Universal immunization program

1. Universal Immunization
Program (UIP)
Name – Sanchit Singhal Submitted To:-
Dr. Nunna Sujata mam
Dr. Priyanka Wadhwa
Dr. Payal Thakur
Dr. Bharat Sethi

2. Universal Immunization Program
Index
o Introduction
o History
o Vaccines Under UIP
o Vaccine Preventable Diseases (VPDs)
o National Immunization Schedule (NIS)
o Implementation of routin Examination
Components:
• Policy& Strategy
• Cold chain, vaccines and logistics
• Injection safety and waste disposal
• Adverse Events Following Immunization (AEFI)
• Strategic communication
• Training
• Monitoring and evaluation
o Schemes:
• Routine Immunization
• Immunization campaigns
o Pulse Polio Programme
o Mission Indradhanush
o Achievements
O References 2

3. • Universal Immunization Programme (UIP), started in India in 1985.
• ‘Ministry of Health & Family Welfare’ provides several vaccines
to infants, chidren & pregnant women through UIP.
• Immunization typically involves administration of a vaccine,
through which a person is made immune to an infectious disease.
• Vaccine stimulate the body's own immune system to protect against
subsequent infection or disease.
• Most vaccines are given by injecion but some are given by mouth or
sprayed into the nose.
• Immunization are also called vaccination, needles, shots or jabs.
Introduction
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4. • Largest UIP program in the world.
• Targets include 26 million infants and 30.2 million pregnant women
every year
• Protection against six Vaccine Preventable Diseases (VPDs) -
Tuberculosis, Diphtheria, Tetanus, Pertussis, Polio and Measles
• Two new vaccines (JE and Hepatitis B) introduced in select areas
National Vaccination Day, also known as Immunization Day or Polio
Ravivar:- March 16th
• Target infants : 26 million
Fully immunized: 14.1 million
Partial immunized: 9.0 million
No immunized: 2.9 million
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5. History
Although various traditionalmethods were used earlier, the first instanceof
the use of the scientific method for immunization in India.
• Vaccination for Small pox (1802)
• CompulsoryVaccination Act was passed in India (1892)
• CholeraVaccine trailed in Agra (1893)
• First vaccine developed in India (Plague Vaccine) (1897)
• Typhoid Vaccine trailed (1904-1908)
• Vaccine Institute set up (1910-1930)
• BCG Vaccine stared at pilot level (1948)
• National Smallpox Eradication Programme (1962)
• National Tuberculosis Control Progamme (1962)
• First Indigenous OPV Trivalent(Sabin)was developed & produced (1970)
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6. History
• WHO Expanded Programme For Immunization (1974)
• Small pox Free Declared (1977)
• Expanded Programme of imunization (EPI) (Launched in India)
(1978)
(BCG,DPT, OPV Vaccine)
• Universal lmmunization Programme(UIP) (1985)
• Technology Mission on Immunization (1986)
• Child Survial & Safe Motherhood(CSSM) (1920)
• Reproductive Child Health Programme (RCH 1) (1997)
• Recombinant DNA Hepatitis Vaccine Developed (1997)
• National Rural Health Mission (NRHM) (2005)
• Govt. of India Declared "Year of Intensification of Routine
Immunization” (2012)
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7. Vaccines Under UIP
• Under UIP, following vaccines are provided:
1. BCG (Bacillus Calmette Guerin)
2. DPT (Diphtheria, Pertussis and Tetanus Toxoid)
3. OPV (Oral Polio Vaccine)
4. Measles
5. Hepatitis B
6. TT (Tetanus Toxoid)
7. JE vaccination (in selected high disease burden districts)
8. Hib containing Pentavalent vaccine (DPT+HepB+Hib) (In
selected States)
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8. Diseases Protected by Vaccination under
UIP
1. Diphtheria
2. Pertusis
3. Tetanus
4. Polio
5. Tuberculosis
6. Measles
7. Hepatitis B
8. Japanese Encephalitis (commonly known as brain fever)
9. Meningitis and Pneumonia caused by Haemophilus
Influenzae type b
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17. Implementation of Routine
Immunization
• RI target to vaccinate :-27 million new born each year with all primary
doses and ~100 million children of 1-5 year age with booster doses of UIP
vaccines.
• In addition, 30 million pregnant mothers are targeted for TT vaccination
each year.
• To vaccinate this 10 million immunization sessions are conducted,
(majority at village level)
• As per Coverage Evaluation Survey (2009), 89.8%is provided through
Public sector while private sector contributedto only 8.7%.
• ASHA and AWW support ANM by mobilizing eligible children to session
site thus try to ensure that no child is missed.
• ASHA is also provided an incentive of Rs. 150/session for this activity
• To ensure potentand safe vaccines, a network of ~27,000cold chain points
have been created across the countrywhere vaccines are stored at
recommended temperatures. 17

