Universal Immunization Programmme where you will learn about the history, different types of immunization programmme, National Immunisation Schedule (NIS) for pregnant women, infants and children

1. UNIVERSAL IMMUNIZATION
PROGRAMME
UNIVERSAL IMMUNIZATION
PROGRAMME

2. INTRODUCTION
• Immunization is a process through which a person is
made immune to an infectious disease.
• Immunization typically involves administration of a
vaccine.
• Vaccine stimulate the body’s own immune system to
protect against subsequent infection or disease.
• Most vaccines are given by injection but some are
given by mouth or sprayed into the nose.
• Immunization are also called vaccination, needle
shots.

3. HISTORY
• In the year 1974, WHO launched the ‘Expanded Program on Immunization’ (EPI)
against six most common, preventable diseases- Diphtheria, Pertussis, Tetanus,
Polio, Tuberculosis and Measles.
• In 1978, The primary health care concept was launched for the goal “Health for All”.
The Governtment of India has launched its EPI with objective of reducing the
morbidity and mortality resulting from the vaccine preventable diseases of childhood .
• In 1985, Government of India has launched “Universal Immunization Program”.
It has two components:
 Immunization of pregnant women against tetanus disease.
 Immunization of infants and children against EPI targeted disease.
The aim was to achieve 100% coverage of pregnant women with 2 doses of Tetanus
vaccine and atleast 85% of infants should be vaccinated with 3 doses of DPT, OPV,
1 dose of BCG and 1 dose of Measles Vaccine by 1990.
This program was first taken up in 30 districts and 50 medical colleges in the 1985.
Now this program was extended to all districts with 242 medical colleges.

4. • A “ Technology Mission on Vaccination called Immunization of Vulnerable Population
especially children” was set up to cover all aspects of immunization activity from research
and development to actual delivery of services to the target population.
• With help of existing health care delivery system like primary health centers, hospitals,
MCH centers and ICD units the immunization services are provided to the people.
• To improve the immunization program, Government of India has planned the State
Program Implementation Plan (PIP) .
It consists of :
 Vaccine delivery should be available from PHC to sub centers.
 Deploying retired manpower to carry out immunization activites in urban
slums,undeserved ares and in areas where services are deficient.
 Review meetings should be conducted at state level with the districts for every 6
months.
 Training should be given to ANMs, mid-level managers and other staff members.
 Support is provided for mobilization of children to hospitals by ASHA, women self
groups etc.
 Immunization cards, cold chain charts, monitoring sheets and vaccine inventory charts
etc. should be printed and maintained.

5. ImMUNIZATION PROGRAMMS
• Pulse Polio Immunization Program
 India pulse polio immunization was launched in 1995.
 In this program children under five years of age are provided with oral polio drops in December
and January every fixed days.
 From 1999-2000, house to house vaccination of missed children was also introduced.
 As a result, only one case of polio was reported in 2011 in the month of January.
 As on 25th
Feb 2012, India was removed from the list of polio endemic countries, and on 27th
March 2014, India was certified as polio-free country.
• Hepatitis-B Vaccine
o In 2010-2011, Government of India has introduced universalized hepatits B vaccination to all
states in the country.
o Monovalent hepatits B vaccine is given as intramuscular injection to the infant at 6th
, 10th
, and
14th
week along with the primary series of DPT and polio vaccines

6. • Japanese Encephalitis Vaccine
 This program was launched in 2006 to cover 104 districts in
phased manner.
 Single dose of JE vaccine is given to all children between the
age 1 to 15 years of age through campaigns.
 The JE vaccine is being integrated in to routine immunization
in the districts where campaign had already been conducted to
immunize the new cohort of children by vaccinating with 2
doses at 9-12 months and 16-24 months.

7. Mission Indradhanush
• The Government of India launched Mission Indradhanush on 25th
December 2014, to
cover the children who are either unvaccinated or partially vaccinated agaist seven vaccine
preventable disease, i.e. diphtheria, wooping cough, tetanus, polio, tuberculosis, measles
and hepatitis B.
• The goal to vaccinate all under-fives by the year 2020. 201 high district focus were
covered in the first phase.
• Government of India introduced “Intensified Mission Indradhanush (IMI) “ in select districts
and urban areas of the country.
• IMI focus on children upto 2 years of age and pregnant women who have missed out
routine immunization.
• However, vaccination on demand to children upto 5 years of age will be provided during
IMI rounds.
• Intensified Mission Immunization drive will be spread over 7 working days starting from 7th
of every month.
• These 7 days do not include holidays, sundays and the routine immunization days
planned in that week.

8. National Immunization schedule (nis)
For Pregnant Women
Vaccine When to give Dose Route Site
TT-1 Early in
Pregnancy
0.5 ml Intra-muscular Upper Arm
TT-2 4 Weeks after
TT-1*
0.5 ml Intra-muscular Upper Arm
TT-Booster If received 2 TT
doses in a
pregnancy
within the last
3 yrs*
0.5 ml Intra-muscular Upper Arm

9. For Infants
VACCINE WHEN TO
GIVE
DOSE ROUTE SITE
BCG At birth or as
early as
possible till
one year of age
0.1 ml (0.05 ml
until 1 month
age )
Intra - dermal Left Upper Arm
Hepatitis B – Birth dose At birth or as
early as
possible within
24 hours
0.5 ml Intra -
muscular
Antero –lateral
side of mid-
thigh
OPV 0 At birth or as
early as
possible within
the first 15
days
2 drops Oral Oral
OPV 1,2 & 3 At 6 weeks, 10
weeks & 14
weeks (OPV
can be given till
5 years of age )
2 drops Oral Oral

10. For Infants
Vaccine When to give Dose Route Site
Pentavalent 1,2
& 3
At 6 weeks, 10
weeks & 14
weeks ( can be
given till one
year of age)
0.5 ml Intra-muscular Antero-lateral
side of mid-
thigh
Rotavirus# At 6 weeks, 10
weeks & 14
weeks (can be
given till one
year of age )
5 drops Oral Oral
IPV Two fractional
dose at 6 and
14 weeks of
age
0.1 ml Intra-dermal
two fractional
dose
Intra-dermal:
Right Upper
Arm
Measles / MR
1st
Dose $
9 completed
months – 12
months . (can
be given till 5
years of age)
0.5 ml Sub-cutaneous Right Upper
Arm

11. FOR CHILDREN
VACCINE WHEN TO GIVE DOSE ROUTE SITE
DPT booster -1 16-24 months 0.5 ml Intra-muscular Antero-lateral
side of mid-
thigh
Measles/
MR 2nd
dose $
16-24 months 0.5 ml Sub-cutaneous Right upper
arm
OPV Booster 16-24 months 2 drops Oral Oral
TT 10 years & 6
years
0.5 ml Intra-muscular Upper arm
DPT Booster -2 5-6 years 0.5 ml Intra-muscular Upper Arm
JE-2 16-24 months 0.5 ml Sub- cutaneous Left Upper Arm
Vitamin
A***(2nd
to 9th
dose)
16-18 months.
Then one dose
every 6 months
upto the age of
5 years.
2 ml Oral Oral

12. REFERENCES
1. K. Ravi Shankar, M. Sridevi, A. Lakshmana Rao, Social and Preventive Pharmacy
Pg No. 164-165
2. Kirti Malviya, Dr. Satyajit Sahoo, Dharti Dasadiya, Vidhi Acharya, Essentials of
Social and Preventive Pharmacy Pg No. 131, 133