01. National Immunization Schedule india.pptx

it is national immunization schedule

1. Universal Immunization Programme National Immunization Schedule

2. 2023 3 rd dose of fIPV Introduction of Vaccines under UIP

3. Name of V accine Disease BCG T uberculosis Hep. B Hepatitis – B Pentavalent Diphtheria, Pertussis, Tetanus, Hepatitis B, H. influenzae type B associated meningitis and Pneumonia OPV & IPV Poliomyelitis RVV Rota virus diarrhea Measles Rubella containing vaccine Measles & Rubella DPT Diphtheria, Pertussis and T etanus JE Japanese Encephalitis Td T etanus & Diphtheria PCV Pneumococcal disease Diseases Targeted under UIP

4. Vaccine When to give Max age Dose Diluent Route Site Td-1 Early in pregnancy Give as early as possible in pregnancy 0.5 ml NO Intramuscular Upper Arm Td-2 4 weeks after Td-1 0.5 ml NO Intramuscular Upper Arm Td- Booster If received 2 Td doses in a pregnancy within the last 3 yrs. 0.5 ml NO Intramuscular Upper Arm Give Td 2 or Booster before 36 weeks of pregnancy; Give Td even in labour if previously not received Td National Immunization Schedule for Pregnant Women

5. Vaccine When to give Max age Dose Diluent Route Site BCG At birth 1 yr 0.05ml till 1 month, 0.1 ml from 1 month to 1 year Sodium Chloride Intra-dermal Left Upper Arm Hepatitis B – Birth dose At birth Within 24 hrs of birth 0.5 ml NO Intra-muscular Antero-lateral side of mid-thigh OPV-0 At birth Within 15 days of birth 2 drops NO Oral Oral National Immunization Schedule for Newborn

6. Vaccine When to give Max age Dose Diluent Route Site bOPV 1,2 & 3 At 6, 10 & 14 weeks 5 yrs 2 drops NO Oral Oral Rotassil Vaccine 1,2, 3 At 6, 10 & 14 weeks Initiation - 1 yr Completion – 2 yrs 1 Ampoule (2ml) NO Oral Oral f-IPV 1, 2 & 3 At 6, 14 weeks & 9 months Initiation - 1 yr Completion – 2 yrs 0.1 ml NO Intra-dermal Right Upper Arm (1 & 2 doses) Left upper arm (3 rd dose) PCV 1,2 & Booster At 6, 14 weeks & Booster at 9 months age Initiation - 1 yr Completion – 2 yrs 0.5 ml NO Intra-muscular Antero-lateral side of Right mid-thigh Pentavalent 1,2 & 3 At 6, 10 & 14 weeks Initiation - 1 yr Completion – 2 yrs 0.5 ml NO Intra-muscular Antero-lateral side of Left mid-thigh National Immunization Schedule for Infants

7. Vaccine When to give Max age Dose Diluent Route Site MR - 1st dose 9 - 12 months 5 yrs 0.5 ml Sterile water Sub-cutaneous Right upper Arm JE* - 1st dose 9 -12 months 3 yrs 0.5 ml NO Intra- muscular Antero-lateral side of Right mid-thigh Vitamin A (1 st dose) At 9 months with MR vaccine 1 ml ( 1 lakh IU) NO Oral Oral National Immunization Schedule for Children * JE in Endemic districts only

8. Vaccine When to give Max age Dose Diluent Route Site OPV Booster 16-24 months 5 yrs 2 drops NO Oral Oral Vitamin A (2 nd to 9 th dose) 2 nd dose with MR 2 nd ; Then, one dose every 6 months upto 5 yrs of age. 2 ml (2 lakh IU) NO Oral Oral MR 2nd dose 16-24 months 5 yrs 0.5 ml NO Sub-cutaneous Right upper Arm JE -2 nd dose 16-24 months 3 yrs 0.5 ml NO Intra-muscular Antero-lateral side of Right mid-thigh DPT Booster-1 16-24 months 7 yrs 0.5 ml NO Intra-muscular Antero-lateral side of Left mid-thigh National Immunization Schedule for Children

9. Vaccine When to give Max age Dose Diluent Route Site DPT Booster-2 5-6 years 7 yrs 0.5 ml. NO Intra-muscular Upper Arm Td 10 10 yrs 0.5 ml. NO Intra-muscular Upper Arm Td 16 16 yrs 0.5 ml NO Intra-muscular Upper Arm National Immunization Schedule for Children

10. Age Vaccines given Birth BCG, OPV-0, Hepatitis B Birth dose 6 Weeks bOPV-1, Rota – 1, fIPV-1, PCV-1 & Pentavalent-1 10 weeks bOPV-2, Rota-2 & Pentavalent-2 14 weeks bOPV-3, Rota-3, fIPV-2, PCV-2 & Pentavalent-3 9-12 months Vitamin- A 1 st dose, fIPV-3, MR-1, PCV-B & JE-1* 16-24 months OPV – B, Vitamin- A 2nd dose, MR-2, JE-2*, DPT-B 1 5-6 years DPT-B 2 10 years Td 10 16 years Td 16 Pregnant Women Td 1 & Td 2 or Td Booster** * JE in Endemic districts only ** one dose if previously vaccinated with two Td doses within 3 years National Immunization Schedule

