Presentation on theme: "Pentavalent vaccine Introduction in UIP in India:"— Presentation transcript:
1 Pentavalent vaccine Introduction in UIP in India: Operational aspects
2 Hib vaccine introduction in India Planned for introduction in 2 states (KE, TN) as pentavalent vaccine (DPT+HepB+Hib);10 dose liquid formulation to be used in these states;May be expanded to other states of the country later on.Impact study is also being planned in these states.
3 Hib as pentavalent vaccine: programmatic benefits Will reduce number of pricks from 9+1 (3 each for DPT, HepB and Hib and HepB birth dose) to 3+1, if given in combinationWill not need additional cold chain space (in fact, reduced need, 6 doses will be replaced by 3 of pentavalent vaccine)New vaccine introduction provides the opportunity to strengthen the immunization service delivery
4 UIP Schedule in India BCG At birth or up to one year of age OPV 0 dose OPV ‘0’ dose: within 14 days of birth6, 10 & 14 weeks (Booster at months)Hepatitis B (Birth dose)At Birth or as early as possible within 24 hoursDPTAt 6, 10 & 14 weeks;DPT boosters at months & at 5-6 Years.Hepatitis B 1, 2 & 3At 6, 10, 14 weeks.Measles1st dose at 9 completed months - 12 months. 2nd dose at months (given up to 5 years, if not received earlier)Vitamin A (1st dose) (2nd to 9th dose)At 9 months with measles vaccination16 months with DPT/OPV booster, then 1 dose every 6 months up to 5 years.Japanese Encephalitis16 – 24 months (in endemic states after the campaign)
6 HepB birth doseBirth dose of HepB is given as early as possible but with in 24 hours; for all institutional deliveries;HepB birth dose will continue as earlierStand alone HepB vaccine will be used for HepB birth dose;In May 2011, GoI adopted open vial policy for HepB birth dose and OPV zero dose.These vials can be used for 30 days, if kept properly in cold chain
7 Focus on birth dose of Hep B Labor room and nursery staff have a greater roleOrientation to Obstetricians and the staff nurses neededAvailability of vaccine round the clock close to the labor roomRecording and reporting issues need to be addressedIEC material for use at institutions
8 DPT vaccinesAfter introduction of pentavalent vaccines, DPT will continue to be used for booster doses,ANMs need to be sensitized
9 Pentavalent vaccinePentavalent will replace the DPT and HepB vaccines at 6, 10 and 14 weeks of age.Standalone HepB vaccine will be used for birth doseDPT for 2 booster doses, as earlierThere is no need of booster dose for Hib vaccine
10 “Phasing In” of Pentavalent vaccine It is recommended that the introduction of Hib as pentavalent vaccine should be gradually phased in the NIS by synchronizing it with OPV/ DPT schedule at 6 wks, 10 wk & 14 wks of age.Pentavalent vaccine schedule thus may be started with fresh batch of vaccinees for better compliance & utilization.Give pentavalent vaccine to only those children who are coming for first dose of DPT (Those coming for DPT2 or 3 should receive DPT only).
11 Recording and reporting RIMS and HMIS reporting should be continued as earlierHMIS does not capture HepB birth dose and MCV2, efforts are on to include these,For pentavalent vaccine, separate paper reports need to be sent to immunization division, MoHFWTrack the wastage rate and provide regular monthly reports on stocks of pentavalent vaccine along with Dose wise coverage reports
13 Macro-planning At State Level: Seek commitment and support from various departments and stakeholdersDevelop advocacy and social mobilization activity planPrepare a training planDisseminate immunization guidelines (e.g. injection safety, cold chain, AEFI surveillance)Develop plans for supervision, monitoring and evaluation, including providing of feedback.
14 Micro-planningAt District, Sub-district levels:Revise micro-plans: use prescribed formats for UIP at each levelEstimate: Calculate vaccine and logistics requirement at each levelCold chain: evaluate the availability and adequacy at all levelsIndenting and delivery: ensure availability of required vaccine and other logistics needed to introduce the vaccineModify and disseminate revised formats: reporting, recording and immunization card etcTrainings: health workers and staff at all levelsAdvocacy and social mobilization activities around the introduction of the new vaccine,Supervise and monitor.
15 Update Recording and Reporting Systems Vaccine stock forms and registers,Immunization cards and counterfoilsMCH/Immunization RegisterUIP reporting formats (Tally Sheets, Monthly Progress Report at all levels)Monitoring ChartSupervisory checklistsposted immunization schedules, (tin-plates, posters, wall paintings and billboards)materials for parentsComputer databases
16 Prepare and Train Staff Target: District Immunization Officers (DIO), Medical Officers (MO), cold chain handlers, supervisors, data managers and frontline Health Workers (HW)Approach: Orientation of district-level trainers at the State level should be followed by the training of Medical Officers, supervisors and cold chain handlers.Finally, MOs should conduct sensitization of the frontline Health Workers.Integrate in all the training courses, review meetings etc.Resources:Operational guidelines for pentavalent vaccine introduction in the UIPImmunization Handbook for Health WorkersImmunization Handbook for Medical Officers
17 Supervise and Monitor Supervise planning and implementation Schedule supervisory visitsMonitor implementationMonitor vaccines and logistics supplyMonitor vaccine utilization (coverage)Use reported coverage dataUse RI monitoring data for appropriate actions.