UNIVERSAL IMMUNIZATION PROGRAMME BY ANUSHRI.pptx
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Immunization Programme is the one of the largest programme of world. This programme in India was introduced by WHO in 1978 as Expanded Programme of Immunization (EPI). In 1985 it was expanded as Universal Immunization Programme that covers all the districts in country by 1989-90 .UIP become a part of CSSM in 1992 and RCH in 1997 and is currently one of the key areas under NRHM since 2005 The action of making a person or animal resistant to a particular infectious disease or pathogens typically by vaccination . Or According to WHO – Immunization is the process whereby a person is made immune or resistant to an infectious disease ,typically by the administration of a vaccine 1978: Expanded Programme of immunization (EPI). Limited reach - mostly urban 1985: Universal Immunization Programme (UIP). For reduction of mortality and morbidity due to 6 VPD’s. Indigenous vaccine production capacity enhanced Cold chain established Phased implementation - all districts covered by 1989-90. Monitoring and evaluation system implemented 1986: Technology Mission On Immunization Monitoring under PMO’s 20 point programme Coverage in infants (0 – 12 months) monitored 1992: Child Survival and Safe Motherhood (CSSM) Included both UIP and Safe motherhood program 1997: Reproductive Child Health (RCH 1) 2005: National Rural Health Mission (NRHM) 2012: Government of India declared 2012 as “Year of Intensification of Routine Immunization. 2013: India, along with other South-East Asia Region, declared commitment towards measles elimination and rubella/congenital rubella syndrome (CRS) control by 2020. 2014: No Wild Polio virus case was reported from the country for the last three years and India had a historic achievement and was certified as “polio free country” along with other South East Asia Region (SEAR) countries of WHO. To reduce morbidity and mortality of the major six childhood disease . To achieve 100% coverage for eligible children. To develop a surveillance system . To minimize the efforts and cost of treatment. To deliver an integrated immunization services through health centres . To promote a new healthy generation . Training of all health personnel . Strengthening the cold chain . Promotion of community participation . Integrate vaccination session with PHC services . Ensuring regular supply of potent vaccine Under five year children . Women in the child bearing age (15-45years). Schedule of immunization . Types of the vaccine . Dose of each vaccines . Route of administration. Precautions of vaccinations . RI targets 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 cohort of 157 million beneficiaries, ~10 million immunization sessions are conducted, majority of these are at village level Strategy and policy
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UNIVERSAL IMMUNIZATION PROGRAMME BY ANUSHRI.pptx
- 1. UNIVERSAL IMMUNIZATION PROGRAMME BY; ANUSHRI SRIVASTAVA CLINICAL INSTRUCTOR
- 2. CONTENT Introduction Definition Objectives Strategies Target Vaccines and its types Schedule Complications Mission Indradhanush Pulse Polio Immunization New Initiatives
- 3. INTRODUCTION Immunization Programme is the one of the largest programme of world. This programme in India was introduced by WHO in 1978 as Expanded Programme of Immunization (EPI). In 1985 it was expanded as Universal Immunization Programme that covers all the districts in country by 1989-90 .UIP become a part of CSSM in 1992 and RCH in 1997 and is currently one of the key areas under NRHM since 2005 .
- 4. DEFINITION The action of making a person or animal resistant to a particular infectious disease or pathogens typically by vaccination . Or According to WHO – Immunization is the process whereby a person is made immune or resistant to an infectious disease ,typically by the administration of a vaccine .
- 5. EVOLUTION OF THE PROGRAMME • 1978: Expanded Programme of immunization (EPI). • Limited reach - mostly urban • 1985: Universal Immunization Programme (UIP). • For reduction of mortality and morbidity due to 6 VPD’s. • Indigenous vaccine production capacity enhanced • Cold chain established • Phased implementation - all districts covered by 1989-90. • Monitoring and evaluation system implemented
- 6. EVOLUTION OF THE PROGRAMME • 1986: Technology Mission On Immunization • Monitoring under PMO’s 20 point programme • Coverage in infants (0 – 12 months) monitored • 1992: Child Survival and Safe Motherhood (CSSM) • Included both UIP and Safe motherhood program • 1997: Reproductive Child Health (RCH 1) • 2005: National Rural Health Mission (NRHM) • 2012: Government of India declared 2012 as “Year of Intensification of Routine Immunization.
