Immunization

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Immunization:

Immunization

Immunization:

Immunization

Immunization schedule and FAQ’s:

Immunization schedule and FAQ’s

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Vaccination Age Route Site BCG & Zero Polio At birth or within 15 days Intra dermal - BCG Oral - OPV Left upper arm Hep -B Zero dose at birth ? Intra muscular Mid lateral thigh DPT , Hep.B & OPV 6 TH week 10 th week 14 th week IM- DPT, Hep -B Oral - OPV Mid lateral thigh MEASLES After completion of 270 days Subcutaneous Right upper arm DPT , OPV & Measles booster Doses 16-24 moths IM- DPT SC- Measles Oral - OPV Mid lateral thigh DPT 2 nd Booster 5 Year Intra muscular Upper arm TT PM - 2 doses Children 10 & 16 yr Intra muscular Upper arm Vaccination schedule

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BCG

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Why give BCG vaccine only on the left upper arm? BCG is given on the left upper arm to maintain uniformity and for helping surveyors in verifying the receipt of the vaccine.

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Why is BCG given only up to one year of age? Most children acquire natural clinical / sub-clinical tuberculosis infection by the age of one year. This too protects against severe form of childhood tuberculosis eg . TB meningitis.

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If no scar appears after administering BGC, should one re-vaccinate the child? There is no need to revaccinate the child even if there is no scar.

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OPV

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Till what age can a child be given OPV ? OPV can be given to children till 5 years of age.

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Can an infant be breastfed immediately after OPV Yes.

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DPT

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If a child could not receive DPT1, 2, 3 and OPV1,2,3 according to the schedule, till what age can the vaccine be given ? The DPT vaccine can be given upto 7 years of age and OPV can be given till 5 years of age.

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Why should there be a minimum gap of 4 weeks between two doses of DPT? This is because decreasing the interval between two doses may interfere with the antibody response and protection.

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Why give the DPT vaccine in the antero-lateral mid thigh and not the gluteal region (buttocks)? DPT is given in the antero -lateral mid-thigh and not the gluteal region to prevent damage to the sciatic nerve. Moreover, the vaccine deposited in the fat of gluteal region does not invoke the appropriate immune response.

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Hepatitis B

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Until what age can Hepatitis B vaccine be given According to the National Immunization Schedule, Hepatitis B vaccine should given with the first, second and third doses of DPT till one year of age.

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Measles

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Why give the Measles vaccine only on the right upper arm? The Measles vaccine is given on the right upper arm to maintain uniformity and to help surveyors in verifying the receipt of the vaccine.

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If a child has received the Measles vaccine before 9 months of age, is it necessary to repeat the vaccine later? Yes, the Measles vaccine needs to be administered, according to the National Immunization Schedule, after the completion of 9 months until 12 months of age. If not administered in the ideal age for Measles vaccine, it can be administered until 5 years of age.

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JE VACCINE

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If a child above 16-24 months of age has been immunized with JE vaccine during an SIA, can it receive the JE vaccine again, as part of RI ? No, currently this is a single dose vaccine and should not be repeated.

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If a child above 2 years (24 months) of age has not received the JE vaccine through either RI or an SIA, should s/he be given the JE vaccine ? Yes, the child is eligible to receive a dose of the JE vaccine, through RI, till the age of 15 years.

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All vaccines

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If a child who has never been vaccinated is brought at 9 months of age, can all the due vaccines be given to a child on the same day. Yes, all the due vaccines can be given during the same session but at different injection sites using separate AD syringes.

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If a mother / caregiver permits administration of only one injection during an infant’s first visit at 9 months of age, which vaccine should be given. At 9 months of age, the priority is to give measles vaccine with OPV and Vitamin – A.

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Which vaccines can be given to a child between 1-2 years of age, who has never been vaccinated? T he child should be given DPT1, OPV1, Measles It should then be given the second and third doses of DPT and OPV at one month intervals. The booster doses can be given at a minimum of 6 months after administering OPV3/DPT3.

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It is advisable to clean the injection site with a spirit swab before vaccination? True/False False This is because some of the live components of the vaccine are killed if they come in contact with spirit.

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1 . Reconstituted BCG vaccines ( or Reconstituted Measles vaccine) should be discarded after how many hours?  1 hour  2 hours  3 hours  4 hours 2. Which of the following vaccine should not be frozen?  BCG  DPT  OPV  Measles  Hepatitis B  TT 3. DT vaccine at the age of 5 years is replaced by DPT 2 nd booste r  True  False

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4. For how many weeks “used vials” to be preserved in the ILR  2 weeks  4 weeks  1 week  3 weeks 5. Returned unopened vials must be used  within a month  At any time  In the very next Immunization day  not to be used 6.Expired vaccine vials/VVM 3 rd , 4 th stage vaccines to be kept out of ILR/ DF/ WIC  True  False

Routine immunization:

Routine immunization BCG - 10 Dose vials. DPT - 10 Dose vials Hep B - 10 Dose vials TT - 10 Dose vials. OPV - 20 Dose vials. Measles- 5 Dose vials. JE - 10 Dose vials About Vaccine Vials

