IMMUNISATION

1. What is immunisation?
 Immunization is the process whereby a person is made immune or
resistant to an infectious disease, typically by the administration of a
vaccine.
 Vaccines stimulate the body’s own immune system to protect the person
against subsequent infection or disease.

2. Why should someone get immunized?

 The goal of public health is to prevent disease.
 It's much easier and more cost-effective to prevent a disease than to
treat it.
 That's exactly what immunizations aim to do.
 Immunizations protect us from serious diseases and also prevent the
spread of those diseases to others.
 Over the years immunizations have thwarted epidemics of once common
infectious diseases such as measles, mumps, and whooping cough.
 And because of immunizations we've seen the near eradication of others,
such as polio and smallpox.
 Some vaccines need to be given only once; others require updates or
"boosters" to maintain successful immunization and continued protection
against disease.

3. How Effective Are Immunizations?

 Vaccines are very effective at preventing disease, but they don't work all
the time.
 Most of the recommended childhood immunizations are 90%-100% effective,
according to the CDC.
 However, for reasons that are not completely understood, sometimes a child
will not become fully immunized against a disease after receiving a vaccine.
 This is all the more reason to get children vaccinated.
  Children in whom the vaccine is 100% effective protect those few who have
not been completely immunized -- lessening everyone's chance of exposure
to the disease.
 Even in cases where a vaccine has not given a child with 100% immunity, the
symptoms -- if the child is exposed to an infectious disease -- will still
usually be milder than if he or she had not been immunized at all.

4. What are the types of immunisation?

5. What is active immunisation?

 Active immunization can occur naturally when a person comes in contact with,
for example, a microbe.
 The immune system will eventually create antibodies and other defenses
against the microbe.
 The next time, the immune response against this microbe can be very
efficient; this is the case in many of the childhood infections that a person
only contracts once, but then is immune.
 Artificial active immunization is where the microbe, or parts of it, are
injected into the person before they are able to take it in naturally. If whole
microbes are used, they are pre-treated.
 The importance of immunization is so great that the American Centers for
Disease Control and Prevention has named it one of the "Ten Great Public
Health Achievements in the 20th Century".
 Live attenuated vaccines have decreased pathogenicity.
 Their effectiveness depends on the immune systems ability to replicate and
elicits a response similar to natural infection.
 It is usually effective with a single dose.
  Examples of live, attenuated vaccines
include measles, mumps, rubella, MMR, yellow fever, varicella, rotavirus,
and influenza (LAIV).

What is passive immunisation?

 Passive immunization is where pre-synthesized elements of the immune

system are transferred to a person so that the body does not need to
produce these elements itself.
 Currently, antibodies can be used for passive immunization.
 This method of immunization begins to work very quickly, but it is short
lasting, because the antibodies are naturally broken down, and if there are
no B cells to produce more antibodies, they will disappear.
 Passive immunization occurs physiologically, when antibodies are transferred
from mother to fetus during pregnancy, to protect the fetus before and
shortly after birth.
 Artificial passive immunization is normally administered by injection and is
used if there has been a recent outbreak of a particular disease or as an
emergency treatment for toxicity, as in for tetanus.
 The antibodies can be produced in animals, called "serum therapy," although
there is a high chance of anaphylactic shock because of immunity against
animal serum itself.
 Thus, humanized antibodies produced in vitro by cell culture are used instead
if available.
IMMUNISATION SCHEDULE
 INFANTS

