><li>Currently, there are three types of JE vaccines in large-scale use:  </li></ul><ul><li>Mouse ...
The Multiyear Plan Based on the  emergence of JE/ AES new cases and low coverage indicated in the Coverage evaluation surv...
JE Vaccination Program – Overview JE campaigns completed JE campaigns ongoing 111 JE vaccination campaign districts 2006-2...
111 Districts - 2006 - 2011 S.N Name of State District's Name 1 Andhra Pradesh Warrangal 2 Andhra Pradesh Kurnool 3 Andhra...
43 UP Sitapur 44 UP Siddharth Nagar 45 UP Sultanpur 46 UP Unnao 47 Goa North Goa 48 Goa South Goa 49 Assam Sonitpur 50 Ass...
85 Maharashtra Gadchirolli 86 Maharashtra Yavatmal 87 West Bengal Birbhum 88 West Bengal Hoogly 89 West Bengal Burdwan 90 ...
Over 76 million  children have been immunized in the JE vaccination campaigns from 2006 – 2011 Around 3.7 million children...
 
 
 
 
 
JE Vaccination Re-Campaign*  Coverage 2010
AEFIs - During JE Vaccination Campaigns  2006 - 2011 Year Districts Covered Coverage (Million) AEFI Reported Minor Major D...
<ul><li>The 5 year JE vaccination plan is to be completed in 2011 after the campaigns end in Bihar and AP </li></ul><ul><l...
Recommendations <ul><li>Review of JE incidence </li></ul><ul><li>Review JE vaccination program at the State and National l...
<ul><li>Courage is what </li></ul><ul><li>It takes to stand and speak </li></ul><ul><li>Courage is also what  </li></ul><u...
 