In general, :

In general , All Vaccines tend to lose potency on exposure to heat above +8 0 C Some Vaccines lose potency when exposed to freezing temperatures The damage is irreversible

EQUIPMENT - ELECTRICAL:

EQUIPMENT - ELECTRICAL Walk-in-Freezer ( WIF ): . Stores bulk quantity of OPV/Measles & freezes Ice Packs at -20°C. Walk-in-Cooler ( WIC ): storage of bulk vaccine at State & Regional stores. Storage Temp. is + 2°C to + 8°C Deep Freezers ( DF ) Ice Lined Refrigerators ( ILR ) Cold Boxes Vaccine Carriers Ice Packs

Routine immunization:

Routine immunization All vaccines must be stored at PHC in +2 to +8 degree centigrade. OPV and Measles Vaccines must be stored at the bottom of the ILR. T series vaccines (DPT,TT, Hep B and vaccines must be stored in the basket. Vaccine storage

Right way of keeping vaccines in ILR:

Right way of keeping vaccines in ILR Keep all vaccines in baskets Place a thermometer in the center of the ILR. Avoid placing vaccines at bottom of ILR. ( never diluents, freeze sensitive) Leave space between the vaccine boxes Same vaccines in same area. Diluent / freeze sensitive/ Closer expiry date vaccines on top Heat sensitive / Further expiry date vaccines in the bottom of basket

Routine immunization:

Routine immunization 0.I ml AD Syringes for BCG. 0.5 ml AD Syringes for all other vaccines(DPT, Hep B, TT, Measles, JE) 5 ml Disposable Syringes for mixing diluents with vaccine (BCG & Measles) About AD Syringes

Injection Safety: An Introduction:

Injection Safety: An Introduction

Vaccines vulnerable to heat:

BCG (after reconstitution) OPV Measles DPT BCG (before reconstitution) DT,TT, Hep B Vaccines vulnerable to heat

Vaccines vulnerable to Freezing :

Hep- B DPT DT TT Vaccines vulnerable to Freezing

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Temperature recording

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Quality of Vaccine Monitor If the square is lighter than the circle ,if the expiry date is not passed, USE the vaccine.  If the square is dark but lighter than the circle ,if the expiry date is not passed, USE the vaccine.  The square matches the circle DO NOT USE the vaccine . Inform your supervisor.  The square is darker than the circle DO NOT USE the vaccine. Inform your supervisor. 

Routine immunization:

Routine immunization DOUBLE CHECK the vaccine inside the vial, if found any flocculation, indifferent colouring discard it. DOUBLE CHECK the label whether the vaccine is within expiry date. DOUBLE CHECK the AD Syringes, that the packing is intact and ensure its quality on opening. DOUBLE CHECK

Routine immunization:

Routine immunization DOUBLE CHECK if any doubt arise on the quality of AD syringes,discard it and report it. DOUBLE CHECK the diluent for its quality, discard if found any contamination. DOUBLE CHECK that the diluent is taken for the relevant vaccine supplied by same manufacturer. DOUBLE CHECK

Routine immunization:

Routine immunization DOUBLE CHECK the label whether the diluent is within the expiry date. DOUBLE CHECK that the time of reconstitution is clearly written on the label of the vial and use it within 4 hours. DOUBLE CHECK VVM , whether the vial is within VVM I st or 2 nd stage. If found 3 rd or 4 th stage, discard it. DOUBLE CHECK

Routine immunization:

Routine immunization Diluent must be used to the same consignment of vaccine supplied along with it. Using of Diluents

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Due list of Children and Mother for the week Month : Week: I / II / III / IV / V S.No MCR / CCR No. Name of child / Mother & address Sex of Child DOB / weeks of Pregnant TT (M) BCG OPV '0' dose DPT / OPV Hep 'B' Measles DPT / OPV Booster I II / B I II III I II III Name of PHC / Mpty: Name of HSC / Urban Centre: Form -I

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Immunization Performance S.No Name of HSC Weekly target Coverage TT(M) BCG OPV '0' dose DPT / OPV Hep 'B' Measles DPT / OPV Booster JE Weekly Coverage (%) PM Infant I II I II III I II III TT(M) BCG OPV/DPT Mea Hep 'B' Month:----------------- Week: I/ II/ III/ IV/V Name of HUD: Name of PHC / Mpty : Form - II

Low immunization coverage can be attributed to a combination of the following reasons: :

Failure to provide immunization at planned Immunization Sessions. Drop outs: Children who receive one or more vaccination, but do not return for subsequent doses. Left outs : Children who do not receive any vaccination Unreached population: Children whose parents do not know about immunization or face socio-economic barriers to utilize services. Lack of geographic access: children who live too far away from a health center. Resistant population: children whose parents do not believe in immunization services, even though a health center is within reach. Missed Opportunities: children who visit the health center for some other reason, but are not immunized by the health workers. Low immunization coverage can be attributed to a combination of the following reasons:

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