immunization Program of children and healthcare

Child immunization program

1. Mr.PratheeshP T
Lecturer, ChirayuCollege
of Nursing, Bhopal
PREVENTIVE IMMUNIZATION,
IMMUNIZATION PROGRAM

2. General Objectives
Define Immunization.
Significance of Immunization.
Types of Immunity.
Immunizing Agents.
National Immunization Schedule.
Contraindications to vaccinations.
Reactions to EEPI Vaccines.

3. Introduction
Immunizationistheartificialmeansbywhichthe
stateofimmunityisincreased.Thisisthemost
importantinventionthatconferredthehighest
benefittochildrenintheworld.Ithasprevented
manycommunicablediseasessuchasdiphtheriaand
polio.Ithashelpederadicatepolioandsmallpoxfor
thecommunity.Recently,ahighlysuccessful
introductionofimmunizationagainstHaemophilus
influenzaetypeb(Hib)hasachievedthatreduced
invasiveinfectionssuchasHibmeningitis.

4. Definition
“Immunizationisaprocessofprotectingan
individualformadiseasethroughintroductionof
liveorkilledorattenuatedorganismsinthe
individualsystemtocreateimmunity.”

5. Significance
Itisoneofthe‘bestbuys’incommunityhealthand
oneofthemostcosteffectivehealthinterventionsin
reductionofcommunicablediseasesrelated
morbidityandmortality.
Itisamassmeansofprotectingthelargestnumber
ofpeoplefromvariousdiseases.Itgivesresistance
toaninfectiousdiseasesbyproducingoraugmenting
theimmunity.
Artificiallyacquiredimmunityisdevelopedby
immunization.

6. Immunity
Immunityisthesecurityagainstaparticulardisease
andnonsusceptibilitytotheinvasiveorpathogenic
effectsofforeignmicroorganismsortothetoxic
effectofantigenicsubstances.Acquiredimmunity
canbeactiveorpassive.

7. Active Immunity
Activeimmunityisproducedbystimulating
immunologicaldefencemechanism through
administrationofantigenusuallypriortonatural
exposuretoinfection.Activeimmunizingagentsare
knownasvaccines.

8. Passive Immunity
PassiveImmunityisproducedtemporarilyby
supplyingpreformedexogenousanimalorhuman
antibodytosuppressthedisease,givensoonafteror
priortoexposureofaninfection.Itisreadymade
antibodies.Passiveimmunityagentsareantiseraand
immunoglobulins.

9. Immunoglobulin
Theseareantibodies.Antibodiesareagroupof
proteinspresentintheblood,intestinalsecretions
andrespiratorysecretions.

10. Antigen
Avarietyofforeignsubstancesincludingbacteria
viruses,toxinsandforeignproteinsthatstimulate
theformulationofantibodies.

11. Toxins
Apoisonoussubstanceusuallyproducedbythe
invadingmicroorganisms.

12. Antitoxin
Antibody formed in response to a toxin.

13. Toxoid
Atoxinthathasbeentreatedtodestroyitstoxic
propertiesbutretainitsantigenicquality.

14. Immunization Program
Itisaroutineprogramofimmunizationoffered
duringchildhoodforpreventionagainstthekiller
diseasesofchildhoodandpreventoccurrenceof
certaindreadeddiseasesintheadulthoodsothat
humanresourcescanbemaintainedwithout
hazards.

15. Immunizing Agents
Theimmunizingagentsmaybeclassifiedasvaccines
immunoglobulin'sandantisera.

16. Vaccines
Vaccinesareimmuno-biologicalsubstanceswhich
producespecificprotectionagainstagivendisease.It
stimulatesactiveproductionofantibodyandother
immunemechanisms.
Vaccinesarepreparedfromliveattenuated
organisms,orinactivatedofkilledorganisms,
extractedcellularfractions,toxoidsorcombination
ofthese.Morerecentpreparationsaresubunit
vaccinesandrecombinantvaccines.

17. Cont..
Theidealvaccinesshouldinducepermanent
immunity,befreeoftoxicsubstances,haveminimal
sideeffects,notproducediseasetotherecipientand
beeasytoadminister.

18. Live Attenuated Vaccines
Bacterial–BCG,Typhoid(oral)Plague
Viral-Oralpolio,Measles,Mumps,Rubella,Yellow
fever,Influenza.
Rickettsial-Epi,typhus.

19. Killed or Inactivated Vaccines
Bacterial-Pertussis,Typhoid,Cholera,Plague,,CS
Meningitis.
Viral-Rabies,Hepatitis‘B’,Influenza,SalkPolio,
Japaneseencephalitis.

20. Toxoids
Bacterial-Diphtheria and Tetanus.

21. Cellular fractions
Meningococcal and pneumococcal vaccines.

22. Combinations
DPT–Diphtheria,Pertussis,Tetanus
MMR-Mumps,Measles,Rubella
DT-Diphtheria,Tetanus
Hib-Hep.B(H.Influenzae‘B’,Hepatitis‘B’)
Pentavalent–Diphtheria,Pertussis,Tetanus,
HepatitisB,andHaemophilusinfluenzaetypeB
(Hib)

23. National Immunization Schedule
Immunizationscheduleshouldbeplannedaccording
totheneedsofthecommunity.Itshouldberelevant
withexistingcommunityhealthproblems.Itmustbe
effective,feasibleandacceptablebythecommunity.
Everycountryhasitsownimmunizationschedule.

