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7/30/2019 JE in India
1/23
Dr. Navneet Kumar Dham ijaAss istant Commiss ioner - Imm unizat ionMinistry of Health & FW, Gov t. of Ind ia
Mob iles : 8826772555, 9911220066
Offi ce : 23062993, 23062126, 23062728
E-mail : Immun izat ionAC@gmail .com
Japanese EncephalitisVaccination Program In India
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Introduction of JE Vaccination
In 2005, a massive outbreak hit several
districts in many parts of the country and
many cases occurred in eastern U.P. and
adjoining districts of Bihar and Nepal
during this period more than 1600 children
were reported to have died of JE
BRD Medical College, Gorakhpurexperienced up to 20 admissions per day
with patients beyond its capacity where
patients were sharing beds, even in the ICU
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Criteria to identify JE endemic districts
Case load of JE- Total number of cases
reported (AES/ suspected JE/ lab
confirmed JE).
Incidence of JE
Evidence of recent transmission of thedisease
Serological evidence from JE studies.
Epidemiological link to known areas of
transmission.
104 districts in 11 States were identified as JE endemic
Highest Priority Districts
High Risk Districts
Medium Risk Districts
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JE Vaccination Program
Strategy
One time campaign covering
children aged 1-15 years followed by
integration of JE vaccine into UIP as
single dose for new cohort at 1-2
years of age
The Multi Year Plan
104 JE endemic districts to be
covered with JE mass vaccination
campaigns in 11 States in a span of 5years 2006 2010*
Review of data and strengthening of JE surveillance showed 4 new states as JE endemic thereby
including 15 JE endemic states and incerasing the no. of JE campaign districts to 109 in the Multi year
plan. Formation of 2 new districts which split up from Kolar and Thiruvannamalai districts Cheyyar
and Chikballapur increased the no. of JE endemic districts to 111. And recently another district has
split from Rae Bareilly and Sultanpur and a new district has been formed
Chattrapati Sahuji
Magaraj Nagar which has incerased the JE campaign districts to 112
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Vaccine availability
Currently, there are three types of JE vaccines in large-scale use:
Mouse brain-derived, purified and inactivated vaccine
Cell culture-derived, inactivated JE vaccine based on the BeijingP-3 strain (only available in China and being replaced by liveattenuated vaccine).
Cell culture-derived, live attenuated vaccine based on the SA 14-14-2 strain of the JE virus.
Based on research studies, discussions by expert andvaccine availability issues for country needs, SA-14-14-2 JEvaccine manufactured by CDIBP, China was taken up for use
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The Multiyear Plan
Based on the emergence of JE/ AES new cases and low coverage indicated in the Coverage
evaluat ion surv ey report in 2 divis ions of U.P 7 distr icts of Bast i and Gorakhpur divis ions
and 2 distr icts o f Assam, a decision to condu ct re-campaigns in 2010 thereby inc reasing the
no. of dist r ic ts from the in i t ia l ly planned 19 to 28.
