Universal Immunization Programme – Know the Details

Universal Immunization Program (UIP) Mission to provide high quality immunization services to all communities in order to prevent mortality, morbidity and disability from diseases that are preventable through the optimum use of vaccines currently available and vaccines that become available from time to time. UIP was introduced in 1978 as ‘Expanded Programme of Immunization’ (EPI) by the Ministry of Health and Family Welfare, Government of India. In 1985, the programme was modified as ‘Universal Immunization Programme’ (UIP) to be implemented in a phased manner to cover all districts in the country by 1989-90 with the one of largest health Programmes in the world.

Universal Immunization Program – Overview

Universal Immunization Programme (UIP) is one of the largest public health Programmes targeting close to 2.67 crore newborns and 2.9 crore pregnant women annually. The programme now consists of vaccination for 12 diseases- tuberculosis, diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, measles, hepatitis B, diarrhea, Japanese encephalitis, rubella, pneumonia (Haemophilus influenzae type B) and Pneumococcal diseases (pneumococcal pneumonia and meningitis).

The Ministry of Health and Family Welfare, Government of India provides several vaccines to infants, children and pregnant women through the Universal Immunization Programme.

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The Vaccination Schedule under the UIP

Vaccines provided under Universal Immunization Program

BCG

• BCG stands for Bacillus Calmette-Guerin vaccine. It is given to infants to protect them from tubercular meningitis and disseminated TB.
• BCG vaccine is given at birth or as early as possible till 1year of age
• BCG is given as an intradermal injection in the left upper arm.

OPV

• OPV stands for Oral Polio Vaccine. It protects children from poliomyelitis.
• OPV is given at birth called zero dose and three doses are given at 6, 10 and 14 weeks. A booster dose is given at 16-24 months of age.
• OPV is given orally in the form of two drops.

Hepatitis B vaccine

• Hepatitis B vaccine protects from Hepatitis B virus infection.
• Hepatitis B vaccine is given at birth or as early as possible within 24 hours. Subsequently 3 doses are given at 6, 10 and 14 weeks in combination with DPT and Hib in the form of pentavalent vaccine.
• Intramuscular injection is given at anterolateral side of mid thigh

Pentavalent Vaccine

• Pentavalent vaccine is a combined vaccine to protect children from five diseases Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b infection and Hepatitis B.
• Three doses are given at 6, 10 and 14 weeks of age (can be given till one year of age).
• Pentavalent vaccine is given intramuscularly on anterolateral side of mid thigh

Rotavirus Vaccine

• RVV stands for Rotavirus vaccine. It gives protection to infants and children against rotavirus diarrhea. It is given in select states.
• Three doses of vaccine are given at 6, 10, 14 weeks of age (can be given at one year of age).
• 5 drops of liquid vaccine or 2.5 ml (lyophilized vaccine) are given orally.

PCV

• PCV stands for Pneumococcal Conjugate Vaccine. It protects infants and young children against disease caused by the bacterium Streptococcus pneumoniae.
• The vaccine is given as two primary doses at 6 & 14 weeks of age followed by a booster dose at 9-12 months of age
• PCV is given as intramuscular (IM) injection in the antero-lateral side of the mid- thigh. It should be noted that pentavalent vaccine and PCV are given as two separate injections into opposite thighs.

fIPV

• fIPV stands for Fractional Inactivated Poliomyelitis Vaccine. It is used to boost the protection against poliomyelitis.
• Two fractional doses of IPV are given intradermally at 6 and 14 weeks of age.
• It is given as an intradermal injection at the right upper arm.

Measles/ MR vaccine

• Measles vaccine is used to protect children from measles. In a few states Measles and Rubella a combined vaccine is given to protect from Measles and Rubella infection.
• First dose of Measles or MR vaccine is given at 9 completed months to12 months (vaccine can be given up to 5 years if not given at 9-12 months age) and second dose is given at 16-24 months.
• Measles Vaccine is given as a subcutaneous injection in the right upper arm.

JE vaccine

• JE stands for Japanese encephalitis vaccine. It gives protection against Japanese Encephalitis disease. The JE vaccine is given in select districts endemic to JE after the campaign.
• The JE vaccine is given in two doses: first dose is given at 9 completed months-12 months of age and second dose at 16-24 months of age.
• Live attenuated vaccine is given as subcutaneous injection in the left upper arm and killed vaccine is given as intramuscular injection in the anterolateral aspect of mid- thigh.

DPT booster

• DPT is a combined vaccine; it protects children from Diphtheria, Tetanus and Pertussis.
• DPT vaccine at 16-24 months of age is called DPT first booster and DPT 2nd booster is given at 5-6 years of age.
• DPT first booster is given as intramuscular injection in the antero-lateral side of the mid-thigh in the left leg. DPT second booster is given as intramuscular injection in the left upper arm.

Tetanus and adult diphtheria (Td) vaccine:

• TT vaccine has been replaced with Td vaccine in UIP to limit the waning immunity against diphtheria in older age groups.
• Td vaccine is administered to adolescents at 10 and 16 years of age and to pregnant women.
• Td-1 is given early in pregnancy as first dose and 4 weeks after Td1, second dose of Td as Td-2 is given. Td- Booster is given, if a pregnant woman has received 2 TT/Td doses in a pregnancy within the last 3 years.* Intra-muscular Upper Arm
• Td is given as intramuscular injection in the upper arm.

New Vaccines under Universal Immunization Program

• Inactivated Polio Vaccine (IPV): IPV has been introduced in UIP as part of Global Polio end-game strategy, to mitigate the risk associated with tOPV to bOPV switch. IPV was introduced in November 2015 initially in 6 states, which was expanded across the country by April 2016.
• Rotavirus vaccine (RVV): RVV has been introduced to reduce mortality and morbidity caused by Rotavirus diarrhea in March 2016. It has been introduced in 11 states (Andhra Pradesh, Haryana, Himachal Pradesh, Jharkhand, Odisha, Assam, Tripura, Rajasthan, Tamil Nadu, Madhya Pradesh and Uttar Pradesh). The vaccine will be expanded across the country in 2019-20.
• Measles Rubella (MR) vaccine: India is committed to the goal of measles elimination and rubella control and to achieve the goal MR vaccine was introduced in the country through a campaign mode in a phased manner in 2017. The MR campaign targets around 41 crore children in the age group of 9 months to 15 years (covering ⅓ of the total population of the country) followed by 2 doses in routine immunization at 9-12 months and 16-24 months. Rubella component is now under routine immunization as MR vaccine.
• Pneumococcal Conjugate Vaccine (PCV): PCV was launched in May 2017 for reducing Infant mortality and morbidity caused by pneumococcal pneumonia. It has been introduced in Bihar, Himachal Pradesh, Madhya Pradesh, 19 districts of Uttar Pradesh and 18 districts of Rajasthan.
• Tetanus and adult diphtheria (Td) vaccine: TT vaccine has been replaced with Td vaccine in UIP to limit the waning immunity against diphtheria in older age groups. Td vaccine to be administered to adolescents at 10 and 16 years of age and to pregnant women.

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