24. Cont..
TheWHO,launchedglobalimmunizationprogram
in1974,knownasExpandedProgramon
Immunization(EPI)toprotectallchildrenofthe
worldagainstsixkillerdiseases.InIndia,EPIwas
launchedinJanuary1978.

25. Cont..
TheEPIisnowrenamedasUniversalChild
Immunization,asperdeclarationsponsoredby
UNICEF.InIndia,itiscalledasUniversal
ImmunizationProgram(UPI)andwaslaunchedin
1985,November,fortheuniversalcoverageof
immunizationtotheeligiblepopulation.

26. Cont..
TheGlobalAllianceforVaccinesandImmunization
(GAVI)isworldwidecoalitionoforganization,
establishedin1199,toreducedisparitiesinlife
savingvaccineaccessandincreaseglobal
immunizationcoverage.GAVIiscollaborative
missionofGovt.,NGOs,UNICEF,WHOandWorld
Bank.TheGAVIandVaccineFundalsoadoptedthe
objectiveofnewintroductionbutunderused
vaccinesinthedevelopingcountries,wherethe
diseaselikehepatitisBandHInfluenzae‘B’(Hib)
arehighlyprevalent.

27. Cont..
NationalImmunizationScheduleasrecommended
byGovernmentofIndiaforuniformimplementation
throughoutthecountrywasformulated.

28. Recommendations
Intervalbetweentwodosesshouldnotbelessthan
onemonth.
Minorcough,coldsandmildfeverordiarrheaare
notacontraindicationtovaccination.
Insomestateshepatitis‘B’vaccineisgivenas
routineimmunization.
At9monthsofage,Vitamin‘A’oilshouldbegiven
orallywithrecommendeddoseandthentobe
continuedatsixmonthsintervalupto5yearsofage.

29. National Immunization Schedule
Age Vaccine Route
At Birth BCG Intradermal
At Birth OPV Oral
At Birth Hepatitis –B-0 Intramuscular
6-Weeks BCGif not given at
birth
Intradermal
6-Weeks Pentavalent Intramuscular
6-Weeks OPV -1 Oral
6-Weeks Hepatitis –B 1 Intramuscular
2,4and 6 monthsRotavirus Oral

30. National Immunization Schedule
Age Vaccine Route
10 Weeks Pentavalent-2 Intramuscular
10 Weeks OPV -2 Oral
10 Weeks Hepatitis –B 2 Intramuscular
14Weeks Pentavalent-3 Intramuscular
14Weeks OPV -3 Oral
14Weeks Hepatitis –B 3 Intramuscular
9 Months Measles Subcutaneous

31. National Immunization Schedule
Age Vaccine Route
16-24 Months DPT Intramuscular
16-24 Months OPV Oral
16-24 Months Measles Subcutaneous
5-6 Years DT IM
10-16 Years TT IM
Early Pregnancy TT-1 IM
Aftera month TT-2 IM

32. General Contraindications of Vaccinations
Priorallergicreactionstothesameorrelated
vaccine.
Livevaccines,i.e.OPV,BCGandmeasles,arenotto
beadministeredinthefollowingsituations:in
immunosuppressivetherapy,immunodeficiency
disorders,leukemia,lymphomaorgeneralized
malignancy.

33. General Contraindications of Vaccinations
Acuteillnesswithfeverabove38
.
C.Postponeuntil
recoveryhasoccurred.
Specialriskgroupsinwhomtheriskof
complicationsforminfectiousdiseasesishigh
includethosewithchroniclungandcongenitalheart
diseases,Downsyndrome,HIVinfection,Lowbirth
weight(LBW),andaspleniaorhyposplenism.

34. Conditions Not to be taken as contra-indication
to Vaccination.
Mildormoderatelyillchildrenshouldbeimmunized
toincreaseindividualandcommunityprotection.
Malnutrition,lowgradefever,mildacuterespiratory
infection,ordiarrheaandotherminorillnessarenot
contraindicationsforvaccinations.

35. Reactions to EPI Vaccines
MildFever.
LocalPain
Malaise,irritability.
Transientrash.
ALumporpapuleappearsonthethirdweekafter
BCGvaccination.Itisgenerallynotpainfulbutis
tendertotouch.Thepapuleincreasesinsizeupto6-
10mmindiameterbythesixthweek.Thenodule
softenswiththeformationofpus.Notreatmentis
necessary.Attheendof10-12weeks,onlyasmall
scarisvisible.

36. Reactions to EPI Vaccines
RegionalLymphnodeenlargementandsuppuration
observed2-8weeksafterBCGvaccinationisusually
aresultofthevaccinebeinginjectedsubcutaneously
insteadofintra-dermally.
Inveryrarecases,afeverofmorethan105
.
F,
convulsionsorcollapseafterDPTvaccinationhas
beenobserved.Insuchcases,furtherdosesofDPT
shouldnotbegiven.

37. Conclusion
Immunizationistheprocesswherebyapersonis
madeimmuneorresistanttoaninfectiousdisease,
typicallybytheadministrationofavaccine.

38. Summary
Summaryincludesintroduction,definition,National
immunizationprogram,ImmunizationScheduleand
contraindications.