Year
No. of
Districts
covered till
date Total Population
Target
population
- 1-15
years
Total JE
vaccination
campaign
coverage
JE
vaccination
campaign
coverage %
1 2006 11
29420139 10531554 9308688 88.39
2 2007 27
65934009 21758223 18431087 84.713 2008 22
57772199 20040262 16881941 84.24
4 2009 30
45032191 27170604 18097182 66.61
5 2010* 19
28292755.21 9336609 7626354 81.7
6
2010*re-
campaigns 9 23211927
7659936 7495380
97.85
Total for India till
date118 249663220 96497188 77840632 80.67
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JE Vaccination Program Overview
JE campaign States & districts
1 Andhra Pradesh 10
2 Kerala 2
3 Uttar Pradesh 34
4 Goa 2
5 Assam 11
6 Bihar 6
7 Haryana 6
8 Karnataka 8
9 Tamil Nadu 10
10 Maharashtra 8
11 West Bengal 5
12 Manipur 5
13 Nagaland 2
14 Arunanchal Pradesh 1
15 Uttrakhand 1
Total 111
JE vaccinat ion Campaigns in al l the 112 distr ic ts have been com pleted in 15
states
112 JE vaccination
campaign districts
2006-2011
JE campaigns completed
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111 Districts - 2006 - 2011
S.N Name of State District's Name
1 Andhra Pradesh Warrangal
2 Andhra Pradesh Kurnool
3 Andhra Pradesh Krishna
4 Andhra Pradesh Nellore
5 Andhra Pradesh Medak
6 Andhra Pradesh Adilabad
7 Andhra Pradesh Khamam
8 Andhra Pradesh Nalgonda
9 Andhra Pradesh Mahboobnagar
10 Andhra Pradesh Nizamabad
11 Kerala Thiruvananthapuram
12 Kerala Alappuzha
13 UP Allahabad
14 UP Ambedkar Nagar
15 UP Azamgarh
16 UP Ballia
17 UP Balrampur
18 UP Barabanki
19 UP Bareilly
20 UP Basti
21 UP Behraich
22 UP Deoria
23 UP Faizabad
24 UP Fatehpur
25 UP Ghazipur
26 UP Gonda
27 UP Gorakhpur
28 UP Hardoi
29 UP Jaunpur
30 UP Kanpur Nagar
31 UP Kheri
32 UP Kushi Nagar
33 UP Lucknow
34 UP Maharajganj
35 UP Mau
36 UP Muzaffar Nagar
37 UP Pratapgarh
38 UP Rae Barelly
39 UP Saharanpur
40 UP Shahjahanpur
41 UP Shrawasti
42 UP Sant Kabir Nagar
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43 UP Sitapur
44 UP Siddharth Nagar
45 UP Sultanpur
46 UP Unnao
47 Goa North Goa
48 Goa South Goa
49 Assam Sonitpur
50 Assam Dibrugarh
51 Assam Jorhat
52 Assam Dhemaji
53 Assam Sivsagar
54 Assam Golaghat
55 Assam Tinsukia
56 Assam Lakhimpur
57 Assam Kamrup
58 Assam Udalgiri
59 Assam Nagaon
60 Bihar Champaran West
61 Bihar Muzaffarpur
62 Bihar Gaya63 Bihar Gopalganj
64 Bihar Nawada
65 Bihar Siwan
66 Haryana Kurukshetra
67 Haryana Ambala
68 Haryana Panipat
69 Haryana Karnal
70 Haryana Yamuna Nagar
71 Haryana Kaithal
72 Karnataka Bellary
73 Karnataka Kolar (+C ballapur )74 Karnataka Raichure
75 Karnataka Koppal
76 Karnataka Mandya
77 Karnataka Bijapure
78 Karnataka Dharwad
79 Maharashtra Amravati+Amravati MC
80 Maharashtra Bhandara
81 Maharashtra Nagpur Rural
82 Maharashtra Washim
83 Maharashtra Beed
84 Maharashtra Latur
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85 Maharashtra Gadchirolli
86 Maharashtra Yavatmal87 West Bengal Birbhum
88 West Bengal Hoogly
89 West Bengal Burdwan
90 West Bengal Howrah
91 West Bengal West Medinapore92 Tamil Nadu Cuddalore
93 Tamil Nadu Villupuram
94 Tamil Nadu Virudhunagar
95 Tamil Nadu Trichy
96 Tamil Nadu Thiruvarur97 Tamil Nadu Madurai
98 Tamil Nadu Perambalur
99 Tamil Nadu Thanjavur
100Tamil Nadu Thiruvannamalai
101Manipur Imphal east
102Manipur Imphal West
103Manipur Thoubal
104Manipur Bishnupur
105Manipur Chandel
106Nagaland Dimapur
107Nagaland Mokongchung
108 Arunanchal Pradesh Lohit
109Uttrakhand Udham Singh Nagar
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0
10
20
30
40
50
60
70
80
90
100 88% 84.7% 84.2%
66.6%69.6%
97.9%
Cove
rage%
Year of Campaign
JE vaccination campaigns - Year coverage
2006 - 2011
Over 76 mi l l ion chi ldren have been imm unized in the JE vaccinat ion camp aigns from
2006 2011 Arou nd 3.7 mi l l ion chi ldren h ave been immu nized w ith JE vaccine t i l l
date under RI
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010
20
30
40
50
60
70
80
90
100
West Bengal Assam Karnataka U.P.
