The process of making a person resistant to an infectious disease, typically by the administration of a vaccine, is called immunisation. Most vaccines are dead or weakened antigens that stimulate an immune response in the person’s body and prevent them from subsequent disease or infection. They have been estimated to avert 2-3 million deaths every year. They are not only cost effective but can also be made accessible to hard-to-reach and vulnerable populations. The delivery of vaccines can be effectively managed through targeted outreach activities.
The Immunization programme in India was introduced in 1978 as the Expanded Programme of Immunization (EPI). It was further expanded as the Universal Immunization Programme in 1985. The UIP provides free vaccines against 11 life threatening diseases - Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and Meningitis due to Haemophilus Influenzae type b (Hib), Measles, Rubella, Japanese Encephalitis (JE) and Rotavirus diarrhoea. (Rubella, JE and Rotavirus vaccine in select states and districts)
A vaccination schedule is given by the State to enable timely immunization. A significant delay in vaccination can put children at a risk of serious diseases that can easily be prevented. The following immunization schedule recommended by the Ministry of Health, Government of India, is most widely followed by child healthcare providers across the country:
Vaccine |
When to give |
Maximum age |
Dose |
Route |
Site |
For Pregnant Women |
|
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Td -1 |
early pregnancy |
-- |
0.5ml |
Intra- muscular |
Upper arm |
Td -2 |
4 weeks after 1st dose of Td* |
-- |
0.5ml |
Intra- muscular |
Upper arm |
Td booster |
If received 2 Td doses in a pregnancy within the last 3yrs |
-- |
0.5ml |
Intra- muscular |
Upper arm |
For Infants |
|
||||
BCG |
At birth or as early as possible till 1 year of age |
At birth till one year |
0.1ml (0.05ml until 1month age) |
Intradermal |
Left Upper Arm
|
Hepatitis B - Birth dose |
At birth or as early as possible within 24 hours |
At birth within 24 hours |
0.5 ml |
Intra- muscular |
Antero-lateral side of mid-thigh |
OPV -0 |
At birth or as early as possible within first 15 days |
Within the first 15 days |
2 drops |
Oral |
Oral |
OPV -1,2,3, |
6 weeks, 10 weeks & 14 weeks |
Till 5 years of age |
2 drops |
Oral |
Oral |
fIPV 1 &2 |
6 weeks & 14 weeks |
1 year of age |
0.1 ml |
Intradermal |
Upper arm |
Pentavalent vaccine - 1, 2 & 3** |
6 weeks, 10 weeks & 14 weeks |
1 year of age |
0.5 ml |
Intra- muscular |
Antero-lateral side of mid-thigh |
RVV 1, 2 & 3 |
At 6 weeks, 10 weeks & 14 weeks |
1 year of age |
5 drops |
Oral |
Oral |
PCV 1, 2 & Booster |
At 6 weeks, 14 weeks & 9 months |
1 year of age |
0.5 ml |
Intra- muscular |
Antero-lateral side of mid-thigh |
MCV 1/ MR 1 |
9 completed months - to 12 months. Give up to 5yrs if not received at 9 - 12 months age |
5 years of age |
0.5 ml |
Sub- cutaneous |
Right upper arm |
Vitamin A (1st dose) |
At 9 completed months |
5 years of age |
1ml (1lakh IU) |
Oral |
Oral |
Japanese Encephalitis (1st Dose)*** |
At 9 completed months - 12 months |
15 years of age |
0.5 ml |
Sub- cutaneous |
Left Upper Arm |
For Children and Adolescents |
|
||||
DPT booster 1 |
16- 24 months |
7 years of age |
0. 5 ml |
Intra- muscular |
Antero-lateral side of mid-thigh |
MCV 2/ MR 2 |
16-24 months |
5 years of age |
0.5 ml |
Subcutaneous |
Right Upper arm |
OPV Booster |
16-24 months |
5 years of age |
2 drops |
Oral |
Oral |
Japanese Encephalitis***(if applicable) |
16-24 months |
15 years of age |
0.5 ml |
Sub- cutaneous |
Left Upper Arm |
Vitamin A(2nd to 9th dose) |
18 months (2nd dose). Then, one dose every 6 months upto the age of 5 years. |
5 years of age |
2 ml (2 lakh IU) |
Oral |
Oral |
DPT booster |
5- 6 years |
7 years of age |
0.5 ml |
Intra- muscular |
Upper arm |
Td |
10 years &16 years |
16 years of age |
0.5 ml |
Intra- muscular |
Up |
* Give Td-2 or Booster doses before 36 weeks of pregnancy. However, give these even if more than 36 weeks have passed. Give Td to a women in labour if, she has not previously received Td
Pentavalent vaccine** (containing Diphtheria+Pertussis+Tetanus+Hepatitis B+Hib)
*** JE vaccine at select endemic districts
The Under-5 Mortality Rate (U-5MR) in India is 37 for every 1000 births. One of the major causes for this are diarrhoeal deaths, a disease primarily caused by the rotavirus.
Pentavalent vaccines are a combination of DPT (diphtheria, Pertussis/whooping cough and tetanus), Hepatitis B and Hib vaccines. DPT and Hepatitis B vaccines which are already a part of the immunization programme are being replaced by the pentavalent vaccines in a phased manner. The pentavalent vaccines are administered intramuscularly in doses of 0.5 ml in the mid-thigh region.
