This document outlines immunization strategies including active immunization which induces immunity after antigen exposure, passive immunization which provides short-term immunity through antibodies, and combined strategies. It discusses the goals of immunization programs including protecting populations from diseases like polio, outlines national immunization schedules, and possible adverse effects of different vaccines.

2. • Immunization is the process of rendering a person
immune
• Mass means of protecting the greatest number of people
by reducing the number of susceptible in the community
TYPE:
• Active Immunization
• Passive Immunization
• Combined Passive and Active Immunization

3. Active Immunization
• It is induction of immunity after exposure to an antigen
• There are some infectious diseases whose control is solely
based on active immunization such as polio, tetanus,
diphtheria and measles
• There are also immunization against certain diseases which
are offered to high risk groups or restricted to define
geographic areas where the disease is endemic or a public
health problem
• Every country has its own immunization schedule.

4. Properties of a well thought-out
immunization schedule
• Epidemiologically relevant
• Immunologically effective
• Operationally feasible
• Socially acceptable

5. Universal Immunization
Programme
• In May 1974, the WHO officially launched a global
immunization programme known as Expanded Programme of
Immunization(EPI) to protect all the children of the world
against 6 vaccine-preventable diseases and it was launched in
India in January 1978
• Consists of vaccine - preventable diseases such as Dipththeria,
Wooping Cough, Tetanus, Polio, Tuberculosis and measles
• This programme is now called Universal Child Immunization
and the Indian version of it was launched in November 19,
1985

6. National Immunization
Schedule • BCG
• OPV
• DPT
• TT
• Hepatitis B
• Vitamin A
• Measles
• Japanese Encephalitis
• Rotavirus
• Rubella
• Injectable polio
• Adult vaccine against Japanese Encephalitis

7. National Immunization Schedule
For Pregnant Woman:
Vaccine When to give Dose Route Site
TT - 1 Early in pregnancy 0.5ml Intra-muscular Upper arm
TT - 2 4 weeks after TT 1 0.5ml Intra-muscular Upper arm
TT - Booster If received 2 TT
doses in a pregnancy
within the last 3
years
0.5ml Intra-muscular Upper arm

8. • For Infants
Vaccine When to give Dose Route Site
BCG At birth or as early
as possible till one
year of age
0.1ml Intra – dermal Left upper arm
Hepatitis B At birth or as early
as possible within
24 hours
0.5ml Intra- muscular Antero lateral
aspect 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 6,10 & 14 weeks 2 drops Oral Oral
DPT-1,2 & 3 At 6,10 & 14 weeks 0.5ml Intra-muscular Antero lateral
aspect of mid thigh
Hepatitis B
1,2 & 3
At 6,10 and 14
weeks
0.5ml Intra-muscular Antero lateral
aspect of mid thigh
Measles 9 completed
months – 12
months
0.5ml Sub-cutaneous Right upper arm
Vitamin A (1st
dose)
At 9 months with
measles
1ml(1 lakh
IU)
Oral oral

9. • For Children
Vaccine When to give Dose Route Site
DPT booster 16-24 months 0.5ml Intra-muscular
Antero-lateral aspect
of mid thigh
OPV booster 16-24 months 2 drops Oral Oral
Measles(2nd
dose)
16-24 months 0.5ml Sub-cutaneous
Right upper arm
Japanese
Encephalitis
16-24 months with
DPT/OPV booster
0.5ml Sub-cutaneous
Left upper arm
Vitamin A
(2nd dose to
9th dose)
16 months with
DPT/OPV booster.
Then, one dose every
6 moths up to the
age of 5 years
2ml(2
lakh IU)
Oral Oral
DPT Booster 5-6 years 0.5ml Intra-muscular
Upper arm
TT 10 years & 16 years 0.5ml Intra-muscular
Upper arm

10. Vaccines
BCG OPV DPT
TT Japanese
Encephalitis
Hepatitis B
Measles

11. Classification of adverse
events following Immunization
1. Vaccine reaction: Event caused or precipitated by the vaccine
when given correctly i.e caused by the inherent properties of
the vaccine
2. Programme error: Event caused by an error in the vaccine
preparation, handling or administration
3. Coincidental: Event that happens after immunization but not
caused by the vaccine – a chance association
4. Injection reaction : Event from anxiety or pain from the
injection itself rather than the vaccine
5. Unknown: Events cause cannot be determined

12. Adverse Events of Vaccines
Vaccines Adverse Events
BCG Lymphadenitis, Osteitis/osteomyelitis, Desseminated BCG
infections
OPV Acute Flaccid paralysis
DPT Hypotonic, hyporesponsive episode(HHE or shock
colapse), Persistent inconsolable screaming,
Encephalopathy, seizures
TT Brachial neuritis
Hepatitis B Anaphylaxis
Measles Encephalopathy, seizures
Japanese Encephalitis No specific severe side affects. Anaphylactoid,
Anaphylaxis, Fever, Infection site abscess, Sepsis, Severe
local reaction, Toxic shock syndrome

13. Passive Immunization
It is a short-term expedient useful only when exposure to
infection has just occurred or is imminent within the next few
days.
Preparations available:
• Normal human immunoglobulin
• Specific human immunoglobulin
• Antisera or anti-toxins

14. Combined Active and Passive
Immunization
• In some diseases passive immunization is often undertaken in
conjunction with inactivated vaccine products to provide both
immediate passive immunity and slowly developing active
immunity.
• Examples: Tetanus, Diphtheria, Rabies