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IMMUNIZATION It is a technique used to

induce immune resistance to a specific
disease in humans by exposing the
individual to an antigen in order to raise
antibody to that antigen.

Immunization is the process whereby a person

is made immune or resistant to an infectious
disease, typically by the administration of a
vaccine (WHO)
VACCINATION It is the Vaccines stimulate the body’s
injection of a killed microbe in own immune system to
order to stimulate the immune protect the person against
system against the microbe, subsequent infection or
thereby preventing diseases. disease.
Immunizing agent

Any substance or organism that provokes

an immune response (produces immunity)
when introduced into the body
Types of Vaccine
1. Live • LAVs are derived from (already weekened) disease-
Attenuated causing pathogens (virus/bacteria).
Vaccines • Eg.Tuberculosis (BCG) – Oral Polio Vaccine, paralytic
(LAVs) • poliomyelitis. – Measles – Rotavirus – Yellow Fever

• Made from (already killed via physical/chemical

2. processes) microorganism (virus/bacteria). Therefore,
Inactivate non-disease causing.
d/ Killed
• More stable than LAVs.
• Example: – Inactivated polio vaccine (IPV)
• Bacterial toxins like tetanus & diphtheria,
detoxified/purified toxins are called
toxoids, used in vaccines.
3. Toxoid • Example. – Tetanus Toxoid (TT) –
Vaccine Diphtheria Toxoid (DT and Td)

• Contains only the antigenic

parts/fragments of the pathogen
4. Subunit (virus/bacteria).
(Purified • • Example. – Hepatitis B Vaccine
• Vaccine from conjugated/linked antigens or
toxoids by polysaccharides (coatings). – used
for infants and younger children
• • The linkage(conjugation) helps the immune
5.Conjugated system (immature) react to polysaccharide
(Subunit) coatings (disguise) and protect them from
Vaccine • disease-causing bacterium.
• • Example. – Haemophilus influenza type b
conjugate (Hib) – Pneumococcal Conjugate

• Still in experimental stages

6. Nucleic • Vaccines containing DNA, microbes'genetic
Acid (DNA) material that codes for certain antigens that is
Vaccine administered directly into the body by injection
• Example. – DNA Vaccine against West Nile Virus
6.Combined Vaccines
• More than one kind of immunizing agent is
• To simplify administration
• Reduce costs
• Minimize the number of contacts of the
patient with health system
• Eg: DTP, MMR, DT, DP, Pentavalent
Principles of Immunization
A minimum interval of 4wks is essential between
administration of 2 live vaccines.

2 or more killed antigens can be administered

simultaneously or at any interval

If any relapse in administration occurs, the missed can be

given to resume the course

If immunization status of child is unknown he may be given

age appropriate vaccines

Do not mix vaccines in the same syringe


Severe Therapy
allergic with high
reaction to dose
vaccines steroids

Illness with
The following are not
contraindications :
• Minor illness like URT infections & diarrhea,
• Mild fever,
• Prematurity,
• Allergy to penicillin,
• H/o allergies
• Malnutrition
• Recent exposure to infections,
• Current antibiotic therapy
Immunization milestones – India
• Expanded Programme of immunization BCG,DPT,OPV, typhoid
1978 (urban areas)

• TT vaccine for pregnant women


• Universal Immunization Programme – measles added, typhoid

1985 removed, Focus on children less than 1yr of age

• Vitamin-A supplementation

• Polio National Immunization Days


• VVM introduced on vaccines in UIP


• Hep B introduced as pilot in 33 districts & cities of 10 states

• National Rural Health Mission Launched • Auto Disable
2005 (AD) Syringes introduced into UIP

• JE vaccine introduced after campaigns in endemic

2006 districts

• Hep B expanded to all districts in 10 states & schedule

2007-8 revised to 4 doses from 3 doses 2010 Measles 2nd dose
introduced in

• • Hepatitis B universalized and Haemophilus influenza

2011 type b introduced as pentavalent in 2 states •

• • Pentavalent expanded to 9 states • Second dose of JE

2013 vaccine 2014 India and South East Asia Region certified
• India validated for Maternal and
Neonatal Tetanus elimination •
2015 Pentavalent expanded to all states •
IPV Introduced

• Rotavirus vaccine introduced in 4

states in Phase 1 • Switch to fractional
2016 IPV (Phased) • Rotavirus vaccine
introduced (Phased launch)

• MR Vaccine introduced • PCV

(Phased launch)
Under the UIP, vaccines are provided to prevent the
following VPDs

• Diphtheria • Haemophilus
• Pertussis Influenzae Type B
•Tetanus related diseases
(bacterial meningitis,
• Polio pneumonia and others)
• Measles • Japanese Encephalitis
• Tuberculosis • Encephalitis
• Hepatitis B • Diarrhoeas due to
• Rubella
• Pneumococcal disease
Infants & children

• At birth - HepB, BCG, OPV

• Before age 1 year - for Full Immunization ƒ3 doses of

OPV, 3 doses of Rotavirus (where applicable), 3 doses
of Pentavalent, 2 doses of fractional IPV, 3 doses of PCV
(where applicable), MR vacccine -1st dose , JE 1st dose
(where applicable)

• Before age 2 years - for Complete Immunization ƒMR

vaccine - 2nd dose, DPT booster, Polio booster and JE
2nd dose (where applicable)
OPV • oral polio vaccine

BCG • bacillus Calmette-Guerin

Hep B • hepatitis B

• Pneumococcal Conjugate
PCV Vaccine

DPT • diphtheria–pertussis–tetanus

Injection site
reactions (pain,
Mild fever Shivering
swelling and

Muscle and joint

Headache Fatigue
• These symptoms usually pass within a couple of
• Children may sometimes develop a high
temperature . If this happens, keep the child cool.
• Make sure they don't wear too many layers of
clothes or blankets and give them plenty of cool
• Provide them a dose of infant paracetamol or
ibuprofen liquid according to the instructions
Cold chain
Cold-chain room
• All electrical cold-chain equipment are
kept in a separate room with restricted
entry to keep the vaccines and cold-chain
equipment safe and secure
Ice-lined refrigerator (ILR)
• An ILR maintains a cabinet temperature
between +2°C and +8°C. It is used to store
UIP vaccines at the PHC and district
• An ILR with a top-opening lid prevents loss
of cold air during door opening and can
• keep vaccines safe with as little as 8 hours
electricity supply in a 24-hour period.
• ILRs are available in two sizes – large (for
districts) and small (for PHCs).
Deep freezer (DF)

• Freezing ice packs in the DF maintains the

cabinet temperature between -15°C and -
• Unlike the ILR, the DF has little or limited
holdover time,
• At the PHC level, DF is used only for
preparation of ice packs.
• At the district headquarters, DFs have
been supplied for storage of
recommended vaccines such as OPV and
Cold box
• A cold box is an insulated box used for
transportation and emergency storage of
vaccines and ice packs.
• It is available in two sizes, large and
It is used to:

Also used for storing

Collect and transport Store vaccines for frozen ice packs,
large quantities of transfer up to 5 e.G. During
vaccines; days, emergencies and
before campaigns.

store vaccines in case

of breakdown of ILR, as
a contingency measure;
Ice packs

• Ice packs are plastic containers filled with

water. These are hard frozen in the deep
• They are placed inside a vaccine carrier and
cold box to improve and maintain the
holdover time.
• They are also used in ILRs as inside lining to
improve and maintain holdover time during
electricity failure.