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Background: Various strategies have been made to make vaccines universally available including to most hard-to-reach and vulnerable population. However, change in coverage level never reached upto expected level in spite of giving so much effort by the Govt. of India and World bodies. Therefore, there is the need to look beyond. Hence, the process evaluation of Universal Immunization Program (UIP) was conducted to evaluate the process of UIP using selected variables. Methods: A cross-sectional observation was done during the period from May 2017 to April 2020 among the 14 health?care facilities and 36 selected session sites, and interview was done to 48 health?care providers working at different levels, located in Imphal East district of Manipur. Both checklist and pretested semi-structured questioners were used for collection of data. Descriptive statistics such as frequency, proportion, and percentage were used. Results: Ice-lined refrigerator and Deep-freezer were found to be present in working condition in 11 (100%) centers. The use of vaccine carrier was found in all 36 (100%) centers. Way of vaccine administration was found to be correct in 26 (72.2%) centers. Availability of up?to?date microplan was found in 18 (78.3%) centers. Conclusions: Barriers in the UIP were not uniform throughout the villages and districts. Hence, area?specific measures need to be taken up for overcoming the barriers and challenges.
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Purpose: Vaccination is one of the best cost-effective methods for preventing childhood morbidity and mortality. The objective of this study was to identify children with missed and delayed vaccinations along with factors associated with incomplete vaccinations. Methodology: A prospective observational study was conducted for 7 months. Relevant data was collected through a face-to-face interview and immunization status was evaluated based on their vaccination card which was compared against UIP. Result: Out of 347 subjects, 93.94% of them were completely immunized and majority of the missed vaccines were measles 1st dose (58.82%), Japanese Encephalitis vaccine 1st dose (29.41%). Lack of access to health care, less contact of adolescents to physicians, missed opportunities for vaccination, resistance towards immunization and poor birth weight were the reasons identified for incomplete vaccination. Conclusion: Immunization is one of the biggest health accomplishments saving millions of lives. Our study concluded that most of the participants were completely immunized indicating a positive attitude towards immunization. However, further exploration is required to assess and improve the vaccination coverage among rural population.
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The objective of this research was to generate the evidence on the private sector's contribution to overall immunization coverage for selected pediatric vaccines in India. Using IMS Health's (now IQVIA) vaccine sales audit data and innovative methodological approach we estimated private-sector vaccine share in the total immunization coverage across selected pediatric vaccines in India. Our estimates suggest that private sector remains an important contributor to immunization services in India not only for Universal Immunization Program vaccines (Bacillus Calmette朑u閞in [19.23%], HiB pentavalent [11.09%], hepatitis B [5.75%], oral poliovirus vaccine [5.48%], Diphtheria-Pertussis-Tetanus [2.66%], and measles [2.17%]) but also for newer vaccines (hepatitis A [4.2%], rotavirus [3.4%], typhoid [3.3%], and pneumococcal conjugate vaccine [2.5%]). As the private sector continues to remain an important access point for immunization services in the country, avenues for potential synergy between public and private sectors should be explored to improve the coverage and quality of immunization services.
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Introduction: Vaccines are one of most successful healthinterventions that bring about significant reduction ininfectious diseases and adverse health consequences. In India,The Expanded Program on Immunization (EPI) was launchedin 1978 and it was re-designated as the Universal Immunizationprogram (UIP) in 1985, with a goal to cover at least 85% ofinfants. In India 7.4 million children are not immunized. Studyaimed to determine the knowledge, attitude and practice ofmothers with under five children about immunization.Material and methods: Research was conducted to determinethe knowledge attitude and practice of mothers with underfive children about immunization. A cross sectional study wasconducted among mothers having children aged more thantwo and half years in the field practice area of K.S. HegdeMedical Academy. Data was collected using a pre-tested semistructured questionnaire from 348 mothers during a periodof two months. Among the study participants (92) 26% werefrom urban area and (256) 74% were from rural area. Motherswere the main decision makers regarding vaccination of thechild in both urban and rural areas.Results: Majority 99% supported vaccination. Majority 97%of the mothers in both the urban and rural areas believedthat vaccines were protective. In the study it was seen that93% of the mothers had vaccinated their children as pervaccination card and the rest of the mothers were not upto date with vaccinating their children. Only 43%of themothers were aware of the side effects and 32% knew aboutcontraindications. In this study it was found that 32% of themothers believed that vaccination could be done even if thechild had fever. Only 22% of the mothers were aware of theSMS notification program by the government.Conclusion: In the study the reasons stated by the mothersfor not fully vaccinating the child were because of the sideeffects 44%, difficulty in reaching the center 28% and longcrowds 19%.According to our study, majority of the motherswere supportive of immunizing their children but unaware oftheir contraindications and side effects.
