IMMUNISATIon.pptx

KGMU CON , LUCKNOW ( IMMUNISATION PROGRAMME AND COLD CHAIN ) 1

2
IMMUNISATION PROGRAMME AND COLD CHAIN
BY - NIDHI DWIVEDI

Immunization is a global health and
development success story, saving millions
of lives every year. Vaccines reduce risks of
getting a disease by working with your
body’s natural defences to build
protection. When you get a vaccine, your
immune system responds .

We now have vaccines to prevent more than 20 life-threatening
diseases, helping people of all ages live longer, healthier lives.
Immunization currently prevents 3.5 - 5 million deaths every year
from diseases like diphtheria, tetanus, pertussis, influenza and
measles .

Immunization, is the process by which
an individual’s immune system
becomes fortified against an infectious
agent (known as the immunogen ) .
IMMUNISATION

IMMUNITY
The resistance offered by the host to the
harmful effects of pathogenic microbial
infection is called immunity .

TYPES OF IMMUNITY
INNATE IMMUNITY ACQUIRED IMMUNITY
NON-SPECIFIC SPECIFIC
PASSIVE
NATURAL ARTIFICIAL
NATURAL ARTIFICIAL
ACTIVE

 Innate Immunity - This is the
basic immunity which is genetically
passed on from one generation to
the other. It is present in the
individual by birth .
TYPES OF IMMUNITY

 Acquired Immunity :The immunity
acquired during lifetime of an
individual is known as acquired
immunity . It is of two types :

1.Active Immunity : Stimulating
active immunological defense
mechanism through administration of
antigens usually before natural
exposure to infections agents is known
as Active Immunity.

2.Passive Immunity : Temporarily
supplying preformed exogenous
antibodies to suppress disease, given
soon after or before exposure to
infectious agent is known as Passive
Immunity.

Vaccines are biological preparation
that produce immunity to a specific
disease. When you are immune to a
disease, it means you are protected
against that disease .
VACCINE

Live vaccines are prepared from
live organisms which have lost
their capacity to induce full
blown disease .
TYPES OF VACCINES
1. Live Attenuated

These vaccines consist of
suspensions of killed or
inactivated organisms.
2 . Inactivated or Killed
Vaccines

Certain organisms like diphtheria bacilli and
tetanus bacilli produce exotoxins ( toxins
produced by bacteria ) which are
detoxicated ( to remove toxic characteristics
) and used in preparation of vaccines.
3. TOXOIDS

Some vaccines are prepared from
extracted cellular fractions for example
Meningococcal vaccine produced from
polysaccharide cell wall of antigen.
4. CELLULAR FRACTIONS

If more than one kind of
immunizing agent is included in the
vaccine, it is called as combination
vaccine. Example , DPT vaccine,
MMR , DT , etc .
5. COMBINATION VACCINES

Types of vaccine Vaccine against bacteria Vaccine against virus
1.Live Attenuated Vaccine  BCG
 Cholera
 Typhoid Oral
 OPV
 Mumps
 Measles
 Rubella
 Rota Virus
2.Killed Vaccine  Diptheria
 Pertussis
 Pneumococcal
 Typhoid
 Rabies
 Polio
 H.Influezna
 Hepatitis B
 Measles
3.Toxoid  Diptheria
 Tetanus

19
MILESTONES OF IMMUNISATION
PROGRMME IN INDIA
•1978 : WHO's EPI, already in operation since 1974, was adopted by
India. Six vaccines : BCG , Oral Polio Vaccine (OPV) , DTP and
Typhoid were covered under EPI .
•1985 : UIP was launched to boost immunization coverage beyond
infancy in India with two changes .
Exclusion of typhoid vaccine
Inclusion of measles vaccine

KGMU CON , LUCKNOW ( IMMUNISATION PROGRAMME AND COLD CHAIN )
20
•1990 : Vitamin A supplementation was introduced in the UIP .
•1995 : PNID (Polio Nation Immunisation Days ) introduced
•2002 : Hepatitis B vaccine introduced in 2002 in some States .
•2011 : Hib , hepatitis B , DPT vaccine (pentavalent vaccine)
introduced in some states .
•2014 : Mission Indradhanush and MMR introduced.
•2017 : MR vaccine campaign Intensified Mission Indradhanush

Mission Indradhanush is a health mission
of the Government of India. It was
launched by Union Health Minister J. P.
Nadda on 25 December 2014.The scheme
this seeks to drive towards 90% full
immunisation coverage of India and
sustain the same by year 2022.