- 7. EVOLUTION OF THE PROGRAMME • 2013: India, along with other South-East Asia Region, declared commitment towards measles elimination and rubella/congenital rubella syndrome (CRS) control by 2020. • 2014: No Wild Polio virus case was reported from the country for the last three years and India had a historic achievement and was certified as “polio free country” along with other South East Asia Region (SEAR) countries of WHO.
- 8. OBJECTIVES 1. To reduce morbidity and mortality of the major six childhood disease . 2. To achieve 100% coverage for eligible children. 3. To develop a surveillance system .
- 9. CONTD……… 4. To minimize the efforts and cost of treatment. 5. To deliver an integrated immunization services through health centres . 6. To promote a new healthy generation .
- 10. STRATEGIES 1. Training of all health personnel . 2. Strengthening the cold chain . 3. Promotion of community participation . 4. Integrate vaccination session with PHC services . 5. Ensuring regular supply of potent vaccine .
- 11. TARGET 1. Under five year children . 2. Women in the child bearing age (15-45years). 3. Schedule of immunization . 4. Types of the vaccine . 5. Dose of each vaccines . 6. Route of administration. 7. Precautions of vaccinations .
- 12. TARGET • RI targets 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 cohort of 157 million beneficiaries, ~10 million immunization sessions are conducted, majority of these are at village level
- 13. COMPONENTS • Strategy and policy • Cold chain system, Vaccines, logistics • Injection safety and waste disposal • AEFI (Adverse Event Following Immunization)Surveillance System in India • Strategic communication • Immunization Trainings • Monitoring and evaluation
- 14. VACCINES Definition – A vaccine is an immune biological substances designed to produce specific protection against a given disease.
- 15. TYPES OF VACCINES 1. Live attenuated Vaccine Vaccines against bacteria Vaccines against virus BCG Oral polio vaccine Cholera Mumps Typhoid Measles Rubella Rotavirus
- 16. 2. Inactivated or killed vaccines Vaccines against bacteria Vaccines against virus Diphtheria Rabies Pertussis Influenza Typhoid Hepatitis B Pneumococcal
- 17. 3. TOXIOD VACCINES • Diphtheria • Tetanus
- 18. 4. CELLULAR FTRACTION • eg. Meningococcal vaccines
- 19. 5. COMBINATION VACCINE • Eg. DPT , MMR , DT
- 21. National Technical Advisory Group on Immunization (NTAGI) • Injectable Polio Vaccine (IPV): National Technical Advisory Group on Immunization (NTAGI) recommended Injectable Polio Vaccine (IPV) introduction as an additional dose along with 3rd dose of DPT in the entire country in the first quarter of 2016. • Rota virus vaccine: NTAGI recommended the introduction of rotavirus vaccine in Universal Immunization Programme in a phased manner. • Rubella vaccine is to be introduced as MR vaccine replacing the measles containing vaccine first dose (MCV1) at 9 months and second dose (MCV2) at 16-24 months.
