Spotters in "National Immunization Schedule (NIS) " for CFM & MPH students

-

For Infants & Children:

1. Vaccine: BCG


Important points:

  • Type: Live bacterial, lyophilized
  • Strain: Bovine strain Danish-1331
  • When to give: At birth or as soon as possible after birth.
  • Maximum age: Till one year of age.
  • Dose: 0.05 ml until one month, 0.1 ml beyond the age of one month.
  • Diluent: Yes, Sodium chloride (Manufacturer-supplied).
  • Route: Intra- dermal (ID).
  • Site: Upper Arm - LEFT.
  • Booster dose: Not required.
  • Contraindications: Symptomatic HIV infection, Pregnancy, Radiation therapy (i.e. total-body radiation).
  • Possible minor adverse reaction: Local reaction (pain, swelling, redness).
  • Expected Frequency: Common.
  • Rare vaccine reactions: Suppurative lymphadenitis (2-6 months), BCG osteitis (1-12 months), Disseminated BCG infection (1-12 months).
  • Storage: +2 to +8 degree C; Unused reconstituted vaccine should be discarded after 6 hours or at the end of session whichever is earlier. Protect the vaccine from direct sunlight.
  • Note: There is no need to revaccinate the child if a scar is not formed after BCG vaccination.
  • Protective value: 15 to 20 years, up to 80%.

2.  Vaccine: Hepatitis B

Important points:

  • Type: Monovalent antigen, subunit genetically engineered plasma-derived vaccine (PDV).
  • Composition: 20 mcg of 22 nm surface antigen particles (HbsAg) per ml.
  • When to give: Birth dose- At birth or as early as possible.
  • Maximum age: Within 24 hours as it helps to prevent perinatal transmission of Hepatitis B.
  • Dose: 0.5 ml
  • Diluent: No
  • Route: Intramuscular 
  • Site: Antero-lateral side of mid-thigh-LEFT
  • Contraindications: Current serious illness.
  • Possible minor adverse reaction: Local reaction (pain, swelling, redness), Fever.
  • Expected frequency: Adults up to 30%, Children up to 5%. 
  • Rare vaccine reactions: Anaphylaxis (0-1 hour).
  • Storage: +2 to +8 degree C, Never freeze.
  • Protective value: Over 95% for 5 years.


3.  Vaccine: OPV



Important points:

Type: Live Bivalent

OPV-0: 

  • When to give: As early as possible.
  • Maximum age: within the first 15 days.
  • Dose: 2 drops
  • Diluent: No
  • Route: Oral

OPV-1, 2 & 3: 

  • When to give: 6, 10 & 14 weeks.
  • Maximum age: Up to 5 years of age.
  • Dose: 2 drops
  • Diluent: No
  • Route: Oral
OPV booster:
  • When to give: 16-24 months.
  • Maximum age: Up to 5 years of age.
  • Dose: 2 drops
  • Diluent: No
  • Route: Oral

Possible minor adverse reaction: None

Rare vaccine reactions: VAPP

Storage: +2 to +8 degree C, may be frozen for a long duration.

Protective value: Lifetime


4.  Vaccine: IPV

Important points:

  • When to give: At 14 weeks.
  • Maximum age: Up to one year of age.
  • Dose: 0.5 ml
  • Diluent: No
  • Route: Intra- muscular 
  • Site: Antero-lateral side of mid-thigh-RIGHT
  • Possible minor adverse reaction: None


5.  Vaccine: Rotavirus

Important points:

  • When to give: At 6, 10 & 14 weeks.
  • Maximum age: Up to one year of age.
  • Dose: 5 drops.
  • Diluent: No
  • Route: Oral
  • Storage: +2 to +8 degree C.
  • Protective value: 80%
  • Rotavirus vaccine is being introduced in phases.

