Vaccination Dialogue -Haryana VACCINDICON 24 .pptx

Common questions on ACVIP Recommendations

1. ACVIP recommendations & NIP Program: How to bridge the gap? Panelists: Dr Harish Pemde Dr Lalit Mehendiratta Dr Ashwani Sood Dr Ramesh Chaudhary Dr Satish Sharma Moderator: Dr S G Kasi

2. Let’s understand the differences between NIP & IAP schedules Factor NIP IAP Target Community: What is best for the community Individual child: What is best for the individual child Determinant Epidemiology and disease burden Risk for an individual child Aim Reduce disease burden Morbidity, Mortality, Death, HCU Protect individual child In addition, indirect benefits, prevent even minor complications, Considerations Cost – Efficacy - Safety Safety – Efficacy - Cost Funding Government: Free for every child in our country Parents/caretakers Logistic issues Crucial Not relevant Schedule Piggyback on existing schedule Flexible The most cost-effective schedule will be adopted The safest and most immunogenic/efficacious schedule will be adopted

3. Vaccine NIP IAP BCG Till 1 year Till 5 years No revaccination for absent scar Revaccination once for absent scar OPV Birth-6w-10w-14m-18months Birth IPV fIPV : 6w-14-9m IPV: 6w-10—14w-18m-5 years PCV 2+1 schedule 3+1 schedule Hib 6w-10w-14m 6w-10w-14m + B-18 m Rotavirus: 1 st dose Till 1 y Till 14 completed weeks Rotavirus: Final dose Till 2 years Till 32 weeks Measles containing vaccine MR 9m-18m MMR 9m-15m-5y TCV, Influenza, HPV, Hep A, Varicella Not included Included

4. PCV: A 14 weeks infant comes to your clinic for the 14 weeks vaccines. So far, the child has received all the vaccines as per the NIP schedule. Now they wish to change to the schedule that you follow in your practice. Will you offer 1 dose of PCV (14 weeks) now (as per NIP) or 2 doses at an interval of 4 weeks (14 weeks and 18 weeks- as per IAP)? How does 2 priming doses compare with 3 priming doses? HP

5. PCV: A child has received PCV in 2+1 schedule in the NIP, has come at 18 month for his boosters at your clinic. Should he be offered a PCV booster dose (as per IAP schedule)? A child who has received 2 doses of PCV at 6-14 weeks comes to you at 9 months for the TCV. Will you offer the booster of PCV now (at 9 months as per NIP) or postpone to the IAP recommended age of 15 months? LM AS

6. Polio vaccines: Will you continue with b-OPV? RC Will you consider f-IPV in your practice? RC

7. A 10 weeks infant is brought to you for vaccines. The infant has received the 6 weeks vaccines according to the NIP. For various reasons they wish to shift to your practice and administer vaccines as per the IAP schedule. There is no confusion regarding DPT/Hib/HBV. How will you manage the Polio vaccines? Standalone IPV is not available. SS

8. Options: Send them back to NIP for polio vaccines only and administer the Pentavalent vaccines in your clinic Ignore the fIPV given in NIP and Give 3 doses of Hexavalent vaccine at 4 weeks interval Give 2 doses of Hexavalent vaccine at 8 weeks interval Give 2 doses of Hexavalent vaccine at 4 weeks interval with the assumption that 1x fIPV + 2 x IM-IPV (4 weeks interval) gives adequate protection SS

9. A 6 months infant is brought to you for Influenza vaccine. The infant has received all vaccines as per NIP. Will you advise that the fIPV administered as per the NIP schedule is sufficient? OR Will you advise an addition dose of an IPV containing vaccine? How? HP

10. How will you compare fIPV at 6w-14w-9m (NIP) and 6w-10w-14w-18m (IAP)? Seroprotection rates Antibody titers (GMTs)? LM

11. What is the role of IM-IPV booster at 4-6 years? AS

12. A 6 months infant is brought to you for vaccinations. The infant has received the 1 st round of vaccines including the Rotavirus vaccine at 5 months (as per NIP). Will you administer the 2 nd dose of the RVV in your clinic? Is it safe to administer the Rotavirus vaccine to this infant who received the 1 st dose beyond the permitted age of 14w+6d? RC

13. Is there a need for booster of Hib vaccine in the 2 nd year? SS

14. BCG A young Indian couple have relocated from USA to India, with 2 kids 2y and 8y of age. Both have not received the BCG vaccine. Options: BCG for then 2y kid only BCG for both kids No need for BCG for both kids HP

15. Rabies vaccine: Following a Cat 3 exposure a 4 year boy received local RIG and 1 st dose of ID Rabies vaccine. The parents wish to continue the schedule in your clinic. Will you offer ID vaccine in your clinic? Will you consider the 1 st ID dose and continue remaining doses as per the IAP schedule of IM vaccines Will you consider the 1 st ID dose as invalid and administer the full PEP as per the IAP schedule of IM vaccines 4 doses or 5 doses?? LM

16. MR/MMR A child who has received 1 dose of MR in the NIP at 9 months, is brought to you at 12 months for MMR vaccine 1 or 2 or 3 doses of MMR? Schedule? A child who has received 2 doses of MR in the NIP at 9 & 18 months, is brought to you at 2 years for protection against Mumps, as there is a mumps outbreak in the community. 1 or 2 doses of MMR? Schedule? SS