Latest Information related to Universal Immunization Schedule (till 2017) is incorporated with some key informations.

1. UNIVERSAL IMMUNIZATION PROGRAM (UIP)
MS. ANNU VERMA (LECTURER)
(MAHARISHI MARKANDESHWAR COLLEGE OF NURSING)
MAHARISHI MARKANDESHWAR UNIVERSITY
MULLANA,AMBALA

2. INTRODUCTION
 National Immunization Program aims to reduce mortality
and morbidity by protecting children from the vaccine
preventable diseases of Tuberculosis, Polio, Diphtheria,
Pertussis, Tetanus, Hepatitis B, Measles and Japanese
Encephalitis.
 Universal Immunization Programme is a vaccination
program launched by the Government of India in 1985. It
became a part of Child Survival and Safe Motherhood
Programme in 1992 and is currently one of the key areas
under National Rural Health Mission(NRHM) since 2005.

3. INTRODUCTION
 The World Health Organization
(WHO) estimates active
immunization currently averts 2 to
3 million deaths every year.
However 22.6 million infants
worldwide are still missing out on
basic vaccines, mostly in
developing countries.

4. INTRODUCTION
 The program now consists of vaccination for 12 diseases-
tuberculosis, diphtheria, pertussis (whooping cough), tetanus,
poliomyelitis, measles, Hepatitis B, Diarrhoea, Japanese
Encephalits, rubella, Pneumonia( Heamophilus Influenza Type
B)and Pneumococcal diseases (Pneumococcal Pneumonia and
Meningitis). Hepatitis B and Pneumococcal diseases was added
to the UIP in 2007 and 2017 respectively .
 Pentavalent vaccine was introduced in 8 states i.e, Tamil Nadu,
Kerala, Haryana, J &K, Gujrat, Karnataka, Goa and
Pundcherry.
 ASHA and AWW support ANM by mobolizing eligible
children to session. ASHA is also provided an incentive of Rs.
150/- per session for this activity

5. Frequently Asked Questions
 What is immunization ?
 It is the process of giving vaccines to the development of
body’s protective response.
 How do vaccines work ?
 Vaccines work by protecting the body before disease
strikes. Vaccines stimulate the body to produce the
antibodies to fight off the serious illnesses for which child
has been vaccinated.
 Why start vaccination early in life ?
 Children are susceptible to diseases at a young age, and
the consequences of these diseases can be life-threatening.

6. Frequently Asked Questions
 Are immunizations safe ?
 Yes, very safe. But like any medicine they can occasionally
cause reactions. Children are in much more danger from the
diseases than from the vaccination.
 What are contraindications to immunization ?
 All infants should be immunized except in 3 rare situations of
Anaphylaxis or a severe allergic reaction, Convulsion or
encephalitis with a previous dose of DPT and High fever
 Can vaccination be given if a child has Mild fever, diarrhea
or cough ?
 Yes, mild fever, diarrhoea and cough are not contra indications
for immunization.

7. Frequently Asked Questions
 What are the side-effects of vaccines ?
 Only very few infants and children develop side effects after
vaccination. They are mild (redness and swelling at the injection site)
and go away within a few days.
 If a child who has never been vaccinated is brought at 9 months of
age, can all the due vaccines be given on the same day ?
 Yes, all due vaccines can be given during the same session but at
different injection sites using separate syringes.
 Which vaccines can be given to a child between 1-5 years of age,
who has never been vaccinated ?
 Give DPT1, OPV-1, Measles and 2ml of Vitamin A solution. Then
follow with 2 and 3 doses of DPT and OPV at one month intervals.
And so on as per interval.