6.  Vaccine: Pentavalent

Important points:

  • It contains a combination of DPT, Hepatitis B & Hib.
  • Pentavalent vaccine is introduced in place of DPT and Hep B 1, 2 & 3 .
  • When to give: At 6, 10 & 14 weeks.
  • Maximum age: Up to one year of age.
  • Dose: 0.5 ml
  • Diluent: No
  • Route: Intra-muscular
  • Site: Antero-lateral side of mid-thigh-LEFT
  • Storage: +2 to +8 degree C.
DPT booster-1:
  • When to give: 16-24 months. 
  • Maximum age: Up to 7 years of age.
  • Dose: 0.5 ml 
  • Diluent: No
  • Route: Intra-muscular
  • Site: Antero-lateral side of mid-thigh-LEFT
DPT booster-2:
  • When to give: 5-6 years. 
  • Maximum age: Up to 7 years of age.
  • Dose: 0.5 ml 
  • Diluent: No
  • Route: Intra-muscular
  • Site: Upper arm-LEFT
TT:
  • When to give: 10 years & 16 years. 
  • Dose: 0.5 ml 
  • Diluent: No
  • Route: Intra-muscular
  • Site: Upper arm.
  • Storage: +2 to +8 degree C, never freeze.
  • Note: Td - Tetanus diphtheria to replace TT - to be added in schedule.

7.  Vaccine: Measles

Important points: 

1st dose:

  • When to give: 9-12 completed months.
  • Maximum age: Up to 5 years of age.
  • Dose: 0.5 ml
  • Diluent: Sterile water
  • Route: Subcutaneous
  • Site: Right upper arm

2nd dose:

  • When to give: 16-24 months.
  • Maximum age: Up to 5 years of age.
  • Dose: 0.5 ml
  • Diluent: Sterile water
  • Route: Subcutaneous
  • Site: Right upper arm
  • Storage: +2 to +8 degree C, may be frozen during long storage.
  • Protective value: Lifetime.

Contraindications: Pregnancy, Radiation therapy.

Possible minor adverse reaction: Local reactions (pain, swelling, redness); irritability, malaise & non-specific symptoms.

Rare vaccine reactions: Febrile seizures

Note:  MR vaccine introduced in phases replacing measles vaccine in the UIP schedule. If first dose delayed beyond 12 months ensure minimum one month gap between 2 MR doses.

8.  Vaccine: JE

Important points:

1st dose:

  • When to give: 9-12 completed months.
  • Maximum age: Up to 15 years of age.
  • Dose: 0.5 ml
  • Diluent: Phosphate buffer 
  • Route: Subcutaneous
  • Site: Left upper arm

2nd dose:

  • When to give: 16-24 months.
  • Dose: 0.5 ml
  • Diluent: Phosphate buffer 
  • Route: Subcutaneous
  • Site: Left upper arm
  • Storage: +2 to +8 degree C.
  • Protective value: About 3 years.

Possible minor adverse reaction: Local reactions, Low-grade fever, myalgia, gastrointestinal upset.

Rare vaccine reactions: Neurologic events (encephalitis, encephalopathy, peripheral neuropathy).

Note: JE vaccine has been introduced in select endemic districts. If first dose is delayed beyond 12 months ensure minimum 3 months gap between 2 JE doses.

9.  Vaccine: Vitamin A

Important points:

1st dose:

  • When to give: At 9 completed months with measles.
  • Maximum age: Up to 5 years of age.
  • Dose: 1 ml (1 lake IU)
  • Diluent: No
  • Route: Oral

2nd-9th dose:

  • When to give: At 16 months, then one dose every 6 months.
  • Maximum age: Up to 5 years of age.
  • Dose: 2 ml (2 lake IU)
  • Diluent: No 
  • Route: Oral 
  • The 2nd to 9th doses of Vitamin A can be administered to children 1-5 years old during biannual rounds, in collaboration with ICDS.