18. Components:
1. Strategy and policy
Major goal :-
• The goal of this vaccine policy is to guide decision making in order
to develop a long term plan to strengthen the UIP.
• This policy addresses issues of vaccine security, management,
regulation guidelines, vaccine research and development and
product development.
• To ensure informed decision making for any modification in UIP
schedule or inclusion of new vaccines, there is a National Technical
Advisory Group on Immunization (NTAGI) which comprises of a
number of technical experts, national program leaders and
managers, representatives from development partners and
professional bodies.
• All issues related to the program and vaccines are presented to this
group for review and discussions and final recommendations.
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19. 2. Cold Chain System, Vaccines and Logistics
• Cold Chain is a system of storing and transporting vaccine at the recommended
temperature range from the point of manufactureto point of use.
• India has built a vast cold chain infrastructure to ensure that only potent and
effective vaccines reach millionsof beneficiaries across the country.
Suppliedby manufacturers
Four Government MedicalStore Depots
(at Karnal, Mumbai,Chennai and Kolkata)
State and Regionalvaccine stores
Divisionalvaccinestores and district
PHCs and CHCs
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20. Maintaining Cold Chain System
• Done in cold boxes using insulated vaccine vans
• Vaccines carriers with icepacks are used to transport vaccines from
PHCs to the outreach sessions in the village.
• At state level :- State Cold Chain Officers
• At regional, divisional and district levels:- Cold chain technicians
• At the PHCs and CHCs:- Cold chain handlers (pharmacists, male
and female multi-purpose health workers, etc)
• Tasked with proper storage, handling,temperature charting.
• For maintenance of cold chain equipment, Govt. of India provides
funds to the state under NRHM.
• Supplies are made to states on a quarterly basis
• State Vaccine Stores can store vaccines for three months to send
monthly indents to district stores.
• PHCs can store vaccines for a maximum of one month only.
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21. 3. Injection safety and waste disposal
• A large number of vaccination sessions across the country every
year.
• Unsafe injection practices harm:- the recipient of the injection, the
health worker and the community resulting in potentially life
threatening infections such as HIV/AIDS, Hepatitis B and C, etc.
• To ensure safe injection practices, GOI ensure continuous supply of
injection safety equipments (AD syringes, reconstitution syringes,
hub cutters and waste disposal bags).
• Trainings are conducted
• Disposal of immunization waste is strictly as per Central Pollution
Control Board (CPCB) guidelines for biomedical waste disposal.
• Like disposal of sharps in sharp pits and treated plastic waste
through proper recycling
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22. 4. AEFI Surveillance System in India:
• Started IN:- First publishedin 2005
• The WHO defines AEFI as “a medical incident that takes place after an
immunization, causes concern, and believed to be caused by
immunization”.
• Monitorsimmunization safety, detectsand responds to adverse events
following immunization
• Corrects unsafe immunization practices
• Reduces the negative impact and contributesto the quality of immunization
activities.
• These have been disseminated to medical officers all over the country
• Broaderrange of expertise has been added to the National AEFI committee
such as Pharmacology, Forensic Medicine, Pathology, Immunology,
Epidemiology, Communication etc besides Paediatrics and Immunization
program related experts.
• Workshops have been conductedat national level
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23. 5.Strategic communication
• Refers to policy-making and guidance for consistent
information activity through coherent messaging.
• The issue of media advocacy, proactive planning and effective
media response is emerging as one of the key elements of
strategic communication support to achieving full Routine
Immunization coverage in the country.
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24. 6. Immunization Trainings
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Name of training Duration Levels Participants
Immunization
training for
Medical Officers
3 days State/ Regional/distict All contractual and
regular Medical
Officers including
AYUSH
Immunization
training of Health
Workers
2 days District level All female and male
Multi Purpose Health
workers and their
supervisors
Training of Vaccine
and Cold Chain
Handlers
2 days District level All health workers
(Pharmacists /staff
nurses/ANMs/LHVs
/Male MPWs/etc.)
Training of state,
district and block
data entry
operators
1 day data entry operators at
state, district and block
levels.