8. Age Vaccine name Dosage Route Site Disease prevented
At
Birth
BCG(Bacillus
Calmette Guerin)
OPV-0
Hepatitis B-0
0.1 ml
(0.05 ml untill
1 month age)
2 drops
0.5 ml
ID
Oral
IM
Left upper arm
Oral
Antero-lateral side of
mid thigh (Right)
TB
Polio
Hepatitis B
1 ½
month
Rotavirus-1
OPV-1
IPV-1
DPT-1
Hepatitis B-1
Or
Pentavalent-1
5 drops
2 drops
0.1 ml
0.5 ml
0.5 ml
0.5 ml
Oral
Oral
ID
IM
IM
IM
Oral
Oral
Right upper arm
Antero-lateral side of
mid thigh (Left)
Antero-lateral side of
mid thigh (Right)
Antero-lateral side of
mid thigh (Left)
Rotavirus/Diarrhoea
Polio
Diphtheria, Pertusis,
Teatnus
Hepatitis B
DPT, Hepatitis B
, Hi B
2 ½
month
Rotavirus-2
OPV-2
DPT-2
Hepatitis B-2
Or
Pentavalent-2
5 drops
2 drops
0.5 ml
0.5 ml
0.5 ml
Oral
Oral
IM
IM
IM
---do--- ---do---
KEY: ID-Intradermal, IM-Intramuscular, SC-Subcutaneous, JE-Japanese Encephalitis

9. Age Vaccine name Dosage Route Site Disease prevented
3 ½
months
Rotavirus-3
OPV-3
IPV-2
DPT-3
Hepatitis B-3
Or
Pentavalent-3
(can be given upto
1 yr)*
5 drops
2 drops
0.1 ml
0.5 ml
0.5 ml
0.5 ml
Oral
Oral
ID
IM
IM
IM
Oral
Oral
Right upper arm
Antero-lateral side of
mid thigh (Left)
Antero-lateral side of
mid thigh (Right)
Left Antero-lateral side
of mid thigh
Rotavirus/Diarrhoea
Polio
Diphtheria, Pertusis,
Teatnus
Hepatitis B
DPT, Hepatitis B
, Hi B
9 -12
moths
{upto 5
yrs if not
received)
Measles-1
Vitamin A
JE-1
0.5 ml
1 lakh IU
0.5 ml
SC
Oral
SC
Right upper arm
Oral
Right upper arm
Measles
Night Blindness
Japanese
Encephalitis
16-24
months
DPT (Booster)-1
OPV (Booster)
Vit A (Every 6 mo
till 5 yrs)
Measles-2
(upto 5 yrs)*
JE-2
0.5 ml
2 drops
2 lakh IU
0.5 ml
0.5 ml
IM
Oral
Oral
SC
SC
Oral
Oral
Right upper arm
Right upper arm

10. Age Vaccine name Dosage Route Disease prevented
5 -6 years
10 years
16 years
DPT (Booster)-2
TT-1
TT-2
0.5 ml
0.5 ml
0.5 ml
IM
IM
IM
Teatnus Toxoid
Early in
Pregnancy
(Primi)
TT-1 0.5 ml IM
4 weeks
after TT-1
TT-2 0.5 ml IM

11. MISSED DOSES SCHEDULE
 BCG-can be given before 4 weeks, 2nd after1 month, 3rd dose
after 6 month of 1st dose.
 No catch up above 5 yrs.
 DPT- Missed primary doses can be completed till 1 yr of age, 1st
Booster-upto 4 years, 2nd Booster- before 7 yrs
 Hib-
 for <12mo (2 doses at 4 weeks interval, B-12-18 mo),
 for 12-15 (1 dose followed by Booster after 4 weeks)
 >15 (single dose). No catch up above 5 yrs.
 Rotavirus- can be given before 8 months of age at a minimum
gap of 4 weeks. No catch-up after 8 months.

12. S.NO VACCINE DETAILS
1. Polio -Highly Contagious, spread through fecal-oral route,
ingestion of contaminated food and water or oral-oral
route.
-cause abdominal pain, diarrhoea, muscle paralysis,
disability and deformities of hip,ankle and feet.
2. Japanese
Encephalitis
(JE)
-Diseases Caused by Flavi Virus that affect the
membranes around the brain.
-Passed on to humans from animals through an infected
mosquito.
3. Measles
(Khasra)
-Transmitted by droplets from nose, mouth or throat.
-Characterized by fever and Upper Respiratory Tract
Symptoms like cough and cold.
4. Hepatitis B -Found in blood and body fluids
-Newborns and individual upto 18 yrs are at grat risk
-Cause muscle pain, jaundice, high fever
5. Rotavirus -Common causes of severe diarrhoea less than 2 years of
age.
-Spread from person to person due to bacterial and
parasiting agents that are primarily transmitted through
contaminated food and water.

