Universal Immunization Programme

National Immunization Schedule

Introduction of Vaccines under UIP

2023
3rd dose of
fIPV
 Diseases Targeted under UIP

Name of Vaccine Disease

BCG Tuberculosis
Hep. B Hepatitis – B
Diphtheria, Pertussis, Tetanus, Hepatitis B,
Pentavalent
H. influenzae type B associated meningitis and Pneumonia
OPV & IPV Poliomyelitis
RVV Rota virus diarrhea
Measles Rubella containing vaccine Measles & Rubella
DPT Diphtheria, Pertussis and Tetanus
JE Japanese Encephalitis
Td Tetanus & Diphtheria
PCV Pneumococcal disease
 National Immunization Schedule for Pregnant Women
Vaccine When to give Max age Dose Diluent Route Site

Td-1 Early in Give as early 0.5 ml NO Intramuscular Upper Arm

pregnancy as possible
in pregnancy
Td-2 4 weeks after 0.5 ml NO Intramuscular Upper Arm
Td-1
Td- Booster If received 2 0.5 ml NO Intramuscular Upper Arm
Td doses in a
pregnancy
within the last
3 yrs.

Give Td 2 or Booster before 36 weeks of pregnancy;

Give Td even in labour if previously not received Td
 National Immunization Schedule for Newborn

Vaccine When to give Max age Dose Diluent Route Site

0.05ml till 1
month,
0.1 ml Sodium Left Upper
BCG At birth 1 yr from 1 Intra-dermal Arm
Chloride
month to 1
year
Hepatitis B – Within 24 Intra- Antero-
Birth dose At birth 0.5 ml NO muscular lateral side
hrs of birth of mid-thigh

OPV-0 At birth Within 15 2 drops Oral Oral

NO
days of birth
 National Immunization Schedule for Infants
Site
Vaccine When to give Max age Dose Diluent Route

bOPV 1,2 & 3 At 6, 10 & 14 2 drops NO Oral Oral

weeks 5 yrs
Initiation - 1 yr
Rotassil At 6, 10 & 14 Completion – 1 Ampoule NO Oral Oral
Vaccine 1,2, 3 weeks 2 yrs (2ml)
Initiation - 1 yr Right Upper Arm
f-IPV 1, 2 & 3 At 6, 14 weeks Completion – 0.1 ml NO Intra- (1 & 2 doses)
& 9 months 2 yrs dermal Left upper arm
(3rd dose)
At 6, 14 weeks Initiation - 1 yr
PCV 1,2 & & Booster at 9 Completion – Intra- Antero-lateral side
Booster months age 2 yrs 0.5 ml NO muscular of Right mid-thigh

Pentavalent At 6, 10 & 14 Initiation - 1 yr 0.5 ml NO Intra- Antero-lateral side

1,2 & 3 weeks Completion – muscular of Left mid-thigh
2 yrs
 National Immunization Schedule for Children

Site
Vaccine When to give Max age Dose Diluent Route
MR - 1st 9 - 12 5 yrs 0.5 ml Sterile Sub- Right upper
dose months water cutaneous Arm

JE* - 1st 9 -12 months 3 yrs 0.5 ml NO Intra- Antero-lateral

dose muscular side of Right
mid-thigh

Vitamin A At 9 months 1 ml NO Oral Oral

(1st dose) with MR ( 1 lakh
vaccine IU)

*JE in Endemic districts only

 National Immunization Schedule for Children
Site
Vaccine When to give Max age Dose Diluent Route

OPV Booster 16-24 months 5 yrs 2 drops NO Oral Oral

2nd dose with
MR 2nd;
Vitamin A 2 ml
Then, one dose NO Oral Oral
(2nd to 9th dose) (2 lakh IU)
every 6 months upto
5 yrs of age.

Sub-
MR 2nd dose 16-24 months 5 yrs 0.5 ml NO Right upper Arm
cutaneous

Antero-lateral
JE -2 dose
nd
16-24 months 3 yrs 0.5 ml NO Intra- side of Right mid-
muscular thigh

Intra- Antero-lateral
DPT Booster-1 16-24 months 7 yrs 0.5 ml NO muscular side of Left mid-
thigh
 National Immunization Schedule for Children

Site
Vaccine When to give Max age Dose Diluent Route

DPT 5-6 years 7 yrs 0.5 ml. NO Intra- Upper Arm

Booster-2 muscular

Td 10 10 yrs 0.5 ml. NO Intra- Upper Arm

muscular

Td 16 16 yrs 0.5 ml NO Intra- Upper Arm

muscular
 National Immunization Schedule
Age Vaccines given
Birth BCG, OPV-0, Hepatitis B Birth dose
6 Weeks bOPV-1, Rota – 1, fIPV-1, PCV-1 & Pentavalent-1
10 weeks bOPV-2, Rota-2 & Pentavalent-2
14 weeks bOPV-3, Rota-3, fIPV-2, PCV-2 & Pentavalent-3
9-12 months Vitamin- A 1st dose, fIPV-3, MR-1, PCV-B & JE-1*
16-24 months OPV – B, Vitamin- A 2nd dose, MR-2, JE-2*, DPT-B 1
5-6 years DPT-B 2
10 years Td 10
16 years Td 16
Pregnant Women Td 1 & Td 2 or Td Booster**
* JE in Endemic districts only
**one dose if previously vaccinated with two Td doses within 3 years
 Beneficiaries under UIP
Vaccines given
Age

