Immunization programme
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The document discusses immunization programs and schedules. It notes that many developed countries have virtually eliminated vaccine-preventable diseases through active immunization programs. It defines active and passive immunization. For active immunization, it discusses routine immunization schedules that have been developed for different countries based on disease prevalence and cost-benefit factors. It provides details on India's Universal Immunization Programme and National Immunization Schedule. It also summarizes objectives and recommendations of the WHO's Expanded Programme on Immunization.
Immunization programme
- 2. IMMUNIZATION • By systematic active immunization programs, many developed countries have virtually eliminated ‘vaccine preventable diseases’ (VPD ) such as diphtheria, pertussis, tetanus, measles, mumps, rubella and poliomyelitis.
- 3. IMMUNIZATION • Immunization against microbial pathogens • Type- Active immunization (Vaccination) Passive immunization (Immunoglobulin administration). • Vaccine- is an immunobiological preparation (immunogen) that provides specific protection against a given disease (by formation of specific protective antibody and/or immunocompetent T cell response).
- 5. Routine immunization schedules • Routine immunization schedules have been developed for different countries and- Modified from time to time, based on the prevalence of infectious diseases Their public health importance availability of suitable vaccines their cost benefit factors and logistics. • In India- Expanded Programme on Immunization (EPI) and Universal Immunisation Programme (UIP) • have been able to provide protection against VPDs .
- 6. National lmmunization Schedule (NIS) • Most logical and cost effective strategies for the prevention of childhood sicknesses and disabilities. • NIS recommended by the Ministry of Health, Goverment of India includes vaccines that are given free of cost basic need for all children of our country.
- 7. National lmmunization Schedule (NIS)
- 8. National lmmunization Schedule (NIS)
- 9. NIS continue ….. Give TT·2 or booster doses before 36 weeks of pregnancy
- 11. Expanded Programme on Immunization (EPI) • In 1974- EPI Established by World Health Assembly resolution - to build on the success of the global smallpox eradication programme, and to ensure that all children in all countries benefited from life-saving vaccines. • In 1977- the goal was set to make immunization against Diphtheria, Pertussis, Tetanus, Poliomyelitis, Measles and Tuberculosis Available to every child in the world by 1990
- 12. EXPANDED MEANS …. • Expanding the number of diseases to be covered • Expanding the number of children and target population to be covered • Expanding coverage to all corners of the country and spreading services to reach the less privileged sectors of the society
- 13. OBJECTIVES • To increase coverage of immunization for eligible children. • To reduce the incidence of vaccine preventable diseases among children • Promoting safe injection techniques • Improve the stocking and availability of vaccines • Protecting vaccine potency through cold chain management • To prepare for introduction of new vaccines
- 14. WHO EPI SCHEDULE • Recommendations for- All children Children residing in certain regions Children in some high-risk populations Children receiving vaccinations from immunization programmes with certain characteristics
- 17. RECOMMENDATION FOR ALL CHILDREN
- 18. BCG •Recommended for children living in countries with a high-disease burden and for high-risk children living in countries with low-disease burden Hepatitis B •Premature low birth weight (<2000g) may not respond well to vaccination at birth. Therefore, doses given to infants <2000g should not be counted towards the primary series. •Additional target groups include people who frequently require blood or blood products, dialysis patients, recipients of solid organ transplantations, injecting drug users, household and sexual contacts of people with chronic HBV infection, people with multiple sexual partners, as well as health-care workers. OPV plus IPV •In polio-endemic countries and in countries at high risk for importation Sequential IPV–OPV •In countries with high vaccination coverage (e.g. 90%–95%) and low importation risk. IPV-only schedule •In countries with sustained high vaccination coverage and very low risk of both WPV importation and transmission
- 20. DTP •Tetanus toxoid containing booster should be administered during adolescence - 12-15 years. •National programmes may consider the vaccination of pregnant women with 1 dose of Tdap (in the 2nd or 3rd trimester and preferably at least 15 days before the end of pregnancy) Hib (3p) •In countries where the peak burden of severe Hib disease occurs in young infants. Hib (3p+1, 2p+1) •Where the greatest disease morbidity and mortality occur later, or where rate reductions of disease are not fully sustained after the routine use of Hib vaccine . •Child older than 12 months of age, only one dose is recommended. •Hib vaccine is not required for healthy children after 5 years of age Pneumococcal •HIV-positive infants and pre-term neonates who have received their 3 primary vaccine doses before reaching 12 months of age may benefit from a booster dose in the second year of life Rotavirus •Vaccination of children >24 months of age is not recommended. •Carries low risk of intussusception
- 22. Measles •In countries with ongoing transmission in which the risk of measles mortality remains high, MCV1 should be given at age 9 months. •In countries with low rates of measles the first dose may be administered at age 12 months . •In areas where there is a high incidence of both HIV infection and measles, MCV1 may be offered as early as age 6 months. Rubella •Blood or blood products may interfere with vaccine efficacy. •Vaccination should be delayed for 3 months post transfusion. •Transfusion should be delayed 14 days post vaccination. HPV •A 3-dose schedule (0, 1–2, 6 months) is recommended for females aged 15 years and older, and for those know to be immunocompromised and/or HIV-infected.
- 23. Recommendations for children residing in certain regions
- 24. Japanese Encephalitis Primary target population typically children aged <15 years . Yellow Fever Contraindicated in children aged <6 months and is not recommended for those aged 6-8 months, except during epidemics. Tick-Borne Encephalitis Important target for immunization - individuals aged >50–60 years.
- 25. Recommendations for children in some high-risk populations
- 26. Typhoid Recommended for school-age and/or preschool-age children. Cholera (Duckoral) •Intake of food and drink should be avoided for 1 hour before and after vaccination. •If the interval between doses is delayed >6 weeks, primary vaccination should be restarted. •If the interval between primary immunization, and the booster is >6 months, primary immunization must be restarted. Meningococcal MenA conjugate vaccine •For infants younger than 9 months, a 2-dose schedule should be used starting at 3 months of age, with an interval of at least 8 weeks between doses. Rabies •Rabies vaccine should not be administered in the gluteal area, as the induction of an adequate immune response may be less reliable.
- 27. Recommendations for children receiving vaccinations from immunization programmes with certain characteristics Revaccinate annually, single dose
- 28. Seasonal Influenza (Inactivated Vaccine) •Risk groups to be considered are Pregnant women Children aged 6-59 months, Elderly persons ≥ 65 years of age, Individuals with specific chronic medical conditions, Health-care workers.
- 29. Passive immunization • Passive immunoprophylaxis- – given in the form of commercially available, ready made immunoglobulins – prepared against the pathogenic microorganism. – immunoglobulins act faster, without involvement of host immune apparatus. – useful in the following circumstances: For immunocompromized individuals who cannot synthesize antibodies. For postexposure prophylaxis to achieve an immediate effect.
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