13. Adverse events following
Immunization (AEFI)
 An Adverse Event Following Immunization (AEFI) is
a medical incident that takes place after an
immunization, causes concern, and is believed to be
caused by immunization.
 It may occur due to Vaccine reaction, Program Error,
Injection Reaction, Coincidental or Unknown reason

14. Common Program errors leading to AEFIs
are:
 Contact of needle with unsterile surface e.g. finger, swab, table etc.;
Contaminated vaccine or diluent (Infection e.g. local abscess at site of
injection, sepsis).
 Use of reconstituted vaccines beyond the 4 hours (2 hrs for JE);
 Reuse of reconstituted vaccine at subsequent sessions (Toxic shock
syndrome, sepsis leading to death).
 Reuse of disposable syringe & needle (HepB, HIV, HepC etc.
 Reconstitution with incorrect diluent; Drug substituted for diluent (Less
vaccine effectiveness; Drug reaction; Death).
 BCG/T series vaccine given subcutaneously (Local reaction or abscess).
 Administration of frozen and thawed freeze-sensitive vaccine (Increased
local reaction as sterile abscess).
 DPT2 given after H/O convulsions with DPT1 (convulsion).

15. Avoid the AEFIs due to program errors by
following these steps:
 Use separate site for each injection.
 Never carry and use reconstituted vaccine from one
session site to another.
 After injection, do not re-cap or bend the needle
 Ask the beneficiaries to wait for half an hour after
vaccination.
 Leave the list of children vaccinated in a session with the
AWW/ASHA and request them to be alert and report
AEFIs.
 Share contact details of self and PHC

16. When a serious adverse event
e.g. convulsions or anaphylaxis occurs, the health worker should
immediately:
 Give primary care: lay child flat; ensure airway is clear. If child is
unconscious, put in semi-prone position.
 Refer immediately to the MO (PHC) or nearest AEFI management centre
for prompt treatment. Accompany the patient if needed. Inform the AEFI
management centre by telephone.
 Inform immediately to the supervisor/ MO (PHC)/ DIO and assist in
investigation of AEFIs.
 Report deaths, injection site abscesses and other complications in the
monthly report.
 Mention in the report any non-occurrence of AEFI. A nil report is also
important.

17. Managing Minor reactions due to vaccines
 For local reaction (pain, swelling, redness), use Cold cloth
at injection site; Give Paracetamol.
 For Fever >101 degree F, Give extra fluids; tepid sponging
and Paracetamol.

18. World Immunization Week 2017
 The World Health Assembly endorsed World Immunization
Week during its May 2012 meeting
 Each World Immunization Week focuses on a theme. The
themes have included the following:
 2017: "Vaccines Work"
 2015-2016: "Close the immunization gap"
 2014: "Are you up-to-date?"
 2013: "Protect your world – get vaccinated"
 2012: "Immunization saves lives"

19. Theme: #Vaccines Work
 World Immunization Week – celebrated in the last week of
April – aims to promote the use of vaccines to protect
people of all ages against disease.
 Immunization saves millions of lives and is widely
recognized as one of the world’s most successful and cost-
effective health interventions.
 Today, there are still 19.4 million unvaccinated and under-
vaccinated children in the world.

21. REFERENCES
BOOK:
 Park K. Preventive & Social Medicine, Bhanot Publishers. 19th
ed.
 Gulani KK. Community Health Nursing (Principles &
Practices). Kumar Publishers. 2nd ed
INTERNET:
 http://www.searo.who.int/india/topics/routine_immunization/I
mmunization_info_kit_for_Health_Workers_English.pdf?ua=1
 https://en.wikipedia.org/wiki/Universal_Immunization_Progra
mme
 World Health Organization, World Immunization Week 2016.
Accessed 27 January 2016.