Universal immunisation program

updated ppt for studying and teaching purpose regarding the universal immunisation program and national immunisation program

1. Dr. Shivangi Dixit UNIVERSAL IMMUNISATION PROGRAM

2. 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.

3. KEY ROLES ROUTINE IMMUNISATION CAMPAIGNS(POLIO,MEASLES & JAPANESE ENCAPHALITIS) MONITORING ADVERSE EVENTS FOLLOWING IMMUNISATION VACCINE AND COLD STORAGE LOGISTICS STRATEGIC COMMUNICATION IMMUNISATION TRAININGS

4. 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)

5. 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)

6. 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

7. 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.

8. VARIOUS CAMPAIGNS

9. 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

10. 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

11. 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 arm for BCG; sub- cutaneous in Right arm for Measles; intramuscular in anterolateral aspect of mid thigh for DPT and Hep . B. Allow dose to self-disperse instead of massaging. Explain potential adverse events following immunization and what to do.

12. NATIONAL IMMUNISATION SCHEDULE

13. 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.

14. 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

15. 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

16. 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.

17. 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.

18. 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.

19. 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).