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Universal Immunization Program 2017

Annu verma
Annu verma

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

1 of 21
UNIVERSAL IMMUNIZATION PROGRAM (UIP) MS. ANNU VERMA (LECTURER) (MAHARISHI MARKANDESHWAR COLLEGE OF NURSING) MAHARISHI MARKANDESHWAR UNIVERSITY MULLANA,AMBALA
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.
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.
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
Frequently Asked Questions What is immunization ? It is the process of giving vaccines to the development of bodys 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.
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.
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.
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 遜 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 遜 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
Age Vaccine name Dosage Route Site Disease prevented 3 遜 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
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
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.
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.
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
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).
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
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.
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.
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"
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 worlds most successful and cost- effective health interventions. Today, there are still 19.4 million unvaccinated and under- vaccinated children in the world.
Universal Immunization Program 2017
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.

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Universal Immunization Program 2017

  • 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 bodys 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 遜 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 遜 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 遜 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 worlds 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.