Dr. Shivangi Dixit

UNIVERSAL IMMUNISATION PROGRAM

Universal Immunization

Programme

• vaccination program launched by the

Government of India in1985.

• 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.

Ministry of health &

family welfare

National rural health mission

Immunisationdivision(RCH

program)

KEY ROLES

ROUTINE IMMUNISATION

CAMPAIGNS(POLIO,MEASLES & JAPANESE

ENCAPHALITIS)

MONITORING ADVERSE EVENTS FOLLOWING

IMMUNISATION

VACCINE AND COLD STORAGE LOGISTICS

STRATEGIC COMMUNICATION

IMMUNISATION TRAININGS

EVOLUTION OF THE

PROGRAMME 1974-Expanded Programme of Immunisation(EPI)

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)

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)

VPD SURVEILLANCE

Create evidence base to enable planning &

development of eefective interventions

Integrated disease surveillance projects-for

dectection of early warning signals of

outbreaks(for control, elimination & eradication)

National polio surveillance project

WHO/NPSP provides technical and training

support for AFP & measles surveillance

State Programme Implementation

Plan (PIP)

Support for alternate vaccine delivery from PHC to sub-centre and outreach sessions;

Deploying retired manpower to carry out immunization activities in urban slums and underserved areas, where services are deficient;

Mobility support to district immunization officer as per state plan for monitoring and supportive supervision;

Review meeting at the state level at 6 monthly intervals;

Training of ANM, cold chain handlers, mid-level managers, refrigerator

mechanics etc.;

Support for mobilization of children to immunization session sites by ASHA, women self-help groups

Printing of immunization cards, monitoring sheet, cold chain chart vaccine inventory charts etc.

VARIOUS CAMPAIGNS

PULSE POLIO IMMUNIZATION PROGRAMME

INTRODUCTION OF HEPATITIS-B

VACCINE

INTRODUCTION OF JAPANESE

ENCEPHALITIS VACCINE

INTRODUCTION OF MEASLES VACCINE

SECOND

OPPORTUNITY

INTRODUCTION OF PENTAVALENT

VACCINE

(DPT + Hep-B + Hib)

MISSION INDRADHANUSH

Do’s Dont’s Vaccination

Schedule

It is safe and effective to

give BCG, DPT, OPV and Measles

vaccines at the same time to a

child who has completed 9

months and never been

vaccinated.

Withhold the vaccine in

case of illness such as cold,

cough, diarrhoea or fever.

Give BCG to infants less

than 1 yr of age (never give BCG to

children above 1 year of age).

If a child is brought late for

a dose, pick up where the schedule

was left off. For example, if a child

left with DPT- 2 and comes after 3

months give DPT-3.

DO’S DON’T’S

Cold Chain

Check expiry date and

VVM label of vaccine vial before

immunizing every child.

leave vaccine carrier in sunlight;

this spoils vaccines that are

sensitive to heat and light.

Keep the vaccines and diluents in a

plastic bag/zipper bag in the centre

of vaccine carrier with 4 conditioned

ice-packs.

û

Leave the lid open; this can allow

heat and light into the carrier, which

can spoil vaccines.

Make sure that the diluents are also

at +2 to +8 centigrade before

reconstitution.

Drop or sit on the vaccine carrier:

this can damage the carrier.

Take one ice pack from vaccine

carrier and keep reconstituted BCG

& Measles vaccines only on the top

of the ice pack.

Carry vaccines in handbag as this

can spoil vaccines that are sensitive

to heat.

DO’S DON’T’S

Wash hands before

conducting the session

Use un-sterile syringe or

needle for immunization

Verify beneficiary’s record and

age of the child.

.. Draw air into AD syringes

Screen for contra-indications. Touch any part of the needle.

Check label of the vial and

expiry date.

Recap the needle

Lightly shake the vial of T-

Series Vaccine before drawing

the dose.

.Leave the needle inside the

vial

Use a new AD syringe for

each injection and new

disposable syringe for each

reconstitution.

. Use reconstituted

measles and BCG vaccine

after 4hrs and JE after 2 hrs

Use correct diluent for

reconstitution of vaccine.

Use vaccine with VVM in

unusable stage or with expiry

date

Give appropriate vaccine.

Inject vaccine using the

correct site and route for the

vaccine e.g. Intradermal in left

NATIONAL IMMUNISATION

SCHEDULE

COMPONENTS OF NIS

I. Strategy and policy:

achieving an acceptable, affordable and sustainable standard of health

targets of improving access and utilization of immunization in the country

policy addresses issues of vaccine security, management, regulation guidelines, vaccine research and development and product development.

II. Cold Chain System, Vaccines and Logistics:

system of storing and transporting vaccine at the recommended temperature range from the point of manufacture to point of use.

vaccines are supplied by manufacturers directly to four Government Medical Store Depots (at Karnal, Mumbai, Chennai and Kolkata) and state and regional vaccine stores.

vaccines are further supplied to last cold chain points which are usually situated in Primary Health Centers (PHCs) and Community Health Centers.

daily upkeep of Ice Lined Refrigerators (ILRs) and Deep Freezers (DFs) including temperature charting.

Supplies are made to states on a quarterly basis on receipt of indent. State Vaccine Stores can store vaccines for three months and so can district vaccine stores.

III. Injection safety and waste disposal:

to ensure continuous supply of injection safety equipments

Trainings are conducted and supported by job-aids, on job training

Disposal of immunization waste is strictly as per Central Pollution Control Board (CPCB) guidelines for biomedical waste disposal

segregation of waste at source (at the session site), transportation to the PHC or CHC, treatment of sharps and potentially biohazardous plastic waste, disposal of sharps in sharp pits and treated plastic waste through proper recycling

IV. Strategic communication:

policy-making and guidance for consistent

information activity through coherent messaging

issue of media advocacy, proactive planning and

effective media response is emerging as one of

the key elements

The diseases being targeted are diphtheria,

whooping cough, tetanus, poliomyelitis,

tuberculosis, measles and Hepatitis B. In addition

to these, vaccines for Japanese Encephalitis[2]

and Haemophilus influenzae type B are also

being provided in selected states.

Schemes:

a) Routine Immunization:

Objectives:

The stated objectives of UIP are:

To rapidly increase immunization coverage.

To improve the quality of services.

To establish a reliable cold chain system to the health facility level.

Monitoring of performance.

To achieve self sufficiency in vaccine production.

Scope and eligibility:

India has one of the largest Universal Immunization Programs (UIP) in the world in terms of the quantities of vaccines used, number of beneficiaries covered, geographical spread and human resources involved.

Under the UIP, all vaccines are given free of cost to the beneficiaries as per the National Immunization Schedule.

o All beneficiaries’ namely pregnant women and children can get themselves vaccinated at the nearest Government/Private health facility or at an immunization post (Anganwadi centres/ other identified sites) near to their village/urban locality on fixed days.

o The UIP covers all sections of the society across the country with the same high quality vaccines.

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) for more than 33 months.

Besides, vaccination has contributed significantly

to the decline in the cases and deaths due to the

Vaccine Preventable Diseases (VPDs).