NATIONAL NATIONAL IMMUNIZATION IMMUNIZATION

SCHEDULE AND ITS SCHEDULE AND ITS COVERAGECOVERAGE

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IMMUNIZATIONIMMUNIZATION

�� A mass means of controlling the spread of A mass means of controlling the spread of infectious diseases.infectious diseases.

�� Can be achieved using Can be achieved using vaccines, vaccines, immunoglobulinsimmunoglobulins and and antiseraantisera..

�� Types:Types:Active.Active.Passive.Passive.Combined(DPTCombined(DPT).).

�� Given as a routine during infancy and Given as a routine during infancy and childhood, with periodic boosters.childhood, with periodic boosters.

�� Immunizations against certain diseases Immunizations against certain diseases restricted to definite geographic areas restricted to definite geographic areas where the disease is endemic.where the disease is endemic.

An immunization schedule must be:An immunization schedule must be:�� Epidemiologically relevant.Epidemiologically relevant.�� ImmunologicallyImmunologically effective.effective.�� Operationally feasible.Operationally feasible.�� Socially acceptable.Socially acceptable.

Universal Immunization Universal Immunization ProgrammeProgramme

oo The WHO launched a global immunization The WHO launched a global immunization programme in 1974, known as programme in 1974, known as Expanded Expanded Programme on Programme on Immunization(EPIImmunization(EPI),), to protect to protect against the six vaccineagainst the six vaccine--preventable diseases,preventable diseases,--Diphtheria, Whooping cough, Tetanus, Polio, Diphtheria, Whooping cough, Tetanus, Polio, Tuberculosis and Measles.Tuberculosis and Measles.oo EPI launched in India in January 1978.EPI launched in India in January 1978.

oo The programme now called The programme now called Universal Universal ChildChild Immunization, 1990,Immunization, 1990, by UNICEF.by UNICEF.

oo The Indian version, the The Indian version, the UniversalUniversalImmunization ProgrammeImmunization Programme launched in launched in 1985.1985.

WHO EPI ScheduleWHO EPI Schedule

Measles.Measles.9 months9 months

DPT, Oral polio.DPT, Oral polio.14 weeks14 weeks

DPT, Oral polio.DPT, Oral polio.10 weeks10 weeks

DPT, Oral polio.DPT, Oral polio.6 weeks6 weeks

BCG , Oral polio.BCG , Oral polio.BirthBirth

VACCINEVACCINEAGEAGE

Status of World Vaccine availability Status of World Vaccine availability and demandand demand-- 1997 to 20031997 to 2003

DTPDTP

0

100

200

300

400

500

600

1997 1998 1999 2000 2001 2002 2003

DemandAvailable

BCGBCG

0

50

100

150

200

250

300

350

400

1997 1998 1999 2000 2001 2002 2003

DemandAvailable

MeaslesMeasles

0

50

100

150

200

250

300

350

400

1997 1998 1999 2000 2001 2002 2003

DemandAvailable

TTTT

0

100

200

300

400

500

600

1997 1998 1999 2000 2001 2002 2003

DemandAvailable

Map of Polio endemic countries in Map of Polio endemic countries in 19881988

And in 2004And in 2004

�� When EPI was launched in 1974, less When EPI was launched in 1974, less than 5% of the world's children were than 5% of the world's children were immunized during their 1st year of life immunized during their 1st year of life against six killer diseases.against six killer diseases.

�� Today, nearly 75% of children receive Today, nearly 75% of children receive these lifethese life--saving vaccinations and saving vaccinations and increasing numbers are also protected by increasing numbers are also protected by new and undernew and under--used vaccines, like used vaccines, like Hepatitis B.Hepatitis B.

�� However, a quarter of the world’s children However, a quarter of the world’s children –– about 34 million infants about 34 million infants –– are not are not immunized against these killer diseases.immunized against these killer diseases.

�� While globally rates have risen, While globally rates have risen, immunization levels have actually immunization levels have actually decreased in some countries like subdecreased in some countries like sub--Saharan Africa to just above 50% in 2000, Saharan Africa to just above 50% in 2000, and in 12 of the poorest countries rates and in 12 of the poorest countries rates are below 35%.are below 35%.

National Immunization ScheduleNational Immunization Schedule

a)a) For infants:For infants:1)1) At birthAt birth-- BCG and OPV, 0 dose.BCG and OPV, 0 dose.2)2) At 6 weeksAt 6 weeks-- BCG.BCG.

-- DPTDPT--1 and OPV1 and OPV--1.1.3)3) At 10 weeksAt 10 weeks-- DPTDPT--2 and OPV2 and OPV--2.2.4)4) At 14 weeksAt 14 weeks-- DPTDPT--3 and OPV3 and OPV--3.3.5)5) At 9 monthsAt 9 months-- Measles. Measles.

b)b) At 16At 16-- 24 months24 months-- DPT and OPV.DPT and OPV.c)c) AT 5AT 5--6 years6 years-- DT.DT.d)d) At 10 and at 16 yearsAt 10 and at 16 years-- TT.TT.e)e) For pregnant women:For pregnant women:1)1) Early in pregnancyEarly in pregnancy-- TTTT--1 or Booster.1 or Booster.2)2) 1 month after TT1 month after TT--11-- TTTT--2.2.

Coverage in IndiaCoverage in India

�� Uttar Pradesh is the country’s most Uttar Pradesh is the country’s most populous state, with 180 million populous state, with 180 million inhabitants.inhabitants.

�� Between May and November 2004 Between May and November 2004 vaccination rates increased from 45% to vaccination rates increased from 45% to 78%.78%.

�� More than 34 million children are More than 34 million children are vaccinated.vaccinated.

�� But 1 million children are still being But 1 million children are still being missed, most of them under the age of 2.missed, most of them under the age of 2.

�� The challenge of reaching these children The challenge of reaching these children is compounded by apathy and distrust is compounded by apathy and distrust towards the public sector, engendered by towards the public sector, engendered by poor basic health and education services. poor basic health and education services.

6363Infant mortality rate, Infant mortality rate, 20032003

146146Infant mortality rate, Infant mortality rate, 19601960

8787UnderUnder--5 mortality 5 mortality rate, 2003rate, 2003

242242UnderUnder--5 mortality 5 mortality rate, 1960rate, 1960

No. of childrenNo. of childrenBasic IndicatorsBasic Indicators

ConclusionConclusion

�� Although significant progress has been Although significant progress has been made made –– over 20 million lives have been over 20 million lives have been saved by immunizations in the last 2 saved by immunizations in the last 2 decades, we have not achieved the goal of decades, we have not achieved the goal of reaching 80% [coverage] of the world's reaching 80% [coverage] of the world's children.children.

�� And tremendous inequities remain in And tremendous inequities remain in terms of access to vaccines both between terms of access to vaccines both between and within countries.and within countries.