NAME OF AGE INFECTION CAUSATIVE SITE ROUT DOSE

VACCINE TO BE ORANISM E
PREVENTED
Hepatitis B - Birth Hepatitis – B Hepatitis – B Virus Antero- Intra- 0.5 ml
Birth dose lateral side muscul
of mid- ar
thigh
Bacillus At tuberculosis Mycobacterium tubercu Left Upper Intra- 0.1ml 
Calmette– birth / losis  bacteria Arm dermal
Guérin  (BCG) as
early
as till 1
year
OPV -0 Within Poliomyelitis poliovirus oral oral 2 drops
(Oral polio 1st 15
vaccine) days
OPV -1 6 Poliomyelitis poliovirus oral oral 2
(Oral polio weeks
drops
vaccine)
OPV -2 10 Poliomyelitis poliovirus oral oral 2
(Oral polio weeks
drops
vaccine)
OPV -3 14 Poliomyelitis poliovirus oral oral 2
(Oral polio weeks
drops
vaccine)
fractional 6 Poliomyelitis poliovirus Upper arm Intra- 0.1 ml
dose of weeks dermal
Inactivated
polio vaccine
Pentavalent 6 diphtheria, Diphtheria - Antero- Intra- 0.5 ml
vaccine - 1 weeks whooping Corynebacterium lateral side muscul
cough diphtheria of mid- ar
(pertussis), Whooping cough – thigh
tetanus, Pertussis
hepatitis B Tetanus - Clostridium
and Hib diseas tetani
e Hepatitis B – Hepatitis
B virus
 Hib - Haemophilus
influenzae
Pentavalent 10 diphtheria, Diphtheria - Antero- Intra- 0.5 ml
vaccine - 2 weeks whooping Corynebacterium lateral side muscul
cough diphtheria of mid- ar
(pertussis), Whooping cough – thigh
tetanus, Pertussis
hepatitis B Tetanus - Clostridium
and Hib diseas tetani
e Hepatitis B – Hepatitis
B virus
Hib - Haemophilus
influenzae
Pentavalent 14 diphtheria, Diphtheria - Antero- Intra- 0.5 ml
vaccine - 3 weeks whooping Corynebacterium lateral side muscul
cough diphtheria of mid- ar
(pertussis), Whooping cough – thigh
tetanus, Pertussis
hepatitis B Tetanus - Clostridium
and Hib diseas tetani
e Hepatitis B – Hepatitis
B virus
Hib - Haemophilus
influenzae
RVV 1 6 Diarrhoea Rota virus oral oral 5 drops
(rota virus weeks
vaccine)
RVV 2 10 Diarrhoea Rota virus oral oral 5 drops
(rota virus weeks
vaccine)
RVV 3 14 Diarrhoea Rota virus oral oral 5 drops
(rota virus weeks
vaccine)
PCV 1 6 Polycythemia Streptococcus Antero- Intra- 0.5 ml
(Pneumococcal weeks vera pneumoniae. lateral side muscul
conjugate of mid- ar
vaccine) thigh
PCV 2 14 Polycythemia Streptococcus Antero- Intra- 0.5 ml
(Pneumococcal weeks vera pneumoniae. lateral side muscul
conjugate of mid- ar
vaccine) thigh
PCV booster 12 - 13 Polycythemia Streptococcus Antero- Intra- 0.5 ml
(Pneumococcal months vera pneumoniae. lateral side muscul
conjugate of mid- ar
vaccine) thigh
MCV 1 10 – 12 measles measles virus Right upper Sub - 0.5 ml
measles-‐ months arm cutane
containing ous
vaccine dose 1
Vitamin A (1st 9 - - Oral Oral 1ml
dose) months

Japanese 12  Japanese  Japanese Left upper Sub - 0.5 ml

Encephalitis months encephalitis  encephalitis virus arm cutane
(1st dose) ous
 FOR CHILDREN AND ADOLESCENTS

NAME OF AGE INFECTION TO BE ROUTE SITE

VACCINE PREVENTED

16- 24 m+onths Intra- muscular Antero-lateral

side of mid-thigh

DPT booster
1

MCV 2/ MR 2 16-24 months 0.5 ml Sub-cutaneous Right Upper arm

OPV Booster 16-24 months 2 drops Oral Oral

Japanese Enc 16-24 months 0.5 ml Sub-cutaneous Left Upper Arm

ephalitis

Vitamin A 18 months (2nd 2 ml (2 lakh IU) Oral Oral

dose). Then, one
dose every 6
months upto the
age of 5 years.

DPT booster 5- 6 years 0.5 ml Intra-muscular Upper arm

Td 10 years &16 0.5 ml Intra-muscular Upper arm

years
For pregnant women

Vaccine Age / time Dose Route Site

Td -1 early pregnancy 0.5m intra Upper arm

l muscular

Td -2 4 weeks after 1st dose of Td* 0.5m intra Upper arm

l muscular

Td booster If received 2 Td doses in a pregnancy 0.5m intra Upper arm

within the last 3yrs l muscular

 Td stands for Tetanus, Diphtheria

 Diphtheria is caused by Corynebacterium diphtheria
 Tetanus is caused Clostridium tetani
 Td-2 or Booster doses should be given before 36 weeks of pregnancy.
 However, these can be given even if more than 36 weeks have passed.
 Td can be given to a women in labour if, she has not previously received Td.
ADULTS

Vaccine 19-26 years 27-49 years 59- ≥65 years

64
years
IIV or RIV 1 dose annually
Tdap or Td 1 dose Tdap, then Td or Tdap booster
every 10 yrs
MMR 1 or 2 doses depending on indication (if born in 1957 or later)
VAR 2 doses (if born in 1980 or later) 2 doses
RZV or ZVL 1 or 2 doses
HPV 2 or 3 27 through 45
doses years
depending
on age at
initial
vaccination
or
condition
PCV13 1 dose
PPSV23 1 or 2 doses depending on indication 1 dose
HepA 2 or 3 doses depending on vaccine
HepB 2 or 3 doses depending on vaccine
MenACWY 1 or 2 doses depending on indication
MenB 2 or 3 doses depending on vaccine and indication
Hib 1 or 3 doses depending on indication

1. IIV – Influenza Inactivated Vaccine - influenza viruses

2. RIV – Recombinant Influenza Vaccine - influenza viruses

3. Tdap - Tetanus, Diphtheria, Pertussis

4. MMR -measles, mumps, and rubella.

5. VAR – varicella

6. RZV - recombinant zoster vaccine

7. ZVL - zoster live-attenuated vaccine

8. HPV – Human Papilloma Virus

9. PCV13 - Pneumococcal conjugate vaccine

10. PPSV23 - pneumococcal polysaccharide vaccine

11.MenACWY - Meningococcal conjugate vaccine

12. MenB - meningococcal B vaccine

13. Hib -Haemophilus influenzae type b)