56.12%
82.7% 82.6%
99.9%
JE Vaccination campaign coverage 2006
Coverage%
JE Campaign States
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0
10
20
30
40
5060
70
80
90
100 93%88%
75%
97%90%
87%80%
57%
79%
JE Vaccination campaign coverage 2007
JE Campaign States
Coverage%
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0
10
20
30
40
50
60
70
80
90
100
75%
91%95%
70%
42%
73%
64%
99%
57%
JE Campaign States
JE Vaccination campaign coverage 2008
Coverage
%
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0
10
20
30
40
50
60
70
80
90
74% 74%
82%
34%
87%78%
40% 35%
70%
85%
25%
JE Campaign States
Covera
ge%
JE Vaccination campaign coverage 2009
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0
10
20
30
40
50
60
70
80
90
100
77%
96%
87% 85%
93%
72%
89%
82%
Cov
erage%
JE Campaign States
JE Vaccination campaign coverage 2010
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0
10
20
30
40
50
60
70
80
90
100
Dibrugarh
Sivsagar
Deoria
Gorakhpur
Kushinagar
Maharajganj
S.K.Nagar
SiddharthNagar
Basti
Assam Assam UP UP UP UP UP UP UP
93%
84%
100.2% 99.6% 99% 97% 96%100% 99%
Coverage%
JE Campaign States
JE Vaccination Re-Campaign*
Coverage 2010
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JE vaccination Campaigns and
integration in RI in WB
S.No. Name of Sta te District's NameYear of
Campaign
Coverage Coverage %
JE vaccine
was to be
introduced in
Actually
introduced in
1 West Bengal Burdwan 2006 1229404 56% Jan-07 Feb-09
2 West Bengal Birbhum 2007 792872 74.50% Dec-07 Feb-09
3 West Bengal West Medinapore 2008 1091672 57% Apr-09 Apr-094 West Bengal Hoogly 2009 379295 22.30% Jan-10 Jan-10
5 West Bengal Howrah 2009 440379 28.80% Jan-10 Jan-10
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AEFIs - During JE Vaccination Campaigns
2006 - 2011
Year DistrictsCovered Coverage(Million) AEFIReported Minor Major DeathsInvestigated2006 11 9.3 504 439 65 22
2007 27 18.5 1209 1059 150 8
2008 22 16.9 1039 996 43 6
2009 30 18 755 625 130 5
2010 19 7.4 16 16 0 0
2010* Re-campaigns 9 7.4 180 177 3 1
Total 103 77.5 3703 3312 391 42
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The 5 year JE vaccination plan has been completed in 2011
Previous JE campaign states like Assam, Arunanchal Pradesh,
Manipur, U.P., Bihar, Haryana, Karnataka, Kerala, Tamil Nadu,
Maharashtra, Goa, West Bengal are still reporting JE cases
Issue of Age shift in many states
A large cohort of children still remain un- immunized in
previous campaign districts under JE vaccination in RI
Challenges
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Recommendations
Review of JE incidence
Review JE vaccination program at the State and National
level to recommend the way forward
Strengthen JE vaccination under RI
Coverage reporting
Vaccine demand and supply issues
Monitoring RI sessions
Strengthen coordination and data flow
Immediate action required Introduction of JE
vaccine in RI in the pending districts
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Courage is what
It takes to stand and speak
Courage is also what
It takes to sit down and listen
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