1. A presentation by
Dr. Surbhi Vaish Mittal,
Aarogyam Healthcare & Healing Foundation

2. VACCINATION PROGRAM IN INDIA
 WHO launched EPI-1974, against-
Diphtheria, Pertussis, Tetanus, Polio, T.B., Measles.
 EPI launched in India- 1978.
 Became Universal Immunization Programme -1985.
 Ministry of Health & Family Welfare – 90%
vaccination coverage (public sector)
 Less than 10 % coverage of EPI vaccines- private sector
–urban areas.

3. AIM OF IMMUNIZATION
SCHEDULES
 Reduction of Infant Mortality
 Prevention of serious disability & morbidity
WHO recommends- Schedules which are,
 Epidemiologically relevant
 Immunologically effective
 Operationally feasible
 Socially acceptable
Priority Target age groups –
 Infants- Primary Immunization series
 Newborns & Pregnant women- Tetanus
EPI recommends giving more than 1 vaccine, on the same day-
 better coverage,
 reduce no. of contacts

4. National Immunization Schedule
Age Vaccine
At birth BCG, OPV 0
6 weeks DPT1, OPV1, HB1
10 weeks DPT2, OPV2, HB2
14 weeks DPT3, OPV3, HB3
9 months Measles
16-18 months DPT (Booster), OPV4
5 years DT
10 years TT
16 years TT
Pregnant women TT( 2 doses at 1 month interval)

5. IAP Immunization Schedule
Vaccine Recommended Age
BCG Birth to 2 weeks
OPV Birth, 6, 10, 14 weeks, 16-18 months, 5
yrs & additional pulse polio doses
DPT 6, 10, 14 weeks, 16-18 months, 5 yrs
Hepatitis B At birth, 6, 10, 14 weeks
HiB Conjugate 6, 10, 14 weeks, 16-18 months
Measles 9 months
MMR 15 months
Typhoid 2 years
TT/Td 10, 16 years
TT (2 doses) Pregnant Women
Optional vaccines , Varicella- Above 15 months, Hepatitis A- Above 18 months,
Pneumococcal >6 weeks

6. Vaccination Schedule for the
unimmunized child-
Age Less than 7 years More than 7 years
First Visit BCG, DPT, OPV, HB, Hib BCG, TT/Td, HB
2nd visit ( 1 month later ) DPT, OPV, MMR, HB, TT/Td
Measles/MMR, HB
3rd Visit ( 1 month later ) DPT, OPV, Typhoid (if Typhoid, TT/Td
>2yrs of age)
Fourth Visit ( 1 year later ) DPT, OPV, HB TT/Td, HB

7. Vaccination Schedule in
Adolescents
Vaccine Age
TT/Td Booster at 10, 16 yrs, & every 10 yrs
Rubella/ MMR 1 dose at 12-13 yrs( Monovalent or as
MMR (if not given earlier)
Hepatitis B 3 doses (0, 1, 6 months) if not given
earlier
Typhoid TA, Vi, or Oral Typhoid vaccine every 3
years
Varicella 1 dose upto 12-13 yrs & 2 doses at 1
month interval after 13 yrs if not given
earlier, or did not suffer from chicken
pox
Hepatitis A 2 doses ( 0 & 6 months )if not given
earlier

8. Tetanus Prophylaxis in Wound
Management
History of prior Clean, minor wounds All other wounds
TT/DPT/DT/Td doses
TT*, TIG** TT, TIG
Unknown or <3 doses Yes, No Yes, Yes
3 or more doses No ***, No No ****, No
*TT-Tetanus Toxoid
**TIG-Tetanus Immunoglobulin 250 IU/IM injection
*** Yes, If more than 10 years since last dose
**** Yes, if more than 5 years since last dose

9. Key Points -
 Vaccines stored at +2 to +8 degrees C, except OPV-
stored at -20 degrees C or below.
 Lapsed Immunizations
 Minor Illnesses- Fever, diarrhoea, respiratory
infections & malnutrition
 Both killed & live vaccines- simultaneous
administration , at different sites, using separate
needles for each component.
 Avoid giving injections-Skin infections, Skin lesion or
weeping dermatitis. Prepare skin with disinfectant.
 Sterile needles & syringes- For
reconstitution/administration

10. VACCINE GUIDELINES-
Vaccine Diluent Dose, Route & Contra- Adverse
Site indications Effects
BCG (freeze Normal Saline 0.1ml intra Immuno Axillary lymph
dried) dermal left deficiency adenitis
deltoid
DTP (whole cell None 0.5ml IM, Progressive Fever, local pain
vaccine ) antero-lateral neurological & induration
aspect thigh disease
OPV None 2 drops orally Immuno VAPP rarely
deficiency, HIV (Vaccine
associated
paralytic polio)
HB 10 mcg of None 0.5ml IM, None Local pain,
purified HBsAg antero-lateral erythema
aspect thigh
Measles Sterile water 0.5 ml None Mild fever, mild
(lyophilized) SC/Deltoid/thig rash after 7 days
h
MMR Sterile water 0.5 ml Systemic Mild fever, mild
(lyophilized) SC/Deltoid/ hypersensitivity rash after 7 days

11. VACCINE GUIDELINES CONTINUED
Vaccine Diluent Dose, Rate & Contra Adverse Effects
Site indications
Varicella Sterile water 0.5 ml SC Systemic Milder Varicella
(Lyophilized) deltoid hypersensitivity type rash
to neomycin
Hepatitis A None 0.5 ml IM thigh None Local pain,
erythema
Typhoid Vi None 0.5 ml IM None Mild local
antigen vaccine deltoid reaction
Meningococcal Sterile water 0.5 ml IM or SC None Mild fever, local
vaccine(2 yrs & Deltoid/ Thigh reaction
above, during
epidemics)
Pneumococcal None 0.5 ml IM or SC None Local Reaction
23 Valent anterolateral
vaccine aspect of thigh/
deltoid

12. Thank You