Universal Immunization Programme in India
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IMMUNIZATION PROGRAMME IN
INDIA
DR. MAHESWARI JAIKUMAR
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EDWARD JENNER
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HISTORY• 14 May 1796 - Jenner inoculated
James Phipps, an 8 yr old boy with cowpox lymph taken from Sara Nelms, a milkmaid.
• Boy recovered after a brief illness
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• Jenner inoculated pus taken from a small pox patient.
• Boy showed no reaction.
• Jenner recommended vaccination for prevention of smallpox
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• Smallpox vaccination being a safe, simple, effective and inexpensive procedure, gained universal acceptance.
• Main instrument for eradication for smallpox at global level.
• Small pox has since been eradicated but Jenner lives for ever.
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SMALL POX
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• Small pox eradicated in 1977.
• IMMUNIZATION MOST POWERFUL & COST EFFECTIVE TOOL.
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• The first vaccine having been sent by jenner himself and used in bombay in 1802.
• The pilot projects began during 1960.
• WHO certified India to be free of smallpox in march 1977.
• The global eradication of smallpox is arguably the greatest achievement of twentieth century medicine
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VACCINE PREVENTABLE
DISEASES
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VPD• An infectious disease for which an
effective preventive vaccine exists.
• If a person dies from it, the death is considered a vaccine-preventable death.
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8 TARGETED VPDSDiphtheriaHepatitis B MeaslesPertusisPoliomyelitisTetanusTuberculosisJE
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• DIPHTHERIA• PERTUSSIS• TETANUS• POLIO• TUBERCULOSIS• MEASLES
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DIPHTHERIA
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PERTUSSIS
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PERTUSIS
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TETANUS
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POLIO
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TUBERCULOSIS
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MEASLES
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MEASELS
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MUMPS
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CHIKEN POX
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FULLY IMMUNIZED CHILD• A child who received One dose of
BCG, Three doses of DPT and OPV One dose of measles before one year of age.
• This gives a child the best chance for survival
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MILESTONES IN THE IMMUNIZATION PROGRAM IN
INDIA• 1978: Expanded Program of Immunization
(EPI) introduced after smallpox eradication: BCG, DPT, OPV, Typhoid.
• Limited to mainly urban areas
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• 1985 : Universal Immunization Program (UIP) introduced; Expanded to entire country; Measles added.
• 1990 : Vitamin-A supplementation.
• 1992: Child Survival and Safe Motherhood Program.
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• 1995: Polio National Immunization Days.
• 1997: Reproductive and Child Health Program (RCH I).
• 2005 : RCH-II and the National Rural Health Mission (NRHM).
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EXPANDED PROGRAMME ON IMMUNIZATION 1974
• 1974-
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EXPANDED…• Adding more disease controlling
antigens to vaccination schedules.
• Extending coverage to all corners of a country.
• Spreading services to reach the less privileged sectors of the society
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1978 – PRIMARY HEALTH CONCEPT
• ALMA – ATA declaration included immunization as one of the strategies for achieving HFA by 2000 AD.
• WHO named this immunization programme as EXPANDED PROGRAMME ON IMMUNIZATION.
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• 1985 – UNICEF re named it as “UNIVERSAL IMMUNIZATION PROGRAMME”.
• There is no difference between both the prog.
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• The goal was to achieve universal immunization by 1990.
• EPI is regarded as an instrument of UPI.
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EPI IN INDIA 1978• The Govt of India launched it’s EPI in
1978.
• The objective was to reducing mortality, morbidity resulting from VPDs.
• To achieve a self sufficiency in vaccine production.
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EPI IN INDIA 1978• BCG, OPV, DPT & Measles- under 5
children.
• TT- pregnant women.
• Typhoid added.
• OPV- 1979.
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UNIVERSAL IMMUNIZATION PROG
• 1985 in remembrance of then Prime Minister, Indira Gandhi.
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• The UIP was taken up in 1986 as National Technology Mission & became operational in all districts in the country during 1989-90.
• UIP become a part of the Child Survival and Safe Motherhood (CSSM) Programme in 1992 and Reproductive and Child Health (RCH) Programme in 1997.
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COMPONENTS OF UIP1. Immunization of pregnant women
against tetanus.
2.Immunization of children in their first year of life against 6 VPDs.
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2 COMPONENTS OF UIP
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• 3. The aim was to achieve 100 % coverage of pregnant women with 2 doses of TT.
• & at least 85% coverage of children under one year (with 3 doses of DPT, OPV & one dose of BCG, One dose of MMR) by 1990
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• UIP was first taken up in 30 selected districts & catchment areas of Medical Colleges.
• A technology Mission on Vaccination & Immunization of Vulnerable Population was set up to focus on all aspects of immunization activity.
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OBJECTIVES• To increase immunization coverage.
• To improve quality of service.
• To achieve self sufficiency in vaccine production
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• To train health personnel.
• To supply cold chain equipment and establish a good surveillance network.
• To ensure district wise monitoring
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CHANNEL OF SERVICE PROVISION
• Immunization services are provided through the existing HCDS. (MCH centers, PHC, HSc, Hospitals, Dispensaries).
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Though the target was 100% coverage no country in the world has reached the coverage figure.
Therefore it can be interpreted as “NO CHILD SHOULD BE DENIED OF IMMUNIZATION.”
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STATUS OF VPD -INDIADISEASE 1987 2011 %
DECLINEPOLIMYELITIS 28,257 1 100
DIPTHERIA 12,952 4,233 62.3
PERTUSIS 163,786 3,909 76.13
NNT 11,849 734 93.8
MEASLES 247,519 33,634 86.41
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PROGRAMME IMPLEMENTATION PLAN
• PIP was set to strengthen programme implementation.
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COMPONENTS:
• 1.Support for alternative vaccines delivery from PHC to HSc & out reach sessions.
• 2.Deploying retired manpower to implement vaccination services in urban slums & underserved areas
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3. Mobility support to Dist Immunization Officer.
4. Reviewing meeting at state level with the districts at 6 monthly intervals.
5. Training of ANM, cold chain handlers, mid level managers, refrigerator machines.
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MOBILITY SUPPORT
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6. Support mobilization by ASHAs, Self Help Groups.
7. Printing of immunization cards, monitoring sheets, cold chain chart vaccine inventory charts.
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PULSE POLIO IMMUNIZATION
• 1995.
• Under 5 children.
• Additional oral polio drops administered in December & January.
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STATUS FEB 2012• INDIA is removed from the
list of
“POLIO ENDEMIC COUNTRIES”
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