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Background: In order to eliminate measles and rubella (congenital rubella syndrome) WHO has emphasized on measles and rubella (MR) vaccination campaign and India launched the ambitious MR Campaign with the help of WHO and GAVI. In Odisha the MR campaign was launched on January 29 with a target to cover nearly 1.13 crore children. The objective of the present study is to assess the knowledge of parents regarding measles and rubella infection and to identify the source of information regarding MR campaign. Methods: A cross-sectional study was conducted in Sambalpur City across 10 private schools during February 10 to March 12. Total 440 parents of children aged 5-15 years were given a questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards MR Campaign. The data were collected subsequently in the next 10 days. Out of 440 parents 408 returned filled up questionnaire. Data were entered into and analyzed by using Microsoft Excel.Results: Out of the 408 respondents 362 (88.7%) parents had knowledge about MR campaign. 156 respondents was aware about importance of rubella vaccine. Parent teacher meeting (PTM) was the leading source of information for these. 388 (95%) respondent’s children had received the vaccine during campaign.Conclusions: Parent-teacher's meeting was the main source of information. However social mobilisation such as street play, miking, rallies by school children and NGOs etc., needs to be taken up for such campaigns in future.
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Adolescent immunization is one of the important yet a neglected field in India. There is no adolescent-specific schedule in thegovernment’s Universal Immunization Program. Though a separate adolescent immunization schedule exists for the private sector, thereis almost no data on the coverage rates of the adolescent vaccines. With the changing epidemiology of certain vaccine preventablediseases, rapid development in the field of vaccinology and the advent of some new vaccines, there is a need to revisit the adolescentvaccination schedule. Common vaccine preventable diseases like dengue, mumps, hepatitis A and typhoid should be given higher prioritywhereas an alternate strategy should be adopted on the use of the vaccine against diphtheria, tetanus and pertussis
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Live attenuated SA-14-14-2 vaccine against Japanese encephalitis (JE) was introduced in the routine immunization under Universal Immunization Program in the 181 endemic districts of India. Recently, the Government of India has announced the introduction of one dose of JE vaccine for adults in endemic districts. The policy to mass vaccinate adults has raised several concerns that are discussed in this write-up. Apart from adult vaccination, the continuation of large scale JE vaccination program despite it being a very focal problem, and continued neglect of some other serious public health illnesses have also been highlighted. The issue of lack of authentic data on effectiveness of currently employed SA-14-14-2 JE vaccine has also been discussed.
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The Academy’s Expert group on Immunization has discussed various issues pertaining to rubella vaccine introduction in to the Universal Immunization Program. Though the move to introduce rubella vaccine in to the UIP is laudable, the decision to overlook mumps seems inexplicable and illogical. Logistics also support the use of measles-mump and rubella (MMR) vaccine instead of measles-rubella (MR) vaccine. Regarding the timing of administration of MMR/MR vaccine, the academy recommends that the vaccine should be given early to have much higher coverage than introducing it late at the time of 1st booster of DPT. According to available evidence, both these vaccines (MMR/MR) can be given safely at different ages including at 9 months of age. The second dose should also be of the same antigen (MMR/ MR) and be given along with 1st DPT booster at 16-24 months of age.
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Adverse event following immunization (AEFI) is a critical component of immunization program. The risk of AEFI with vaccination is always weighed against the risk of not immunizing a child. There is an evolving AEFI surveillance system in India for the vaccines delivered through ‘universal immunization program’ (UIP) of government sector, but the reporting remained suboptimal for long in the country, and there is almost no participation from private sector. The AEFI reporting from private sector will provide vital information on the safety of new and underutilized vaccines, not part of the UIP in India. The national guidelines are recently revised and updated. The Indian Academy of Pediatrics believes that pediatricians, especially in private sector have a crucial role to play with reporting of AEFI with newer/underutilized vaccines. Programmatic error, vaccine reaction, injection reactions, coincidental and unknown are the five broad categories of AEFI for programmatic purposes. The serious AEFIs (death, disability, cluster and hospitalization) need to be reported immediately and investigated in detail as per the laid down procedures. Once a serious AEFI happens, primary or urban health centre should be immediately informed by the pediatricians practicing in rural or urban areas, respectively. This advocacy paper from the academy provides guidelines to practitioners on how to report cases, and suggests ways for IAP members to help in ongoing efforts of the government in improving AEFI surveillance in the country. The details about the diagnosis and management of known/expected AEFI with UIP and newer vaccines shall be published later.