For pregnant women:

10.  Vaccine: TT

Important points:

1st dose:

  • When to give: Early in pregnancy. 
  • Dose: 0.5 ml
  • Diluent: No 
  • Route: Intra-muscular
  • Site: Upper arm

2nd dose:

  • When to give: 4 weeks after TT-1.
  • Dose: 0.5 ml
  • Diluent: No 
  • Route: Intra-muscular
  • Site: Upper arm
3rd dose:
  • When to give: If received TT doses in pregnancy within the last 3 years.
  • Dose: 0.5 ml
  • Diluent: No 
  • Route: Intra-muscular
  • Site: upper arm

Possible minor adverse reaction: Local reactions (pain, swelling, redness); malaise & non-specific symptoms.

Rare vaccine reactions: Brachial neuritis, Anaphylaxis. 

Note: Give TT-2 or Booster doses before 36 weeks of pregnancy. However, give these even if more than 36 weeks have passed. Give TT to a woman in labor, if she has not previously received TT.

References:

  1. Park, K. (2019). Park's textbook of preventive and social medicine. 25th. Jabalpur, India: M/S Banarsidas Bhanot.
  2. Kadri AM. (2019). IAPSM's Textbook of Community Medicine. 1st. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd.
  3. https://www.indiamart.com/proddetail/bcg-vaccine-5068383112.html photo credit
  4. https://www.gponline.com/journals-watch-bcg-vaccine-exercise/article/1104980 photo credit
  5. https://mvec.mcri.edu.au/references/bcg-vaccine/ photo credit
  6. https://www.quora.com/Whats-the-full-form-of-BCG photo credit
  7. https://www.indiamart.com/proddetail/hepatitis-b-vaccine-injection-12423014588.html photo credit
  8. https://www.indiamart.com/proddetail/hivac-b-hepatitis-b-vaccine-13778965697.html photo credit
  9. https://www.who.int/immunization_standards/vaccine_quality/vvm_use_availability_7sep10.pdf photo credit
  10. https://www.indiamart.com/proddetail/oral-polio-vaccine-15626476573.html photo credit
  11. https://polioeradication.org/polio-today/polio-prevention/the-vaccines/opv/ photo credit
  12. https://zeenews.india.com/news/health/health-news/inactivated-polio-vaccine-ipv-a-new-tool-in-the-fight-against-polio-watch-to-know-more-about-it_1880645.html photo credit
  13. http://edithzikpi.blogspot.com/2018/06/inactivated-polio-vaccine-introduced.html?m=1 photo credit
  14. https://www.who.int/immunization_standards/vaccine_quality/PQ_184_bOPV13_GSK_10_dose/en/ photo credit
  15. https://health.economictimes.indiatimes.com/news/pharma/sii-invents-the-first-ever-heat-stable-rotavirus-vaccine-in-the-world-rotasiil/70712802 PHOTO CREDIT
  16. https://www.cdc.gov/vaccines/vpd/rotavirus/index.html PHOTO CREDIT
  17. https://www.indiamart.com/proddetail/rota-virus-vaccine-10369163588.html photo credit
  18. https://www.congruentpharmaceutical.com/rotavac-5032209.html photo credit
  19. https://www.downtoearth.org.in/tag/world-immunisation-week photo credit
  20. https://en.vietnamplus.vn/pentavalent-vaccine-combe-five-to-be-used-nationwide/143808.vnp photo credit
  21. http://vbch.dnh.nic.in/pdf/penta.pdf photo credit
  22. https://abcnews.go.com/Health/number-measles-cases-1000-us-time-eradication/story?id=63606750 photo credit
  23. https://abcnews.go.com/Health/number-measles-cases-1000-us-time-eradication/story?id=63606750 photo credit
  24. https://www.who.int/immunization_standards/vaccine_quality/pq266_je_1dose_biologicale/en/ photo credit
  25. https://www.empr.com/home/news/fda-approves-accelerated-vaccination-schedule-for-ixiaro/ photo credit
  26. https://www.indiamart.com/proddetail/pharma-jenvac-7555738812.html photo credit
  27. https://www.path.org/articles/how-once-little-used-vaccine-now-protects-millions-japanese-encephalitis/ photo credit
  28. https://blogs.unicef.org/evidence-for-action/vitamin-supplements-can-save-childs-life/ photo credit
  29. https://www.jaypeedigital.com/eReader/chapter/9789351527794/ch3 photo credit
  30. https://www.indiamart.com/proddetail/tt-vaccine-14701227955.html photo credit
  31. https://www.historyofvaccines.org/index.php/content/tetanus-toxoid-india photo credit