- 22. SCHEDULE
- 23. IMMUNIZATION SCHDULE FOR INFANTS Vaccines When to give Dose Routes Sites BCG At birth or as early as possible till 1 years of age 0.1 ml (0.05mluntil 1 month of age ) ID Left upper arm Hepatitis B birth dose At birth or as early as possible within 24 hours 0.5 ml IM Antero-lateral side 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 wks (OPV can be given till 5 years ) 2 drops Oral Oral
- 24. Vaccines When to give Dose Route s Sites Human papilloma vaccines (HPV) 1,2,3 At 6,10,14 wks (can be given till 1 years of age ) 0.5ml IM Antero-lateral side of mid thigh Pneumococcal conjugate vaccine (PCV) 2 Primary dose at 6 and 14 wks followed by booster dose at 9- 12 months 0.5 ml IM Antero-lateral side of mid thigh Rota virus vaccine (RVV) At 6,10,14 wks (can be given till 1 year of age ) Rotavac -5 drop Rotasil liquid 2ml Oral Oral
- 25. Vaccines When to give Dose Routes Sites Inactivated polio vaccine (IPV) 2 Fractional dose at 6 and 14 wks of age 0.1 ml ID Right upper arm Measles , Rubella (MR) 9 Completed month -12 months (Measles can be given till 5 years of age ) 0.5 ml SC Right upper arm Japanese encephalitis (JE) -1 9 Completed months -12 months 0.5 ml SC –Live attenuated vaccine IM – Killed vaccine Left upper arm (Live attenuated vaccine ) Antero-lateral side of mid thigh (Killed vaccine ) Vitamin A (1ST) Dose At 9 completed months with measles and rubella 1ml Oral Oral
- 26. Vaccines When to give Dose Routes Sites FOR CHILDREN Diphtheria ,Tetanus ,Pertussis booster -1 16-24 months 0.5ml IM Antero-lateral side of mid thigh Measles ,Rubella 2nd dose 16-24 months 0.5 ml SC Right upper arm
- 27. Vaccines When to give Dose Routes Sites Japanese encephalitis -2 16-24 months 0.5 ml SC (Live attenuated ) IM (Killed ) Left upper arm (Live attenuated ) Antero –lateral aspects of mid thigh (Killed vaccine ) VITAMIN – A 2nd -9th dose 16-18 months , then subsequently 1st dose every 6 months (Up to age of 5 years ) 2ml (2 Lakh IU) Oral Oral
- 28. Vaccines When to give Dose Routes Sites Diptheria,Tetanus ,Pertussis booster- 2 5-6 years 0.5 ml IM Upper arm Tetanus ,Diphtheria (TD) 10 and 16 Years 0.5 ml IM Upper arm
- 29. FOR PREGNANT WOMEN Vaccines When to give Dose Routes Sites Tetanus ,Diptheria-1 Early in pregnancy 0.5ml IM Upper arm Tetanus ,Diphtheria -2 4 wks after Td -1 0.5 ml IM Upper arm Tetanus ,Diphtheria - booster If received 2 Td dose in a pregnancy within the last 3 years 0.5 ml IM Upper arm
- 30. COMPLICATIONS 1. Pain ,Swelling ,Redness. 2. Mild fever. 3. Chills . 4. Feeling tired. 5. Headache .
- 31. ERADICATED DISEASES 1. Small pox was declared eradicated in (1980) 2. Yawn (1996 -97) 3. Wild polio 13 january( 2011) 4. Guinea worm disease( 2004)
- 33. INTRODUCTION • The MoHFW, GoI, launched Mission Indradhanush in December 2014 as a special drive to vaccinate all unvaccinated and partially vaccinated children under UIP. • FOCUS- interventions to improve full immunization coverage for children in India from 65% in 2014 to at least 90% earlier than 2020, this will be done through special catch‐up drives.
- 34. COVERAGE AREA • the government has identified 216 high focus districts across the country. The states of Uttar Pradesh (55 high focus districts) and Bihar (19 high focus districts) account for 38% and 10%, respectively, of the total missed children.The states of Maharashtra, Rajasthan, Gujarat, Madhya Pradesh and Assam, with a total of 61 high focus districts, account for 30% of the total missed children
- 35. OBJECTIVES • The main objective of Mission Indradhanush is to ensure high coverage of children and pregnant women with all available vaccines throughout the country, with emphasis on the identified 216 high focus districts during phase III.
