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Universal immunization programme RRT

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Made by Ranjith R Thampi. Covers all the immunisations to be given under the UIP. Made for a SPM seminar. OVerloaded with details.

Publicada em: Saúde e medicina
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Universal immunization programme RRT

  1. 1. Ranjith.R.Thampi IIIrd MBBS
  3. 3. 1978 Expanded Programme of immunization (EPI). Limited reach - mostly urban1985 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 89-90 Monitoring and evaluation system implemented
  4. 4. Implementation of National ImmunizationProgramme District is treated as administrative unit – 593 Primary Health Centers are the last vaccine storage points - 23,109 Services are provided through 142,655 sub centers to the population residing in about 638,588 villages Target for immunization is to cover infant population of over 25 million and around 27 million pregnant women
  5. 5. Immunization services are being providedthrough the existing health care delivery system.There is no separate staff required for theprogramme.Pulse Polio Immunization Programme waslaunched in the country in the year 1995. Underthis, under 5’s are given additional oral poliodrops in December and January every year onfixed days.As a result, there has been a significant declinein the incidence of poliomyelitis.
  6. 6. Primary Vaccination Ring Those outside rings are not vaccinated.Secondary Vaccination Ring
  7. 7. Immuno-biological substances designed toproduce specific protection against a givendisease.*Nowadays vaccines are of sub-unit and recombinant types.Administration: SUBCUTANEOUS & INTR AMUSCULAR
  8. 8. Live Vaccines—BCG, MMR*Not for immunologically challenged.Inactivated(Killed)—iPV, Hepatitis BToxoids—Diphtheria, Tetanus
  9. 9. Immunoglobulins are for passive immunization!5 Major classes include- IgG, IgM, IgA, IgD, IgE.TYPES:Normal Human ImmunoglobulinSpecific Human Immunoglobulin*These are used to replace antibodies inimmunodeficient patients.Administration:INTRAMUSCULAR & INTRAVENOUS
  10. 10. LIVE KILLED TOXOIDS VACCINE VACCINEBCG, POLIO, MMR PERTUSSIS, TYPHOID, CHOLERA DIPHTHERIA, TETANUSVaccines have lost their It stimulates active Exotoxins produced bycapactiy to produce full- immunity. Usually safe but organisms are detoxicatedblown disease, retain less efficacious than live and used in preparation ofimmunogenicity. vaccines. Also requires vaccines. frequent booster doses. Antibodies produced*NOT to be administered neutralise the toxic moietyto persons with immune *NOT to be given when there produced during infection,deficiency diseases, may be or was severe local or rather than act upon thesuppressed immunity. general reaction to a previous organisms. dose.*NOT to be administered HIGHLY EFFICACIOUS.to pregnant women unlessrisk of infection exceedsrisk of harm to fetus withlive vaccine.
  11. 11. Materials prepared in animals. Antitoxinsprepared from non-human source sinclude: Tetanus, Diphtheria, Botulism, Gas gangrene, Snake Bite.
  12. 12. COLD CHAIN?A system of storage and transport of vaccines at lowtemperature from the manufacturer to the actualvaccination site.
  13. 13. Walk in Cold Rooms[WIC]Deep Freezers & ILRsSmall deep freezers and ILRCold boxesVaccine carriersDay CarriersIce packs