Comments

Post a Comment

Popular posts from this blog

Design equations of Rectangular Microstrip Patch Antenna

-
Image
Following design equation can be used to calculate the width and length of rectangular microstrip patch antenna and simulation of 2.4 GHz inset-feed rectangular patch antenna can be found in follwing video.  Microstrip antenna with inset-feed line                           Part-1 Design step for the calculation of W and L Step-1 : To calcualte width 'W' use follwing formula Step-2:   Calculate the effective dielectric constant using formula below. Here    ' ε r '  is relative  dielectric constant of the material. 'h' is height of the substrate and W is the width of patch calculated in first step. Step-3:   Calculate ΔL using formula below. Step-4:   Calculate length of the patch using formula below. v 0    is speed of light in free space. Part-2 Feedline calculation Step-1:   Calculate the input impdedance of the patch using follwing formula. (Typically between 200  Ω  to 250  Ω. You can assume 225  Ω for simplic
Read more

ORS : A boon in dehydration

-
Image
What is ORS? Oral re-hydration salts: It is a glucose-electrolyte formula given by WHO/UNICEF, used for correction of acute diarrhea due to all causes and dehydration in all age groups with aim to reduce mortality. It is available in powder form in sachets/ ready-made solution or it can be easily made at home. How it works? The combination of electrolytes and sugar together stimulates water and electrolyte absorption from the gut and hence  capable of correcting water and electrolyte deficit in conditions such as diarrhea and vomiting. Reasons to celebrate ORS day? ORS Day is celebrated every year on 29th July:  To spread awareness about the importance of Oral Rehydration Salts (ORS) as a low cost method of health intervention.   Among infants and young children, acute diarrhoeal diseases are one of the leading causes of mortality in many developing countries.   Dehydration particularly affects infants, children and old people.  Diarrhea normally lasts for several days, and leaves the
Read more

Spotters in "Environment and Health: Insecticides" for CFM & MPH students

-
Image
Insecticides:   These are substances that are used to kill insects.  Pesticides:   It is a general term that includes  insecticides, fungicides rodenticides, herbicides,  disinfectants, repellents, and other chemicals used for the  control of pests. Insecticides are classified into 3 groups: Contact  poisons, Stomach poisons and Fumigants.  CONTACT  POISONS: These are those insecticides that kill insects primarily by contact  e.g., pyrethrum, DDT, HCH, dieldrin.  STOMACH POISONS: These  are those insecticides which when ingested cause the death of the  insects, e.g., Paris green, sodium fluoride.  FUMIGANTS: These are  those insecticides that give off vapours that have a lethal effect on  the insects, e.g., sulphur dioxide. 1. DDT  (Dichloro-diphenyl-trichloroethane) :  It was first  synthesized in 1874, by a German chemist, Ziedler . I ts insecticidal properties were discovered by the Swiss  scientist, Paul Muller in  1939 .  Important points: PROPERTIES: It is a white  amorphous
Read more

Spotters in "Environment and Health: Mosquito control Measures" for CFM & MPH students

