The document summarizes recent changes to India's Universal Immunization Programme (UIP). Five new vaccines for polio, rotavirus, rubella, Japanese encephalitis, and pneumococcal disease have been added. It also describes vaccination campaigns for rotavirus, pneumococcal disease, Japanese encephalitis, and measles-rubella that have been rolled out across various states. The government launched Mission Indradhanush and Intensified Mission Indradhanush to strengthen routine immunization and reach children and pregnant women who remain unvaccinated.

1. Recent Advances in
Immunisation.
By-
Fahad Ahmad (MBBS -2K16 HIMSR)
27

2. What’s new in UIP?
 According to the recommendation of National technical
advisory group of India (NTAGI), Government of India has
included five new vaccines in the UIP. The five new vaccines
are
1) Inactivated Poliomyelitis Vaccine (IPV) for polio,
2) Rota viral vaccine,
3) vaccine against rubella, and
4) Japanese encephalitis vaccine.
5) Pneumococcal Vaccine(PCV).
With these new vaccines, India’s UIP will provide free vaccines
against 12 life threatening diseases.

3. ROTA VIRUS VACCINE.
 ROTAVAC was licensed by the Drugs Controller General
of India in early 2014.
 Phased introduction of the vaccine in national immunization program started
in 2016 supplied by Bharat Biotech .
 Launched on 26th March 2016 and has been introduced in four states i.e.
Andhra Pradesh, Odisha, Haryana and Himachal Pradesh.
 Rotavirus vaccine is being expanded to the entire country in a phased
manner.
 Schedule: 3 dose vaccine along with pentavalent 1st, 2nd, and 3rd dose.
 Route: Oral.

5. Pneumococcal Vaccine.
 PCV was launched in May 2017 for reducing infant mortality and morbidity caused
by pneumococcal pneumonia.
 The vaccine was rolled out to approximately 21 lakh children in Himachal Pradesh,
6 districts of Uttar Pradesh and 17 districts of Bihar in the first phase.
 This was followed by introduction in Madhya Pradesh, Rajasthan and Haryana in
2018, eventually to be expanded to the whole country in a phased manner.
 Till December, 2017, around 11.20 lakh doses of PCV have been administered to
children in the above mentioned areas.
 Schedule: 3 doses
1st - 6 weeks
2nd - 14 weeks
3rd(BOOSTER) - 9 month.
Route: Intramuscular.

7. Japanese Encephalitis Vaccine.
 Japanese Encephalitis (JE) vaccination under UIP was
started in India in 2006.
 On 2013 JENVAC –CCD live attenuated vaccine with
local strain SA14-14-2 was developed.
 Till 2017, a total of 231 JE endemic districts had been identified of which JE
vaccination campaign was completed in 229 districts.
 A total of 15.16 crore children were vaccinated against JE in vaccination
campaign carried out in these districts.
 Schedule: two doses- at 9-12 months and 16-24 months.
 Route: Subcutaneous.

8. Some terms related to immunization.
 Fully immunized: A child who had completed recommended UIP immunization schedule
of BCG, DPT and OPV(3 doses) and Measles vaccine before one year of age.
 Partially immunized: A child who was not yet fully immunized
(i) Partially immunized but ‘upto date’. Child who had received all the immunization for
which he/she was eligible by age criteria.
(ii) Partially immunized and ‘not upto date’. Child had not completed the doses of vaccine
for his/her age as per schedule.
 Completely immunized: A child who had received all the vaccine eligible for his/her age.
 Unimmunised: A child who had not yet received any vaccine for the age, though eligible.

9. Mission Indradhanush
 To strengthen and re-energize the programme and achieve
full immunization coverage for all children and pregnant
women at a rapid pace, the Government of India launched
“Mission Indradhanush” in December 2014.
 Goal of Mission Indradhanush:
 To ensure full immunization with all available vaccines for children up to two years of age
and pregnant women.
 The Government has identified 201 high focus districts across 28 states in the country
that have the highest number of partially immunized and unimmunized children.
 Earlier the increase in full immunization coverage was 1% per year which has increased
to 6.7% per year through the first two phases of Mission Indradhanush.
 Mission Indradhanush has completed four phases (from April 2015 to July
2017)covering 528 districts wherein 2.55 crore children and 68.79 lakh pregnant women
have been vaccinated.

11. Intensified Mission Indradhanush.
To further intensify the immunization programme, Intensified Mission
Indradhanush (IMI) was launched on October 8, 2017.
Aim: To reach each and every child up to two years of age and all those
pregnant women who have been left uncovered under the UIP.
A total of 190 districts/urban areas across 24 states were identified where
IMI was started.
The focus was on improving immunisation coverage to ensure full
immunisation to more than 90% by December 2018.
With the launch of IMI, achievement of the target of full immunisation under
MI has now been advanced.
As on 15th Jan 2018, no. of children vaccinated were 49.30 lakh, fully
vaccinated was 12.02 lakh, and no. of pregnant women vaccinated was
10.05 lakh.

13. Measles-Rubella (MR) vaccination campaign
 India, along with ten other WHO South East Asia Region member countries, has
resolved to eliminate measles and control rubella/congenital rubella syndrome
(CRS) by 2020.
 The measles-rubella (MR) vaccination campaign was started in the age group of 9
months to less than 15 years in a phased manner across the nation. The campaign
aims to cover approximately 41 crore children.
 Campaign implementation
 The first phase of measles-rubella vaccination campaign has been successfully
completed during February 2017 in five states, namely, Tamil Nadu, Karnataka,
Goa, Lakshadweep and Puducherry.
 More than 3.3 crore children were vaccinated, reaching out to 97% of the intended
age group. The campaign was carried out in schools, community centers and
health facilities.

14.  The next round was taken up in 8 states/UTs (Andhra Pradesh, Chandigarh,
Dadra & Nagar Haveli, Daman & Diu, Himachal Pradesh, Kerala, Telangana and
Uttarakhand) during August 2017, aiming to cover 3.4 crore children.
 Children to be covered
 All children from 9 months to less than 15 years of age will be given a single shot
of Measles-Rubella (MR) vaccination during the campaign.
 Following the campaign, MR vaccine will become a part of routine immunization
and will replace measles vaccine, currently given at 9-12 months and 16-24
months of age of child.
 For those children who have already received such vaccination, the campaign
dose would provide additional boosting to them.