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JE

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JE

  1. 1. Dr. Navneet Kumar Dhamija Assistant Commissioner - Immunization Ministry of Health & FW, Govt. of India Mobiles : 8826772555, 9911220066 Office : 23062993, 23062126, 23062728 E-mail : [email_address] Japanese Encephalitis Vaccination Program In India
  2. 2. Introduction of JE Vaccination <ul><li>In 2005, a massive outbreak hit several districts in many parts of the country and many cases occurred in eastern U.P. and adjoining districts of Bihar and Nepal during this period more than 1600 children were reported to have died of JE </li></ul><ul><li>BRD Medical College, Gorakhpur experienced up to 20 admissions per day with patients beyond its capacity where patients were sharing beds, even in the ICU </li></ul>
  3. 3. Criteria to identify JE endemic districts <ul><ul><li>Case load of JE- Total number of cases reported (AES/ suspected JE/ lab confirmed JE). </li></ul></ul><ul><li>Incidence of JE </li></ul><ul><li>Evidence of recent transmission of the disease </li></ul><ul><ul><li>Serological evidence from JE studies. </li></ul></ul><ul><li>Epidemiological link to known areas of transmission . </li></ul>104 districts in 11 States were identified as JE endemic Highest Priority Districts High Risk Districts Medium Risk Districts
  4. 4. JE Vaccination Program Strategy One time campaign covering children aged 1-15 years followed by integration of JE vaccine into UIP as single dose for new cohort at 1-2 years of age The Multi Year Plan 104 JE endemic districts to be covered with JE mass vaccination campaigns in 11 States in a span of 5 years – 2006 – 2010* Review of data and strengthening of JE surveillance showed 4 new states as JE endemic thereby including 15 JE endemic states and incerasing the no. of JE campaign districts to 109 in the Multi year plan. Formation of 2 new districts which split up from Kolar and Thiruvannamalai districts – Cheyyar and Chikballapur increased the no. of JE endemic districts to 111
  5. 5. Vaccine availability <ul><li>Currently, there are three types of JE vaccines in large-scale use: </li></ul><ul><li>Mouse brain-derived, purified and inactivated vaccine </li></ul><ul><li>Cell culture-derived, inactivated JE vaccine based on the Beijing P-3 strain (only available in China and being replaced by live attenuated vaccine). </li></ul><ul><li>Cell culture-derived, live attenuated vaccine based on the SA 14-14-2 strain of the JE virus. </li></ul>Based on research studies, discussions by expert and vaccine availability issues for country needs, SA-14-14-2 JE vaccine manufactured by CDIBP, China was taken up for use
  6. 6. The Multiyear Plan Based on the emergence of JE/ AES new cases and low coverage indicated in the Coverage evaluation survey report in 2 divisions of U.P – 7 districts of Basti and Gorakhpur divisions and 2 districts of Assam, a decision to conduct re-campaigns in 2010 thereby increasing the no. of districts from the initially planned 19 to 28 . Sno. Year No. of Districts covered till date Target population- 1-15 years Total JE vaccination campaign coverage JE vaccination campaign coverage % Vaccine Requirement (million) 1 2006 11 10531554 9308688 88.39 13 2 2007 27 21758223 18431087 84.71 23 3 2008 22 20040262 16881941 84.24 25 4 2009 30 27170604 18097182 66.61 30 5 2010 (Ongoing) 19 9257562.9 6442115 69.6 10.2 6 2010*re- campaigns 9 7659936 7495380 97.85 8.4 Total for India till date 118 96418142 76656393 79.50 109.6
  7. 7. JE Vaccination Program – Overview JE campaigns completed JE campaigns ongoing 111 JE vaccination campaign districts 2006-2011 Currently JE campaigns are ongoing in Bihar and AP after which the 5 year plan for the JE campaigns in India will be completed JE campaign States & districts 1 Andhra Pradesh 10 2 Kerala 2 3 Uttar Pradesh 34 4 Goa 2 5 Assam 11 6 Bihar 6 7 Haryana 6 8 Karnataka 8 9 Tamil Nadu 10 10 Maharashtra 8 11 West Bengal 5 12 Manipur 5 13 Nagaland 2 14 Arunanchal Pradesh 1 15 Uttrakhand 1 Total 111