-
Image
The integrated approach of mosquito control: This is an approach that avoids the excessive use of any one method (e.g insecticides) but tries to combine one or more methods with a view to obtain maximum results with minimum inputs and also to prevent environmental pollution with toxic chemicals & development of insecticide resistance. The various methods of mosquito control are as follows: 1. Anti- Larval Measures: (a) Environmental Control: Important Points: Source reduction : Mainly the elimination of mosquito breeding places by minor engineering methods such as  Filling- of cesspools & open ditches and arrangement for adequate collection, removal, and disposal of sewage & wastewater. Leveling & getting rid of water-holding containers such as discarded tins, empty pots, broken bottles, coconut shells, etc. Drainage of breeding places, and  Water management (e.g intermittent irrigation) & removal of aquatic plants or destruction by herbicides. Rendering the water u
Read more

Spotters in "Hospital Waste Management" for CFM & MPH students

-
Image
 As per “Bio-medical Waste Management Rules, 2016”  1. Yellow Bin/ Bag: Type of Bag/  Container used:  Non-chlorinated  plastic bags Type of Waste:  1. Human Anatomical Waste A. Tissues, organs, body parts B. Foetus, Umbilical stump, placenta 2. Animal Anatomical Waste:  Tissues, Organs, body parts 3. Soiled Waste:  items contaminated with blood and body fluids A. Dressings, sponges, gauze B. Plaster casts C. Cotton swabs D. Blood bags E. Infected gowns, mask, shoe covers, cap 4.  Expired or Discarded  Medicines:   including antibiotics (except cytotoxic) 5. Chemical Waste: A. Discarded disinfectants, Cleaning agents B. X-ray film developing liquid, Infected secretions C. Aspirated body fluids, Liquid from laboratories 6. Microbiology, Biotechnology, and other clinical  lab waste 7. Chemical Liquid Waste Yellow bin/ bag with the cytotoxic label: 1. Used, discarded, and expired cytotoxic drugs whether in plastic vaccutainers, syringes, glass  vials, ampoules, glass bottles. The containe
Read more

Spotters in "Environment and Health: Mosquitoes- Anopheles" for CFM & MPH students

-
Image
Anopheles Mosquito: Also known as the sophisticated mosquito. The flight range is 3-5 km. Around 45 species of anopheles mosquitoes have been found in India but only a few of them have been incriminated as vectors or carriers of malaria. These are An. fluviatilis & An. minimum (foot-hill regions), An. sundaicus & An. stephensi (coastal regions) and An culicifacies & An. philippinensis (planes). 1. Eggs: Important points: Eggs laid on the surface of the clean water. 100-250 at a time. This stage lasts for 1-2 days. Laid singly, boat-shaped & possess lateral floats. 2. Larva: Important points: The larva is a free-swimming creature. Passes through 4 stages called ' instars ' with moulting between each stage. Floats horizontally in water/ rests parallel to the water surface. No siphon tube at the tip of its abdomen.  Palmate hairs present on abdominal segments. 3. Pupa: Important points: The pupa is comma-shaped in appearance, with a large rounded cephalothorax and
Read more

National Nutrition Week: Healthy diet for Adolescents

-
Image
  Who are Adolescents? As per WHO Adolescents are persons in age group 10-19 years & constitute about 1/4th of India's population. What is the need? Adolescents undergo rapid changes in body size, physiology, psychology & social functioning as it is a transition from childhood to adulthood. It is a phase of rapid growth & development hence nutritional needs vary for them & needs to be taken care. When National Nutrition Week is celebrated? 1st to 7th September every year in India to focus on various aspect of Nutrition among all age groups. What should be included in diet? Grains: 4 - 8 bowls Vegetables: at least 3 servings Fruits: at least 2 servings Meat, fish, egg and alternatives: 200 - 300 gm Milk and alternatives: 2 servings Fat/oil, salt and sugar : eat the least Fluid: 6 - 8 glasses Healthy points for adolescent girls: The menstruation related needs of the girls make the nutrient requirement/ unit body weight more than boys for them Build strong bones:
Read more