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] Intensive pulse polio immunization (IPPI):-

 Pulse polio immunization (PPI) was started in 1988 & is now replaced by
 Intensified means – covering & larger global area with micro planning with
100% immunization coverage.
 Pulse means – at a same time in whole country on national immunization
day (NID).
 NID is defined as a day on which simultaneous administration of extra close
of OPV to 100% children of older five years are, irrespective of previous
immunization status is done in single day.
 Object is to prevent occurrence of new poliomyelitis by year 2010.
 Two rounds of NIDS will be conducted in January & February every year in
all zones. 4 additional rounds in June, July, October & November in high risk
zones as SNIDS (sub-national immunization day).
 On NIDS –OPV is given at fixed posts & house to house approach. This is
followed by mop up round with aggressive door to door campaign to ensure
100% coverage.
 Acute flaccid paralysis (AFP) surveillance is necessary to pick up paralytic
poliomyelitis. It is done by SMO (surveillance medical officer). He conducts,
♦ Reporting of AFP cases.
♦ Collection of stool samples.
♦ Isolation of polio virus.
♦ Follow up of AFP case.
 If wild virus is identified than mop-up round of OPV is done in area
surrounding 10 K.M.
 AFP surveillance rate of > 1 per 100000 populations in children and < 15
years is indicator of good surveillance.
 If no new case of polio is reported for one year country is called “polio – free”
& if for 3 years it is called “polio – eradicated”. After achieving certificate of
polio eradication – IPV (injectable polio vaccine) is started & PPI is continued
for 3 years.
 In short we have adapted four prong strategies to eradicate polio.

High row
with OPV

Door Polio-free nce
India. Of

n In form of

After achieving polio free

Certificate *3 years = eradication.

PPI for 3
years &
Polio Intro
eradicated Of
India. IPV
[3.] Acute flaccid paralysis surveillance :-
 The term AFP means paralysis of acute onset involving limbs leading to
 Poliomyelitis is most important etiology of AFP others are –GBS (guillain –
barge syndrome), transverse myelitis , traumatic neuritis.
 AFP surveillance aims at defecting cases of AFP and reporting them
immediately to district immunization officer of area .
 After reporting workers come in 24 hours and collect two stool samples of
thumb size in sterile container and send them to central laboratory using
reverse cold chain system.
 Central does culturing and PCR of sample to identify virus.

No Vacci Wild
virus ne virus

Discard Confirm
ed, VAPP ed
No polio Vaccine Polio


Mop-up round
In surrounding

# immunization :-
 The induction of immune response by the deliberate inoculation of
appropriate immunogenic in form of vaccine is termed as active
 Types of vaccines available in India are:-
1) Live attenuated bacteria: BCG, S.typhiTy214.
2) Live attenuated virus: OPV, measles, mumps, rubella,
varicella(chicken pox).
3) Killed bacteria: B.pertusis, S.typhi, and V.cholera.
4) Killed virus: IPV, rabies, hepatitis A, Japanese encephalitis,
5) Toxoids: Tetanus, diphtheria.
6) Polysaccharide: Typhoid-virus, pneumococcal, meningococcal.
7) Protein conjugated: H.influenza B.
8) Viral subunit: Hepatitis.
All vaccines except polysaccharide induce complete immune
response-IgM, IgG antibodies cell mediated immunity and memory
cells. But polysaccharide antigens can only directly stimulate B-cells so
IgM, IgG and memory cells are not produced if given before age of 2

Universal immunization schedule :-

1) BCG: Birth or 6 weeks.
2) OPV: Birth 6, 10, 14 weeks, 16-18months.
3) DPT: 6, 10, 14 weeks, 16-18 months.
4) Measles: 9 month plus.
5) DT: 5 year.
6) TT: 10 year and 16 years.

Newer vaccines :-
1) Hepatitis B : 0, 1, 6 months
: 6, 10, 14 weeks.
2) Hib : 6, 10, 14 weeks, 16-18 months.
3) MMR: 15-18 months.
4) Typhoid: After 2 years.
5) Varicella: After 1 year single dose.
6) Hepatitis A: After 1 year.,- 2 doses – 6 month apart.
Now we will discuss primary vaccines:
BCG vaccines:
Bacillus of Chalmette and Guerin (BCG) vaccine is
Live vaccine obtained from the bovine strain of tubercle
In India it is produced at Guindy, Chennai.
a) Age of vaccination :
At birth or 6 weeks.
b) Site :
Intra dermal at middle of deltoid left upper arm.
c) Dose :
0.05 ml of BCG vaccine
d) Reaction :
Papules appears in 2 to 3 weeks after vaccinations and by
4th week grows in size and then subsides or ulcerates which
heals by 8 to 12 weeks leading to BCG scar.
e) Complication :
BCG site abscess
Axillary lymphedenopathy (also called BCG- adenines)
Oral polio vaccines :
Oral polio vaccine is live but attenuated virus.