23
FOR PREGNANT WOMEN
TT 1 - Early in pregnancy.
TT 2 - 4 Weeks after TT 1
TT Booster - If received dose 1 and 2 in
pregnancy , booster dose with in last 3 years.
Dose - 0.5 ml.
Route - Intramuscular
Site - Upper Arm .

FOR INFANTS
Age - At birth or as early as possible till
1 year of age .
Dose - 0.1 ml ( 0.05 ml till 1 month of age ) .
Route - Intradermal
Site - Left upper Arm
BCG

Age - At birth or as early as possible with
in 24 hours of birth .
Dose - 0.5 ml.
Site – Antero lateral side of mid thigh
Hepatitis

Age - At birth or as early as possible with in 15 days
Dose - 2 Drops
Route - Oral
Site - Oral / Mouth
OPV 0

Age - At 6 weeks , 10 weeks , 14 weeks
Dose - 2 Drops
Route - Oral
Site - Oral / Mouth
OPV 1 , 2 , 3

DPT ( Diptheria , Pertussis , Tetanus ) , Hepatitis B ,
Hib.( Haemophilous Influenza Type B ) 1 , 2 , 3 , -
Age - At 6 weeks ,10 weeks ,14 weeks
Dose - 0.5 ml.
Site - Antero lateral side of mid thigh
PENTAVALENT VACCINE

Age - At 6 weeks , 10 weeks , 14 weeks
and can be given upto 1 year of age .
Dose – 5 Drops
Route - Oral
Site – Oral ( Mouth )
Rota Virus

Age - At 6 and 14 weeks of age
( 2 fractional doses )
Dose - 0.1 ml
Route - Intradermal
Site - Right upper arm
IPV

Age - At 9 Completed months - 12 months
Dose - 0.5 ml.
Route - Subcutaneous
Site – Right upper arm
Measles / MR 1ST Dose

Age - At 9 completed months - 12 months
Dose - 0.5 ml.
Site - Left Upper Arm
JE ( Japenese Encephalitis )

Age- At 9 completed months
with measles and rubella .
Dose - 1 ml / 1 lakh IU
Route - Oral
Site - Oral / mouth
Vitamin A 1ST Dose

FOR CHILDREN
Age - At 16-24 months
Dose - 0.5 ml.
Route - Intra-muscular
Site - Antero lateral side of mid thigh
DPT Booster 1

Age - At 16 - 24 months
Dose - 0.5 ml.
Site - Right upper arm
Measles / MR 2ND Dose

Age - At 16 - 24 months
Dose - 2 Drops
Route - Oral
Site - Oral / Mouth
OPV Booster

Age - At 16 -24 Months
Dose - 0.5 ml
Site - Left Upper Arm
JE ( Japanese Encephalitis ) 2ND Dose

Age - At 16 - 18 months , then one dose every 6 months
upto 5 years of age
Dose - 2 ml. ( 2 lakhs IU )
Route - Oral
Site - Oral
Vitamin A

Age - At 5-6 years
Dose - 0.5 ml
Site - Upper Arm
DPT Booster 2

Age - At 10 Years and 16 years
Dose - 0.5 ml
Site – Upper Arm
TT

COLD CHAIN
It refers to the process of maintaining optimal conditions during
the transport, storage, and handling of vaccines, starting at the
manufacturer and ending with the administration of the vaccine
to the client. The optimum temperature for refrigerated vaccines
is between +2°C and +8°C. For frozen vaccines the optimum
temperature is - 15°C or lower. In addition, protection from light
is a necessary .

1. Quality and safety checks are carried out throughout the
production .After being packed in vials the batches are
checked again for quality before leaving the factory .
2. They are stored at temperature 2°C and 8°C , -20 °C or -70 °C
to maintain the efficacy of vaccine .
3. The vaccine stocks is flown in refrigerated storge .
°C
Journey of Vaccine

3 .Then driven in refrigerated trucks and taken to warehouse cold
room .
4 . Then place in small ice boxes and transported to local areas
and administered to recipient by a trained health care professional
.
°C
°C

Journey of Vaccine

The cold chain involves two complementary aspects: a ) the
set chain represented by the walk-in cold rooms, deep
freezers and refrigerators for bulk storage of vaccines at the
manufacturer site, or at major distribution points and the
mobile chain represented by isothermic boxes and vaccine
carriers. This can also be classified as electrical and
nonelectrical cold chain equipments .
Cold Chain Equipments

 Used for bulk storage of vaccines like DPT, DT,
TT, measles, BCG, and hepatitis B at State and
Regional / Divisional Stores
 Store vaccine for about 4-5 districts .
 They maintain a temperature of +2° C to +8° C.
Walk-in-Coolers ( WIC )

 These type of refrigerators have top opening
because they can hold the cold air inside better
than a refrigerator with a front opening .
 It can keep vaccine safe with as little as 8 hrs
continuous electricity supply in a 24-hr period.
Ice Lined Refrigerator (ILR)

 It maintains temperature between 2-8°C . All vaccines are kept
in the basket inside the refrigerator.
 It is used for the vaccines OPV, BCG, DPT, DT, and TT and
measles .
 A thermometer should be placed in basket in between the
vaccines and temperature is checked twice a day.

