Professional Documents
Culture Documents
DR HARIVANSH CHOPRA
DCH.,MD.
PROFESSOR
COMMUNITY MEDICINE
LLRM MEDICAL COLLEGE ,MEERUT
harichop@gmail.com
OBJECTIVES
To study
Cold chain
VVM
FAQs on immunization
Management of anaphylaxis
Vaccine coverage in NFHS
PRIMARY VACCINATION FAILURE
ILR (LARGE) +2°C - +8°C BCG, DPT, DT, TT, At 43°C for 62 Hrs
Measles, Hep-B, Vaccine At 32°C for 78Hrs
stock for 3 months
(60000 doses)
Deep Freezer -15°C - -25°C 100 ice packs At 43°C for 18 Hrs
At 32°C for 22Hrs
ILR (Small) +2°C - +8°C BCG, OPV, DT, DPT, TT, At 43°C for 62 Hrs
Measles, Hep-B, vaccine At 32°C for 78 Hrs
stocks for one
month(25,000 doses)
EQUIPMENT TEMPERATURE STORAGE CAPACITY HOLD OVER TIME
Cold Box (Large) +2°C - +8°C All vaccines stored for At 43°C for 6.5 days
transport or in case of At 32°C for 10 days
power failure (6000 doses
of mixed antigen with 50
ice-packs/72-96 icepacks)
Cold Box (Small) +2°C - +8°C All vaccines stored for At 43°C for 6.5 days
transport or in case of At 32°C for 10 days
power failure (1500 doses
of mixed antigen with 24
ice-packs/36 ice-packs)
Vaccine carrier (1.7 litres) +2°C - +8°C All vaccines carried for 12 At 43°C for 34 Hrs
hours (4 ice packs & 16-20 At 32°C for 51Hrs
vials)
Vaccine Vial Monitor
A- this is
because some
of the live
component of
the vaccine are
killed if they
come in contact
with spirit.
Q- if a child could not receive DPT1,2, 3 & OPV 1, 2 , 3
according to the schedule , upto what age can the
vaccine be given ?
A- this is because
decreasing the interval
between two doses may
not obtain minimal
antibody production for
protection.
Why are the DPT, HepB (birth dose),
IPV and pentavalent vaccines given
in the anterolateral mid-thigh and
not the gluteal region (buttocks)?
- To prevent damage to
the sciatic nerve.
Moreover, the vaccine
deposited in the fat of
gluteal region does not
invoke the appropriate
immune response.
Q-What should one do if the child found allergic to DPT
or develop encephalopathy after DPT ?
A- as pertussis cases
were reported in higher
age group children and
the risk of AEFIs were
not found to be more
after DPT vaccine as
compared to DT
vaccine.
Q-why give the measles vaccine only on the right
upper arm ?
A- to maintain the
uniformity and to
help surveyors in
verifying the receipt
of the vaccine.
Q- If the child receive the measles vaccine before 9 month of
age , is it necessary to repeat the vaccine later ?
A- to maintain
uniformity and for
helping surveyor in
verifying the receipt
of the vaccine.
Q- why do give 0.05 ml dose of vaccine to newborn ?
A- because skin of
newborns is thin and an
intra-dermal injection of
0.01 ml may break the
skin or penetrate into
the deeper tissue and
cause local abscess and
enlarge axillary lymph
node. Dose of 0.05 ml is
sufficient to elicit
adequate protection.
Q- Why BCG is given only up to one year of age ?
A- there is no
need to
revaccinate
the child.
Q- till what age can a child be given OPV ?
A- yes
Q- Can an infant be breast fed Immediately after OPV ?
A- yes
Q- If a girl has received all doses of DPT and TT as per
NIS till 16 years of age & she get pregnant at 20 years of
age, should she get one dose of TT during pregnancy ?
A- NO it is
to be
given to
both boys
and girls .
Q- Can TT given in the first trimester of pregnancy ?
A- Yes, it should be
given as soon as
pregnancy is
diagnosed.
What is the “birth dose” of hepatitis
B?
This refers to the
dose given within
24 hours of birth.
A child vaccinated
with Hep B after
more than 24
hours of birth is
not considered to
have received the
birth dose.
Why is hepatitis B vaccine given only till 1 year of age?
The upper age limit for the first dose of Rotavirus vaccine is one
year of age. If a child has received only the first dose of Rotavirus
vaccine by 12 months of age, two more doses of the vaccine
should be given at an interval of 4 weeks between the two doses
to complete the course.
Should Rotavirus vaccine be given to children who have
already received first dose of OPV
and Pentavalent vaccine?
If the parents want to vaccinate their child from the public sector
after receiving one or two doses of Rotavirus vaccine in a private
facility, a new course of Rotavirus vaccine must be started with all
three doses at one month intervals provided the child is less than
one year old
What is IPV?
No, IPV (injection) will not replace OPV (polio drops), since
IPV is recommended to be administered in addition to
OPV.
Are there any contraindications for use of
IPV?
80 NFHS I
71.6
70 65.1 62.8
NFHS II
62.2
Percentage 60 51.7 53.6
50.7
50 42.2 42
40 35.5
30
20
10
0
BCG DPT 3 OPV 3 Measles All
doses doses Vaccines
Immunization Coverage
78.2 78.2
80 NFHS II
71.6
70 NFHS III
62.8
58.8
60 55.1 55.3
Percentage 50.7
50 42 43.5
40
30
20
10
0
BCG DPT 3 OPV 3 Measles All
doses doses Vaccines
CONCLUSION
Immunization is the second best cost effective public health
intervention.
It is important to remember the national immunization schedule
As well as exception associated with it.
Maintenance of cold chain is essential to produce desired
immunity
Each one of us must practice immunization for the benefit of the
community and country.
harichop@gmail.com 6/19/2019 85
MCQ
Q1- Which of the following statements regarding
live vaccine is false-
Ans -a
Q2- Most heat sensitive vaccine is –
( a)- BCG
(b)- Polio
(c)- Measles
(d)-DPT.
Ans - b
Q 3- the efficacy of cold chain system for oral polio vaccine as
monitored by VVM depends on-
(a) change in color of vaccine.
(b) temperature indicator of the system
(c) Viral potency test.
(d) change in color of monitor.
Ans - d
Q 4- Which is true about BCG-
(a)- Distilled water is used as diluent.
(b)- site of injection is cleaned with spirit.
(c)- mantoux test positive in 6 weeks
(d) WHO recommends Danish 1331 for vaccine production.
ANS- D
Q5- In national immunisation programme, total number of
OPV dose is-
(a)-3 (b)-4
(c)- 5 (d)-6
Ans - c