Pregnant women Td vaccine

BCG
OPV, IPV
Hep B
Pentavalent, DPT, Td
Children from Birth to
PCV
16 yrs
RVV
MR
JE
Vitamin A
 Vaccines vs Route of Administration

Route Vaccines given

Oral OPV, RVV, Vitamin A

Intradermal BCG, fIPV

Hep B, PCV,
Intramuscular Pentavalent, DPT, Td,
JE

Subcutaneous MR
Route
 Vaccines vs Site of Administration

Site Vaccines given

Oral OPV, RVV, Vitamin A

Left Upper Arm BCG, fIPV-3, DPT B2

Right Upper Arm MR-1, MR-2, fIPV-1, 2

Right Thigh PCV, JE

Left Thigh Hep B, Pentavalent, DPT, DPTB1

 Recommended time interval between doses of vaccines

Vaccines Time Interval

OPV, RVV, Pentavalent, DPT 4 weeks

PCV, fIPV 8 weeks

MR, JE 4 weeks

DPT / Pentavalent 3 dose and DPT B1 6 months

Two live Injectable vaccines if not given

simultaneously (BCG, MR) 4 weeks
 Full vs Complete Immunization

Achievement Age Vaccines Received

BCG,
OPV – 3 primary doses
RVV – 3 doses
Full Immunization Plus Before 1 yr fIPV – 3 doses
PCV – 2 doses & 1 booster dose
Pentavalent – 3 doses
MR1 / JE1
All vaccines under Full Immunization
PLUS
Complete
Immunization Before 2 yrs OPV B
DPT B1
MR2 / JE 2
Comparative Immunogenicity data for fIPV schedules
Table1: Type 2 seroconversion (%) with TWO dose of IPV or fIPV
6-14 weeks 14-36 weeks
Full dose IPV 89.3 (84.4-93.4) 100.0 (99.6-100.0)
Fractional IPV 79.6 (70.8-87.2) 98.2 (93.8-99.8)

Observations from the above table:

• Seroconversion against PV2 with the current schedule of 2 doses of fIPV at 6 and 14
weeks in the immunization schedule is 79%
• Even two full doses at 6 and 14 weeks, it only reaches up to 89%

• But with delayed first dose and longer interval between two doses (14 weeks-9 months
schedule), whether full or fractional, it reaches nearly 100%

• An alternative could be to retain the two dose fIPV schedule at 6 and 14 weeks and add
third dose full/fractional at MCV1 contact
 Initiation Age vs Vaccines Administered

Initiation Age Vaccines Administered

At 6 weeks As per schedule

At completed 9 months and before
completed 12 months As per schedule

OPV 3 primary doses and OPV Booster

DPT 3 primary doses and DPT B1
At completed 1 yr and before 5 yrs MR1 and MR 2
JE 1 and JE 2 (should be completed before 3 yrs)
Vitamin A doses at 6 months interval

At completed 5 yrs and before 7 yrs DPT 3 primary doses and 2 booster doses
 Scenarios vs Recommendations

• If a child is brought late for a subsequent dose do not restart the

schedule again. Pick up where the schedule was left off.

• If more than one injection must be given in one limb, then ensure that
the distance between the two injection sites is at least 1 inch apart.

• If the parents want to vaccinate their child from the public sector after
receiving one or two doses of vaccine in a private facility, the remaining
doses may be provided as per the NIS
Sequence of Vaccination
Sequence of Vaccination
Arrangement of Vaccines
Four Key Messages to Care-giver

1. What vaccine was given and what disease it prevents

(e.g. BCG for preventing TB)

2. When and where to come for the next visit.

3. What minor adverse-events could occur and how to

deal with them.

4. To keep the vaccination card safe and to bring it

along for the next visit
 Paracetamol Syrup - Recommendations
• Should be used only if fever develops, •Recommended strength: 125mg/5ml
and never prophylactically •Recommended dose: 10-15 mg/kg body weight
• Following vaccination with
Pentavalent / DPT antigens

Age group Dose When

6 weeks - 6 months 2.5 ml

6 - 24 months 5 ml In case of fever*, following vaccination

2 - 4 years 7.5 ml and 4-6 hourly thereafter if needed #

4 - 6 years 10 ml

Paracetamol is not recommended in children weighing <2 kg

* Axillary temperature > 38°C/100.4°F or child feels hot to touch

# Maximum four doses in 24 hours with a gap of at least four hours between two doses
 Vitamin A - Recommendations

• A Vitamin A bottle, once opened, should be used within 8 weeks.

• Write the date of opening on the bottle.
• It must be kept away from direct sunlight.
• Use the spoon or the measuring cap supplied with the bottle to dispense Vit A to
the child
• Doses: -
– Up to 1 yr age – 100,000 IU (1 ml solution)
– > 1 Yrs Age – 200,000 IU (2 ml solution)
 Zinc tablet (Along with ORS) –
Recommendations for Diarrhoea Management

• Age 2-6 months: 10 mg of dispersible tablet for 14 days.

• Age 6 months to 5 years: 20 mg of dispersible tablet for 14 days.

 Bio – Medical Waste Management

l Cut hub of AD and l Plastic part of

l Needle Caps
Disposable syringes Syringe
l Wrappers
l Broken vials and l Unbroken used vials
ampoules
Anaphylaxis Kit
Corresponding volume markings on Insulin & tuberculin syringes

Markings of age-appropriate
dosage of adrenaline in mL
(tuberculin syringes) and
equivalent volume in units
(insulin syringes)
Thank you