  14. 14. For Infants Vaccine & Dose Route At Birth BCG 0.1ml + OPV 2drops( 0 dose) Intradermal 6 weeks BCG 0.1ml [if not at birth] Intradermal DPT-1 0.5ml + OPV-1 2drops I/M + Oral 10 weeks DPT-2 + OPV-2 I/M + Oral 14 weeks DPT-3 + OPV-3 I/M + Oral 9-12 months Measles 0.5ml + Vit. A 2ml Deep S/C + Oral At 18 months DPT + OPV[Boosters-1] I/M + Oral At 24, 30, 36 months Vitamin A 2ml Oral At 5-6 years DT[Booster-2] I/M At 10 and 16 years Tetanus Toxoid I/M For Pregnant Women Vaccine & Dose Route Early in Pregnancy TT-1 or Booster I/M One month after TT-1 TT-2 I/MINTERVAL BETWEEN TWO DOSES SHOULD NOT BE LESS THAN ONE MONTH!
  15. 15. BCG upper, small pox lower.
  16. 16. Progress so far ….
  17. 17. VACCINE PREVENTABLE DISEASE SURVILLANCE Incidence of Neonatal Tetanus Incidence of MeaslesSource CBHI In 2004 1087 NNT cases and 51546 Measles reported
  18. 18. VACCINE PREVENTABLE DISEASE SURVILLANCE Incidence of Diphtheria Incidence of Whooping coughSource CBHI In 2004 8465 Diphtheria cases and 32786 Pertussis reported
  19. 19. Full Immunization Coverage by States (in %)Coverage evaluation 100shows a varied 90 1998-99coverage among the 80 1999-00States. While the 2000-01 70Southern States 2001-02 60have been 50consistentlyachieving high 40coverage levels, the 30situation in Northern 20States is a matter of 10concern. 0 GU TN WB HR UA J khand RJ All India DL PB MP HP J&K MH Bihar UP AP Source: Unicef CES
  20. 20. Performance under Immunization Programme Immunisation, IFA, Vit.A: 2002-03 2003-04 2004-05 2005-06 2006-07TT – Pregnant Women ( 2nd dose + Booster) 19294 19410 17844 17610 18186IFA Tablets (Preg. Women-Prophylactic completed) 16326 14759 17741 18029 15537DPT ( 3rd Dose ) 18199 17031 16836 16185 16352Polio ( 3rd Dose) 18199 17031 16836 16185 16352BCG 31025 30412 29354 36182 42101Measles 16991 16555 16118 15934 16328Vit-A (Total 1st dose for below and up to 1 year) 15544 13537 15320 15224 14495Vit-A (Total 2nd to 5th dose ) 45062 30635 37399 38005 40104DT ( 2nd dose) 19207 19147 18583 20383 17342TT (10 Years) ( 2nd dose) 21303 20548 18283 19094 18329TT (16 Years) ( 2nd dose) 21057 20286 18515 18981 14649
  21. 21. ConcernsLarge birth cohort - 25 million births every yearDeclining coverage in some major states • An average of 14.4 % children receiving BCG do not receive measles vaccinePoor immunization data quality • Discrepancies between reported and surveyed dataVaried program management and supervision at all levelsUnsafe injection practices and waste disposal: Significant percentage of injections used in the immunization sector are unsafe Low priority on medical waste disposal
  22. 22. The virus is also present in body fluids andexcretions such as saliva, breast milk, semen,vaginal secretions, urine, bile and feces.Semen and Saliva are known culprits fortransmission.
  23. 23. Hepatitis Human ImmunoglobulinVaccineTarget Population Dose StatusPercutaneous or mucosal 0.05-0.07 ml/kg body wt Recommended For Preventionexposure Repeat after a monthNewborns of mothers 0.05 ml/kg body wt Recommended For Preventionwith HBsAg At birth, 3 & 6 monthsSexual contacts of acute 0.05 ml/kg body wt Optional for Preventionhepatitis B patients Repeat after a month Immunization against Hepatitis has become an interesting addition to the UIP in India.
  24. 24. Ian Before Ian After
  25. 25. i. Test for Sensitivity Reactionii. Adrenaline (1:1000 solution) to be kept ready.iii.Properly sterilize equipment and apparatus.iv. Measles and BCG vaccines to be reconstituted only with diluents supplied by manufacturer.v. Reconstituted Vaccines must NEVER be retained for subsequent use.vi. Don’t store anything else in the refrigerator other than vaccines.
  26. 26. Have a Great Day!