Immunisation program in india
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IMMUNISATION PROGRAM IN INDIA
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IMMUNIZATION: COMMON TERMSImmunity :
Resistance of a host to a specific agent, characterized by measurable and protective surface or humoral antibody and by cell mediated immune responses.
Immunization:
Process of inducing immunity by stimulating immune system through antigens.
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Vaccine:
A preparation of a weakened or killed pathogen, such as a bacterium or virus, or of a portion of the pathogen's structure that upon administration stimulates antibody production or cellular immunity against the pathogen but is incapable of causing severe infection.
Vaccination:
Administration of antigenic material (the vaccine) to produce immunity to a disease.
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Ring immunization:
Vaccination of people in close contact with an isolated infected patient.
Catch up rounds:
Additional effort besides routine immunization to cover left outs
Mop-up rounds:
When the final pockets of polio virus transmission have been identified through standard surveillance, door-to-door immunization in high-risk districts.
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HERD IMMUNITY?Resistance to spread of infectious disease in a group
because of few susceptible members, making transmission unlikely.
The immunologic status of a population, determined by the ratio of resistant to susceptible members and their distribution.
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MILESTONES IN IMMUNIZATION PROGRAM IN INDIA1978: EPI
1985: UIP, Measles vaccine added
1988: AEFI Surveillance
1990: Vitamin A
1992: CSSM
1995: Polio National Immunization days
1997: RCH-I
2005: RCH-II and NRHM
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EARLY VACCINES:•BCG , DPT & Typhoid•OPV Added•1985: Measles added & Typhoid dropped•TT for Pregant•2006: Hepatitis B, second dose of measles and Japanese Encephalitis •2011, pentavalent vaccine
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STRATEGIES•Reduce Morbidity & mortality of VPDs by Immunisation• Ingenious vaccine production•Cold chain establishment•Phased Implementation & full coverage by 1990•Monitoring & evaluation
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NATIONAL IMMUNISATION SCHEDULE
EXERCISE FOR STUDENTS
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MONITORING•AFP Surveillance•Measles Surveillance•AEFI Surveillance•IDSP•Mother & Child Tracking System
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COVERAGE
•RSOC by UNICEF 2012•65% in INDIA•6.6% no vaccination•89% TT for Preg Women
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COLD CHAIN
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COLD CHAIN• The ‘cold chain’ is the system
of transporting and storing vaccines at recommended temperature from the point of manufacture to the point of use.
• The World Health Organization (WHO) reported that in 2005, nearly half of all vaccines were RUINED in transit due to poor cold chain services.
Manufacturer
Distributor
Vaccine Depots
Provider office
Client
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Cold chain storage
equipmentWalk in cold rooms Deep freezers Ice lined
refrigerators
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1.Walk in cold rooms(WIC)At regional levelStorage up to 3 months
At district & PHC levelsTemp :- -15oc to -25ocAt PHC, used only for the preparation of ice packs
2.Deep freezers
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3.Ice lined refrigerators(ILR)Both at district and PHC levels
Temp :- +2oc to +8ocILR’s are top opening, can hold cold air inside better than front opening refrigerators
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VACCINE SENSITIVITY
• Sensitivity to HEATBCGVaricellaMMRMenCHepatitis BDT and/or aP/IPV/HIB
• Sensitivity to COLDHepB and
combinationDTand/or
aP/IPV/HIBInfluenza
MenC*MMR
*Varicella *BCG
(*Freeze dried)
MOST SENSITIVE
Temperature must be recorded twice in a day with dial thermometer
LEAST SENSITIVE
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Transporting Equipment
(Periphery)Cold boxes Vaccine
carriers Day carriers
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Used for transport of
vaccines Fully frozen ice packs
placed at the bottom and sides
DPT, TT, DT should not be kept in direct contact
1.Cold boxes
Used to carry small quantity of vaccines(16 to 20 vials)
For out of reach sessions
4 icepacks are used
2.Vaccine
carriers
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3.Day carriers
Used to carry very small quantities of vaccines(6 to 8 vials)
For a near by session2 icepacks are usedFor only 2 hours period
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Vaccine Vial Monitor(VVM)VVM is a label containing heat sensitive material that is placed on a vaccine vial to register heat exposure over time
Vaccine vial monitor
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SHAKE TESTFOR COLD INJURY
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CONCLUSION• The Immunization program started in 1978 has
undergone various transition over the decades. More & more vaccines are being added.• But at its core it continues to have the same objective.
Protect the children against the most prevalent and serious diseases through universal coverage.• A proper monitoring system is essential to realise this
objective.• Quality of the vaccine is more important than quantity as
universal coverage without proper immune response is a waste.• A proper meticulously maintained Cold chain is the most
feasible way of maintaining the quality of a vaccine.