25. 7.Monitoring and evaluation:
At three levels:-
1) From the health sub-centre to PHC, district, state and national level. This reporting
has been computerized and the data is available from health facility level and above
every month.
2) Conducts period population based survey (include National Family Health Survey
(NFHS), District Level Health Survey (DLHS), Annual Health Survey (AHS) and
UNICEF Coverage Evaluation Survey (CES)
3) Also plans targeted studies and surveys to evaluate the performance of various
components under UIP. Some of the examples are VMAT/EVSM
At national level also, immunization division has constituted Immunization Action
Group (IAG) to review the program, discuss issues and suggest solutions.
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26. Schemes
Routine Immunization:
Objectives:
• To rapidly increase immunization coverage.
• To improve the quality of services.
• To establish a reliable cold chain system
• Monitoring of performance.
• To achieve self sufficiency in vaccine production.
Scope and eligibility:
Under the UIP, all vaccines are given free of cost to the beneficiaries as
per the National Immunization Schedule.
All beneficiaries’ namely pregnant women and children can get
themselves vaccinated at the nearest Government/Private health
facility
The UIP covers all sections of the society
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27. Immunization Campaigns
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28. PULSE POLIO IMMUNIZATION
PROGRAMME
• Launched: 1995.
• For:- Children under five years of age are given additional
oral polio drops in December and January every year on
fixed days.
• From 1999-2000,house to house vaccination of missed
children was also introduced.
• In addition,large scale multi- district mop-ups have been
conducted.
• As a result only one case of polio was reported in 2011 in
the month of January.
• As on 25th Feb 2012, India:- removed from the list of polio
endemic countries
• On 27th March 2014, India:- certified as polio-free country.
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29. Misson Indradhanush
• Launched on 25-12-2014 by Govt. of India.
• Immunization mission for children below 2 years
• It provides vaccination against 12 Vaccine-Preventable
Disease (VPD)
Diphtheria Whooping Cough
Tetanus Infections Hemophilus Influenza Type B
Polio Tuberculosis
Hepatitis B MeningItis & Pneumonia
Rotavirus Vacci MR
JE PCV
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31. Mission Indradhanush (MI)
IntensifiedMissionIndradhanush (IMI)
• lt was launchedto in October2017
• It focus to improve immunization coverage in selected districts & cities to
ensure full immunization to more than 90% by December 2018 instead of
2020.
IntensifiedMissionIndradhanush 2.0
• It was national wide lmmunization drive to mark the 25 years of pulse polio
programme (2019-20)
• It had targets of full immunization coverage in 272 disticts spread over 27
states
• lt aimed to achieve atleast 90% pan-india immunization coverage by 2022
IntensifiedMission Indradhanush 3.0
• IM 3.0 was launchedin 2021.
• Focus of the IMI 3.0 was the children & pregnant women who had missed
their doses during he Covid-19 pandemic.
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32. Achievements
• The biggest achievement of the immunization program is
the eradication of small pox.
• One more significant milestone is that India is free of
Poliomyelitis caused by Wild Polio Virus (WPV).
• Vaccination has contributed significantly to the decline in
the cases and deaths due to the Vaccine Preventable
Diseases(VPDs).
• Reduced child mortality by 75 %.
• Saved 27 millions child’s life annually.
• Prevented 1 lakh infant death.
• Coverage: As per the Coverage Evaluation Survey (CES-
2009), 61% of children in the country are Fully Immunized
with all vaccines.
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33. References
• http://main.mohfw.gov.in
• Park’s Textbook of Preventive and Social
Medicine
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