11. Age Vaccines given Pregnant women Td vaccine Children from Birth to 16 yrs BCG OPV, IPV Hep B Pentavalent, DPT, Td PCV RVV MR JE Vitamin A Beneficiaries under UIP

12. Route Vaccines given Oral OPV, RVV, Vitamin A Intradermal BCG, fIPV Intramuscular Hep B, PCV, Pentavalent, DPT, Td, JE Subcutaneous MR Vaccines vs Route of Administration

13. Site Vaccines given Oral OPV, RVV, Vitamin A Left Upper Arm BCG, fIPV-3, DPT B2 Right Upper Arm MR-1, MR-2, fIPV-1, 2 Right Thigh PCV, JE Left Thigh Hep B, Pentavalent, DPT, DPTB1 Vaccines vs Site of Administration

14. Vaccines Time Interval OPV, RVV, Pentavalent, DPT 4 weeks PCV, fIPV 8 weeks MR, JE 4 weeks DPT / Pentavalent 3 dose and DPT B1 6 months Two live Injectable vaccines if not given simultaneously (BCG, MR) 4 weeks Recommended time interval between doses of vaccines

15. Achievement Age Vaccines Received Full Immunization Plus Before 1 yr BCG, OPV – 3 primary doses RVV – 3 doses fIPV – 3 doses PCV – 2 doses & 1 booster dose Pentavalent – 3 doses MR1 / JE1 Complete Immunization Before 2 yrs All vaccines under Full Immunization PLUS OPV B DPT B1 MR2 / JE 2 Full vs Complete Immunization

16. Table1: Type 2 seroconversion (%) with TWO dose of IPV or fIPV 6-14 weeks 14-36 weeks Full dose IPV 89.3 (84.4-93.4) 100.0 (99.6-100.0) Fractional IPV 79.6 (70.8-87.2) 98.2 (93.8-99.8) Comparative Immunogenicity data for fIPV schedules 16 Observations from the above table: Seroconversion against PV2 with the current schedule of 2 doses of fIPV at 6 and 14 weeks in the immunization schedule is 79 % Even two full doses at 6 and 14 weeks, it only reaches up to 89% But with delayed first dose and longer interval between two doses (14 weeks -9 months schedule ), whether full or fractional, it reaches nearly 100% An alternative could be to retain the two dose fIPV schedule at 6 and 14 weeks and add third dose full /fractional at MCV1 contact

17. Initiation Age Vaccines Administered At 6 weeks As per schedule At completed 9 months and before completed 12 months As per schedule At completed 1 yr and before 5 yrs OPV 3 primary doses and OPV Booster DPT 3 primary doses and DPT B1 MR1 and MR 2 JE 1 and JE 2 (should be completed before 3 yrs) Vitamin A doses at 6 months interval At completed 5 yrs and before 7 yrs DPT 3 primary doses and 2 booster doses Initiation Age vs Vaccines Administered

18. Scenarios vs Recommendations If a child is brought late for a subsequent dose do not restart the schedule again. P ick up where the schedule was left off. If more than one injection must be given in one limb, then ensure that the distance between the two injection sites is at least 1 inch apart. If the parents want to vaccinate their child from the public sector after receiving one or two doses of vaccine in a private facility , the remaining doses may be provided as per the NIS

19. Sequence of Vaccination

20. Sequence of Vaccination

21. Arrangement of Vaccines

22. What vaccine was given and what disease it prevents (e.g. BCG for preventing TB) When and where to come for the next visit. What minor adverse-events could occur and how to deal with them. To keep the vaccination card safe and to bring it along for the next visit Four Key Messages to Care-giver

23. Paracetamol Syrup - Recommendations Should be used only if fever develops, and never prophylactically Following vaccination with Pentavalent / DPT antigens Age group Dose When 6 weeks - 6 months 2.5 ml In case of fever*, following vaccination and 4-6 hourly thereafter if needed # 6 - 24 months 5 ml 2 - 4 years 7.5 ml 4 - 6 years 10 ml Paracetamol is not recommended in children weighing <2 kg * Axillary temperature > 38°C/100.4°F or child feels hot to touch # Maximum four doses in 24 hours with a gap of at least four hours between two doses Recommended strength: 125mg/5ml Recommended dose: 10-15 mg/kg body weight

24. Vitamin A - Recommendations A Vitamin A bottle, once opened, should be used within 8 weeks. Write the date of opening on the bottle. It must be kept away from direct sunlight. Use the spoon or the measuring cap supplied with the bottle to dispense Vit A to the child Doses: - Up to 1 yr age – 100,000 IU (1 ml solution) > 1 Yrs Age – 200,000 IU (2 ml solution)

25. Zinc tablet (Along with ORS) – Recommendations for Diarrhoea Management Age 2-6 months: 10 mg of dispersible tablet for 14 days. Age 6 months to 5 years: 20 mg of dispersible tablet for 14 days.

26. Bio – Medical Waste Management l Cut hub of AD and Disposable syringes l Broken vials and ampoules l Needle Caps l Wrappers l Plastic part of Syringe l Unbroken used vials

27. Anaphylaxis Kit

28. Markings of age-appropriate dosage of adrenaline in mL (tuberculin syringes) and equivalent volume in units (insulin syringes) Corresponding volume markings on Insulin & tuberculin syringes

29. Thank you