New vaccine introduction pentavalent vaccine india_b_ankura

UNDERSTANDING OF New vaccine introduction pentavalent vaccine

1. New Vaccine Introduction- Pentavalent

2. One vaccine against Five diseases (DPT+ Hepatitis B +HiB) Diphtheria Pertussis Tetanus Hepatitis B Haemophilus Influenza B (HiB)

3. What is Hib ? What diseases does it cause? Hib is the abbreviation for Haemophilus influenzae type b , a gram negetive encapsulated cocco bacilus that causes severe infections, as listed below.  Bacterial meningitis – inflammation of the membranes that cover and protect the spinal cord and brain. It is a serious infection.  Pneumonia – inflammation of the lungs.  Epiglottitis – inflammation of the area around the vocal cords and obstruction of the airway.  Septic arthritis – inflammation of the joints.  Septicaemia /Sepsis – presence of pathogenic bacteria in the blood. Rarely caused by HIB but always fatal

4. Haemophilus influenzae type b Clinical Features

5. Key facts about 5 th component of Pentavalent (HIB) 1. Globally, Hib kills more than 370,000 children under five every year. Nearly 20% of symptomatic children die in India. Hib disease survivors are often permanently paralysed,become deaf or get brain damaged. 2. 3 primary dose usually confer protection for more than 15 years 3. Hib vaccine can prevent over a third of pneumonia cases and 90% of Hib meningitis cases. 4 . Not a contraindication , rather specially indicated in case of Asplenia , Sickle cell anaemia , HIV & Other Immunodeficiency

6. Site of injection : Same as DPT or Hep B vaccine- anterolateral aspect of mid-thigh in infants Dose : 0.5 ml dose of the vaccine administered intramuscularly. Route : Injected intramuscularly (I/M) using auto disable (AD) syringe Age group : 3 doses at 6, 10 and 14 weeks. No booster dose. Formulation : It is a liquid vaccine so diluent is not required. Presentation : 10-dose vial. Storage : +2°C to +8°C in ILR; should not be frozen.

7. Pentavalent vaccine introduced – 8 states 178.7 lakhs (1.78 crores) children vaccinated up to April 2014. Pentavalent vaccine introduction proposed in Oct 2014 – 11 states Pentavalent vaccine introduction proposed in Apr 2015 – 16 states States Pentavalent introduction plan Oct 2014 1 Andhra Pradesh 2 Assam 3 Bihar 4 Chhattisgarh 5 Delhi 6 Jharkhand 7 Madhya Pradesh 8 Punjab 9 Rajasthan 10 Uttarakhand 11 West Bengal

8. Pentavalent vaccine will replace DPT 1, 2, 3 and Hep 1, 2, 3 doses . Hep B vaccine will be continued only as birth dose (within 24 hours) in case of institutional deliveries. DPT vaccine will be continued in the RI program as booster dose at 16-24 months and 5 years. Once pentavalent vaccine reaches states , then existing DPT and Hep B Vaccine stocks will need attention . Infants that have already started with DPT vaccination will continue and complete the schedule with DPT vaccine . Upper age limit in UIP is 1 year Interchangeability between licensed brands is acceptable Open vial policy will be followed with pentavalent vaccine. VVM is present on the vial . Pentavalent Vaccine : Key points to Remember  

9. District Hep B Wastage 2013-2014 PURULIA 29 UTTAR DINAJPUR 23.05 BANKURA 22 MURSHIDABAD 22 KOLKATA 20.87 KOCHBIHAR 20.61 HOWRAH 20.06 24-PARGANAS SOUTH 14.4 PASCHIM MEDINIPUR 13.09 NADIA 9.8 MALDA 9.4 HUGLI 1.7 24-PARGANAS NORTH 1.2 JALPAIGURI 1

10. Some Common Block/PU level issues which need to be addressed before launching Pentavalent Incomplete RI micro planning- leading poor defaulter tracking & vaccine wastage Implementation of Open vial policy – Not universally followed according to guideline (Time/Date not written) Repair/ Maintenance of cold chain equipment system – slow response & irregular process Lagging of MCTS updating- connectivity problem/ ANMs are not updating the service/ Knowledge Gap Lack of accountable human resource & lack of Focus in Urban area

11. Communication Plan preparations Sensitization meeting under chairmanship of DM involving all major Private Health facilities, Private Paediatrician & NGOs Written communication/sharing IEC if needed specially who has not been sensitized so far Orientation of media by DM & CMOH ( print, electronic, web based)…. To prevent base less rumor. Training preparations Training of all medical officers and other health personnel (BPHN/PHN, HWs, MOs, Supervisors, AYUSH) Sensitize vaccine & cold chain handlers, data handlers, frontline health workers - ASHA/ AWW.

12. Strengthen AEFI surveillance AEFI Committee formation AEFI management Kit for all Blocks Regular district level review meeting on RI (monthly DTFI) Micro planning preparations Existing RI microplan Very costly vaccine – so wastage should be minimized No. of session should be guided by geographical distribution of population & injection load (25-50/month for OR & 40-70/Month for SC) Good AVD Plan- Daily vaccine return is mandatory Block level Microplanning Meeting for Updating of MP ( in Standard format) By end of September - Vaccine & Logistic supply from state will be done after submission of The Checklist .

13. We have to prevent the effect of this type of baseless rumor

14. Simultaneously we have to arrange for the circulation of the correct message to the community

15. Thank you