It also maintains the cabinet temperature
between 2 and 8°C, but they have hold over
time of only 4 hrs and capacity to store
vaccines/ freeze .
Domestic Refrigerators

A solar refrigerator operate on the same
principle as normal compression
refrigerators but incorporate low voltage
(12 or 24V) DC compressors and motors ,
rather than mains voltage AC types.
 Solar Refrigerators

 Cold boxes are big insulated boxes used for
transportation of vaccines and in emergency to store
vaccines as well as frozen ice packs. These are of
different sizes - 5, 8, 20 and 22 liters .
 The 5 & 8 liters cold box can transport about 1500 &
2400 doses of mixed antigen vaccines, respectively.
 Cold Boxes

 The vaccines should be placed in cartoons or polythene bags and
then place in the cold box.
 The Vaccines are to be covered with a layer of conditioned ice
packs and close the cold box.
 Before the vaccines are placed in the cold boxes, conditioned ice
packs should be placed at the bottom and sides of the cold box.

 The hold over time is more than 90 hrs for 5 litter and 6 days for
20 liter cold box at +43°C ambient temperature, if the cold box is
not opened at all.
 The vials of DPT, D, TT and Hep B vaccines should never be
placed in direct contact with the ice packs to prevent from
freezing and they should be surrounded by OPV/BCG/measles
vaccines.

 Vaccine carriers are used for carrying small
quantities of vaccines (16-20 vials) to the
sub-centers or session sites .
 4 Fully frozen ice packs are used
 Vaccine Carriers

VVM ( Vaccine Vial Monitoring )
VVMs are small indicators that adhere to vaccine
vials and change colour as the vaccine is exposed to
cumulative heat, letting health workers know
whether the vaccine has exceeded a pre-set limit
beyond which the vaccine should not be used.
VVM ( Vaccine Vial Monitoring )

SHAKE TEST

The salient details, especially characteristics and anticipated
adverse reaction(s) of the vaccine should be explained in simple
terms to the parents before its actual administration.
As a rule, live vaccines are contraindicated in subjects with
immunodeficiency .
IMPORTANT GUIDELINES ON IMMUNIZATION

Mixing of vaccines in one syringe is not permitted unless specified
by the manufacturing company.
Live vaccines must not be administered simultaneously with the
exception of OPV and measles/MMR and OPV and oral typhoid
vaccine (TY21). At least 4 weeks gap should be kept between two
live vaccines

SUMMARY
Immunization is a key component of primary
health care and an indisputable human right. It’s
also one of the best health investments money can
buy. Vaccines are also critical to the prevention
and control of infectious disease outbreaks. They
underpin global health security and will be a vital
tool in the battle against antimicrobial resistance.

Immunization is one of the most important
requirement of child to maintain their optimum
health . From time to time lots of modification has
come in the immunization schedule to protect the
human being from various deadly diseases. Every
parent and health care professional need to make
sure that every child get immunized timely .
CONCLUSION

 RECAPITULATION
What is immunity ? What are the various types of immunity ?
When was immunization programme introduced ?
What are the vaccines given to a pregnant women ?
What vaccines are given to a child shortly after the birth ?
What are the vaccines come under Penta Valent vaccine ?
 ASSIGNMENT
 Make a note on the methods of checking the efficacy of Vaccines other than VVM .

 REFERENCES
• Pal Panchali. Textbook of pediatric nursing. Edition 1. Paras Medical
Publishers, 2016 p.121-124.
• Sharma Rimple. Essentials of pediatric nursing. Edition 2. Paras
Medical Publishers, Delhi: Jaypee Publication, 2017 p. 108-110
• Datta Parul. Pediatric Nursing . Edition 4. Jaypee Publication.p. 140-143

IMMUNISATIon.pptx

Recommended

Recommended

More Related Content

Similar to IMMUNISATIon.pptx

Similar to IMMUNISATIon.pptx (20)

More from NidhiDwivedi29

More from NidhiDwivedi29 (6)

Recently uploaded

Recently uploaded (20)

IMMUNISATIon.pptx