- 36. SPECIFIC OBJECTIVES With the launch of Mission Indradhanush, the government aims at: • Generating a high demand for immunization services by addressing communication challenges • Enhancing political, administrative and financial commitment through advocacy with key stakeholders; and • Ensuring that the unvaccinated and partially vaccinated children are fully immunized as per the national immunization schedule
- 37. Areas under focus for Mission Indradhanush Phase III • Areas with vacant sub centres – no auxiliary nurse midwife (ANM) posted for more than 3 months. • Villages/areas with three or more consecutive missed routine immunization sessions – ANMs on long leave or other similar reasons. • High‐risk areas (HRAs) identified by the polio eradication programme that are not having independent routine immunization sessions and clubbed with some other routine immunization sessions. • Areas with low routine immunization coverage identified through measles • outbreaks, cases of diphtheria and neonatal tetanus in the last 2 years.
- 38. Steps for roll‐out of Mission Indradhanush
- 40. State Task Force for Immunization (STFI) • Chairperson: Principal Secretary, Health • Co‐chair: Mission Director, National Health Mission (MD NHM) • Member Secretary: State Immunization Officer (SIO) • Responsibility: Director, Family Welfare; SIO • Timeline: First meeting within 2 days after receiving official communication from the national level. Conduct meetings following completion of each round to review coverage data, monitoring feedback and any other issues, and to plan for the next round. • Frequency: At least one meeting before each Mission Indradhanush round • Review mechanism: MoHFW will review the activity
- 41. District Task Force for Immunization (DTFI) • Chairperson: District Magistrate • Member Secretary: DIO • Responsibility: DIO • Timeline: Within 3‐5 days of state workshop/ communication from the state level. • Frequency: At least one DTFI meeting should be organized prior to each round of Mission Indradhanush, and more frequently if required, to review progress in planning and implementation. • Review mechanism: STFI
- 42. BLOCK LEVEL ACTIVITIES FOR MISSION INDRADHANUSH • Responsibility: Block MO IC • Technical support: Training will be conducted by two MOs trained at district level with support from key development partners such as WHO India NPSP, UNICEF and others. • Financial support: These training sessions will be supported through NHM funds as per guidelines. • Timeline: To be completed within 2–3 days of district workshop • Participants: Health workers (ANMs, LHVs, health supervisors) and social mobilizers (ASHAs, AWWs and link workers) • Review mechanism: DTFI
- 49. • Hon’ble Prime Minister, Shri Narendra Modi, has reviewed Mission Indradhanush under ‘PRAGATI’ – the ICT‐based, multi‐modal platform for Pro‐Active Governance and Timely Implementation” with Chief Secretaries on 17 February 2016. During the session, he emphasized the need for an organized and aggressive action plan to cover all children for immunization in a specific time‐frame.
- 50. PULSE POLIO IMMUNIZATION • National Immunization Days (NIDs) commonly known as Pulse Polio Immunization programme was launched in India in 1995, and is conducted twice in early part of each year. • Additionally, multiple rounds (at least two) of sub - National Immunization Days(SNIDs) have been conducted over the years in high risk states/areas. o In these campaigns, children in the age group of 0-5 years are administered polio drops. Over 170 million children are immunized during each NID and 77 million in SNID
- 51. • In 2005, India was the first country to use monovalent vaccine (type 1) globally, after country level research. • WHO, on 24th February 2012, removed India from the list of “endemic countries with active polio virus transmission” • On 27th March 2014, the Regional Certification Commission of World Health Organizationcertified South-East Asia Region of WHO, which includes India, as polio free.
- 53. COMBATING COVID-19 • On 16th January, 2021, Prime Minister Narendra Modi launched India‟s vaccination programme, which is the largest COVID-19 vaccination drive in the world • HAR GHAR DASTAK • The COVID-19 vaccination campaign „Har Ghar Dastak‟, launched on 3 November 2021, aims at awareness, mobilization and vaccination of all eligible beneficiaries with 1 st dose and all due beneficiaries with 2nd dose of COVID-19 vaccines through House- to-House visits in all States/UTs.
- 54. CONCLUSION I hope you all are understand about this topic .
- 56. ANY QUERIES