The revised immunisation schedule, when pentavalent vaccines are introduced is as follows:
Vaccine |
Schedule |
BCG, Hep B birth dose, OPV-O |
At Birth |
Pentavalent (DPT + Hep B + Hib), OPV |
6 weeks, 10 weeks and 14 weeks |
Measles and Vitamin A |
9-12 months |
DPT booster, OPV booster, Measles2* |
16-24 months |
DPT booster |
5-6 years |
The Indian Academy of Pediatrics which is the largest organization of pediatricians in India endorses the National Immunisation Schedule. The committee has further supplemented the schedule with the Hepatitis B and the MMR (Measles, Mumps, & Rubella) vaccines. Even though Rubella might appear to be a mild illness, it can cause congenital defects in babies if the mother is not protected against Rubella and catches the infection during pregnancy. The schedule is as follows:
Age |
Vaccines |
Birth |
BCG, OPV 0, Hepatitis B -1 |
6 weeks |
IPV-1, DTwP-1, Hepatitis B -2, Hib -1, Rotavirus 1, PCV 1 |
10 weeks |
DTwP-2, IPV 2, Hib -2, Rotavirus 2, PCV 2 |
14 weeks |
DTwP-3 , IPV-3 , Hib -3, Rotavirus 3, PCV 3 |
6 months |
OPV 1, Hep B 3 |
9 months |
OPV 2, MMR-1 |
9-12 months |
Typhoid Conjugate Vaccine |
12 months |
Hep-A 1 |
15 months |
MMR 2, Varicella 1, PCV Booster |
16-18 months |
DTwP B 1 / DTaP booster -1, IPV B 1, Hib booster 1 |
18 months |
Hep-A 2 |
2 years |
Booster of Typhoid Conjugate Vaccine |
4 - 6 years |
DTwP B 2 / DTaP booster -2, OPV 3, MMR 3, Varicella 2, |
10 - 12 years |
Tdap / Td, HPV (Only for females, three doses at 0, 1-2 and 6 months |
BCG: Bacillus Calmette Guerin
OPV: Oral poliovirus vaccine
DTwP: Diphtheria, tetanus, whole cell Pertussis
DT: Diphtheria and tetanus toxoids
TT: Tetanus toxoid
Hep B: Hepatitis B vaccine
MMR: Measles, Mumps and Rubella Vaccine
Hib: Haemophilus influenzae Type ‘b’ Vaccine
IPV: Inactivated poliovirus vaccine
Td: Tetanus, reduced dose diphtheria toxoid
HPV: Human Papillomavirus Vaccine
PCV: Pneumococcal Conjugate Vaccine
TdaP: Tetanus and Diphtheria Toxoids and aCellular Pertussis Vaccine
The Immunization schedule recommended by the WHO is as follows:
The cross below the age (in weeks) table indicates when the vaccine should be given.
Vaccine |
Schedule when vaccine is to be give |
||||||
|
Birth |
6 weeks |
10 weeks |
14 weeks |
9-12 months |
||
Primary vaccination |
|||||||
BCG |
X |
|
|
|
|
||
Polio |
X |
X |
X |
X |
|
||
DTP |
|
X |
X |
X |
|
||
Hepatitis B* |
|
X |
X |
X |
|
||
Rotavirus |
|
X |
X |
X |
|
||
Haemophilus influenzae type b |
|
X |
X |
X |
|
||
Pneumococcal (Conjugate) |
|
X |
X |
X |
|
||
Measles |
|
|
|
|
X |
||
Rubella |
|
|
|
|
X |
Access to health insurance and access to vaccines in accordance with the National Immunization Schedule is imperative for every child in our society. Comparing the number of policies before going with any one of them is a prudent decision during such times as some plans may be better suited for your needs than others. The Health Insurance plans available on the Finserv MARKETS could be the right choice for you. Through such a plan, you can ensure that all the medical expenses that usually come with raising a child are taken care of.
Immunization is a method of providing artificial immunity against antigens by the means of vaccines. Vaccines stimulate an immune response in the body which results in the formation of antibodies that would fight against diseases if our body encounters the same antigens in the future.
A person has some innate immunity at birth and gets some natural immunity from the mother and through breastfeeding. However, this is not enough to tackle infectious and potentially fatal diseases. Artificial vaccines help in the prevention of various serious illnesses which could deter a child's development or even result in death.
At rare occasions vaccination might have some side effects such as pain at the site of injection or a mild fever. The DPT (Diptheria, Pertussis & Tetanus) vaccine shows such side effects while measles like rashes may develop after the administration of a measles vaccine. Some vaccines might also result in allergic reactions in babies. If a baby develops high fever or a loss of consciousness upon being vaccinated, a doctor should be immediately consulted. A timely treatment will result in complete recovery of the child.
Common illnesses like cold and diarrhea are not impediments against getting a child vaccinated. However there are some conditions where a doctor should be consulted before administering a vaccine. They are enlisted below:
The child has a high fever
S/He has had a bad reaction to another immunization
S/He has had a severe reaction after eating eggs
The child had a convulsion (fits) in the past. (With the right advice, children who have had fits in the past can be immunized)
S/He has had, or is having, treatment for cancer
An illness which affects the immune system, for example, HIV or AIDS
The child is taking a medicine which affects the immune system, for example, immunosuppressants or high-dose steroids.
Vaccines undergo extensive trials and tests to ensure safety. They are made available to the public only after these tests have been successfully conducted and the vaccines are found to be safe. Even after the launch of a vaccine, it is periodically assessed and actions are taken if needed.
DPT1, OPV-1, Measles and 2ml of Vitamin A solution should be given to the child. The 2nd and 3rd doses of the DPT and OPV vaccine should then be administered at one month intervals till the child is 2 years of age. Booster doses of the vaccines can be given at a minimum age of 6 months after the OPV3/DPT3 vaccines have been administered.
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