  8. 8. 111 Districts - 2006 - 2011 S.N Name of State District's Name 1 Andhra Pradesh Warrangal 2 Andhra Pradesh Kurnool 3 Andhra Pradesh Krishna 4 Andhra Pradesh Nellore 5 Andhra Pradesh Medak 6 Andhra Pradesh Adilabad 7 Andhra Pradesh Khamam 8 Andhra Pradesh Nalgonda 9 Andhra Pradesh Mahboobnagar 10 Andhra Pradesh Nizamabad 11 Kerala Thiruvananthapuram 12 Kerala Alappuzha 13 UP Allahabad 14 UP Ambedkar Nagar 15 UP Azamgarh 16 UP Ballia 17 UP Balrampur 18 UP Barabanki 19 UP Bareilly 20 UP Basti 21 UP Behraich 22 UP Deoria 23 UP Faizabad 24 UP Fatehpur 25 UP Ghazipur 26 UP Gonda 27 UP Gorakhpur 28 UP Hardoi 29 UP Jaunpur 30 UP Kanpur Nagar 31 UP Kheri 32 UP Kushi Nagar 33 UP Lucknow 34 UP Maharajganj 35 UP Mau 36 UP Muzaffar Nagar 37 UP Pratapgarh 38 UP Rae Barelly 39 UP Saharanpur 40 UP Shahjahanpur 41 UP Shrawasti 42 UP Sant Kabir Nagar
  9. 9. 43 UP Sitapur 44 UP Siddharth Nagar 45 UP Sultanpur 46 UP Unnao 47 Goa North Goa 48 Goa South Goa 49 Assam Sonitpur 50 Assam Dibrugarh 51 Assam Jorhat 52 Assam Dhemaji 53 Assam Sivsagar 54 Assam Golaghat 55 Assam Tinsukia 56 Assam Lakhimpur 57 Assam Kamrup 58 Assam Udalgiri 59 Assam Nagaon 60 Bihar Champaran West 61 Bihar Muzaffarpur 62 Bihar Gaya 63 Bihar Gopalganj 64 Bihar Nawada 65 Bihar Siwan 66 Haryana Kurukshetra 67 Haryana Ambala 68 Haryana Panipat 69 Haryana Karnal 70 Haryana Yamuna Nagar 71 Haryana Kaithal 72 Karnataka Bellary 73 Karnataka Kolar (+C ballapur ) 74 Karnataka Raichure 75 Karnataka Koppal 76 Karnataka Mandya 77 Karnataka Bijapure 78 Karnataka Dharwad 79 Maharashtra Amravati+Amravati MC 80 Maharashtra Bhandara 81 Maharashtra Nagpur Rural 82 Maharashtra Washim 83 Maharashtra Beed 84 Maharashtra Latur
  10. 10. 85 Maharashtra Gadchirolli 86 Maharashtra Yavatmal 87 West Bengal Birbhum 88 West Bengal Hoogly 89 West Bengal Burdwan 90 West Bengal Howrah 91 West Bengal West Medinapore 92 Tamil Nadu Cuddalore 93 Tamil Nadu Villupuram 94 Tamil Nadu Virudhunagar 95 Tamil Nadu Trichy 96 Tamil Nadu Thiruvarur 97 Tamil Nadu Madurai 98 Tamil Nadu Perambalur 99 Tamil Nadu Thanjavur 100 Tamil Nadu Thiruvannamalai 101 Manipur Imphal east 102 Manipur Imphal West 103 Manipur Thoubal 104 Manipur Bishnupur 105 Manipur Chandel 106 Nagaland Dimapur 107 Nagaland Mokongchung 108 Arunanchal Pradesh Lohit 109 Uttrakhand Udham Singh Nagar
  11. 11. Over 76 million children have been immunized in the JE vaccination campaigns from 2006 – 2011 Around 3.7 million children have been immunized with JE vaccine till date under RI
  12. 17. JE Vaccination Re-Campaign* Coverage 2010
  13. 18. AEFIs - During JE Vaccination Campaigns 2006 - 2011 Year Districts Covered Coverage (Million) AEFI Reported Minor Major Deaths Investigated 2006 11 9.3 504 439 65 22 2007 27 18.5 1209 1059 150 8 2008 22 16.9 1039 996 43 6 2009 15 12.7 755 625 130 5 2010 Ongoing 19 6.4 16 16 0 0 2010* Re-campaigns 9 7.6 180 177 3 1 Total 75 57.4 3507 3119 388 41
  14. 19. <ul><li>The 5 year JE vaccination plan is to be completed in 2011 after the campaigns end in Bihar and AP </li></ul><ul><li>Previous JE campaign states like Assam, Arunanchal Pradesh, Manipur, U.P., Bihar, Haryana, Karnataka, Kerala, Tamil Nadu, Maharashtra, Goa, West Bengal are still reporting JE cases </li></ul><ul><li>Issue of Age shift in many states </li></ul><ul><li>A large cohort of children still remain un- immunized in previous campaign districts under JE vaccination in RI </li></ul>Challenges
  15. 20. Recommendations <ul><li>Review of JE incidence </li></ul><ul><li>Review JE vaccination program at the State and National level to recommend the way forward </li></ul><ul><li>Strengthen JE vaccination under RI </li></ul><ul><ul><li>Coverage reporting </li></ul></ul><ul><ul><li>Vaccine demand and supply issues </li></ul></ul><ul><ul><li>Monitoring RI sessions </li></ul></ul><ul><ul><li>Strengthen coordination and data flow </li></ul></ul><ul><ul><li>Immediate action required – Introduction of JE vaccine in RI in the pending districts </li></ul></ul>
  16. 21. <ul><li>Courage is what </li></ul><ul><li>It takes to stand and speak </li></ul><ul><li>Courage is also what </li></ul><ul><li>It takes to sit down and listen </li></ul>

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