All about National Immunization & Schedule Delayed Immunization
Mar 31, 2023
As a doctor it is critical that you are well versed in immunization knowledge. Information regarding Immunization techniques, shots, schedules and others should be on the tip of your tongue.
In this blog post we are going to learn about National Immunization and Schedule Delayed Immunization, which is an important topic for PSM.
NIS- National Immunization Schedule
Beneficiaries of NIS: Birth to 16 years
At birth
BCG, OPV0, HepB
6 weeks
OPV1, RV1, Penta1, fIPV1, PCV1
10 weeks
OPV2, RV2, Penta2, - , -
14 weeks
OPV3, RV3, Penta3, fIPV2, PCV2
9 completed months (Vit A drops also given)
MR1, JE1, PCV booster, fIPV3
16-24 months
MR2, JE2, OPV booster, DPT 1st booster
5-6 years
DPT 2nd booster
10 years
Td1
16 years
Td2
Highlighting point
OPV0 → 0 means birth dose
Order of giving vaccine at birth - BCG, OPV , Hepatitis B
fIPV → 1/5th of IPV full dose
PCV - Pneumococcal conjugate vaccine
JE - Japanese encephalitis
Important information
Introduction of third dose of FIPV from 1st january,2023
What will be the number of doses of fIPV to be given from 1st January ,2023?
3 doses at 6 weeks, 14 weeks and 9 completed months
At 6 weeks,14 weeks - 0.1 ml ID right upper arm
At 9 months - 0.1 ml ID left upper arm
(as MR vaccine is given at right upper arm)
VIT A drops
9 completed months- 1 ml or 1 L IU
Thereafter every 6 months till 5 years of age - 2 ml or 2L IU
Important information
What is the total number of doses of Vit A?
9
What is the total dose of Vit A given?
17 L IU
Routes of vaccines
ORAL
ID - O.1 ml
Angle- 10-15 degree
S/C - 0.5 ml
45 degree
IM - 0.5ml
90 degree
OPV - 2 drops
BCG - 0.05 ml upto 1 month
After 1 month till 1 year - 0.01 ml
Site - left upper arm
9 completed months -
MR - right upper arm
‘t’ series vaccine
Letter t in it
Hepatitis B
Pentavalent
DPT (upto 1st booster)
Anterolateral aspect of left thigh
Rotavirus Vaccine - 5 drops
fIPV- ⅕ of full dose - 0.1ml
Site- right upper arm
fIPV3- left upper arm
JE - left upper arm
JE only in endemic areas
PCV - right thigh
To remember
2 drops of polio can save life Rotavirus - associated with diarrhea - 5 drops After 5 years absorption from leg decreases so DPT2nd booster given in either of upper arm
BCG (golden points)
BCG scar takes 8-12 weeks to form
It can also be given on right upper arm
Left upper arm has been taken for uniformity in the country for proper identification
BCG vaccine offers no protection from pulmonary TB , it protects against extrapulmonary TB
BCG scar not present not necessarily means that the child is not vaccinated so you need not revaccinate
Direct BCG v/s indirect BCG
BCG vaccine till 1 year can be given directly
No need to perform tuberculin test
BCG vaccine after 1 year will be given only after performing tuberculin test called indirect BCG
Beneficiaries of NIS: Pregnant women
Primi- pregnant for first time Or
Multi with last childbirth more than 3 years ago
2 doses of Td vaccine
First dose - as soon as possible
Second dose - 4 weeks or 28 days later
Multi with last childbirth less than 3 years ago
Booster dose of td vaccine around 7th month of pregnancy
Q. A 26-year-old primigravida in her second trimester presented to the hospital to take her Td dose. Which of the following is true regarding Td dose in pregnancy?
1 dose in 2nd trimester
2 doses (1 month apart) in second trimester
1 dose anytime as soon as possible in pregnancy
2 doses (1 month apart) as soon as possible in pregnancy
Q. Zero dose of polio vaccine is given
Within 24 hrs of birth
At birth
At 6 weeks
When child suffers from polio
Q. Dose of vitamin A administered at 16 months
5000 IU
1 lac IU
2 lac IU
1.5 lac IU
Q. You are posted at a PHC and you have to ensure that the routine vaccination process is carried out smoothly. All o the vaccines are given at 16-24 months except:
DPT booster
OPV booster
Japanese encephalitis 2nd dose
PCV booster
Delayed Immunization
OPV birth dose can be given till 15 days
Hepatitis B- birth dose given till 24 hours
Vaccines that can be given upto 1 year -
BCG
Rotavirus Vaccine
Pentavalent
fIPV
PCV
Hepatitis B vaccine alone can also be given till 1-year
Vaccines that can be given upto 5 years
OPV
Measles vaccine
MR vaccine
Vit A drops
Vaccines that can be given upto 7 years
DPT
Vaccines that can be given upto 15 years
JE
Note
Td can be given lifelong
Q. An 18 months old unvaccinated child comes to the PHC for the first time. Vaccines to be given include:
OPV, DPT
Pentavalent vaccine
BCG, OPV
BCG,OPV, MMR, Pentavalent
Tuberculin vs Insulin Syringe
Tuberculin syringe has (0.1ml to 1 ml) markings
Insulin syringe has units 10 to 100 units
There is no interchangeability between the syringes
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