IMMUNIZATIONS : खाेप

---

The world of medicine has a wide variety of global aspects teeming from minor preventions to major surgeries. There is no doubt in accepting the fact that prevention is better than cure. The area of prevention includes a massive range including all the sanitations, disinfections, sterilizations, personnel protection, immunizations, and a lot more.

Immunization revolves around a tiny but thoughtful word to mankind “Vaccine” When exposed to a pathogenic organism, the body mounts an immune response.

Immunization is the process of inducing or providing immunity by administering an immunobiological. Immunization can be active or passive. Immunization revolves around a tiny but thoughtful word to mankind “Vaccine” When exposed to a pathogenic organism, the body mounts an immune response. When exposed to an infectious agent the second time, the host immune response is fairly rapid and sufficient to prevent the disease.

Vaccine is a suspension of live (usually attenuated) or inactivated microorganisms (eg bacteria or viruses) or fractions thereof administered to induce immunity and prevent infectious disease or its sequels.

Hand washing each time

Use of sterile & disposable syringes/needles.

No recapping of the needle. Immediately discard used syringes and needles in a puncture-proof container.

Do not mix different vaccines unless specified.

Keep resuscitation drugs & equipment ready

All vaccines are sensitive biological substances and will lose their potency.

Sensitive to heat, cold, and light.

Follow the recommended storage temperature

Cold chain maintenance

Vaccine vial monitoring(VVM)

• EPI was introduced in 1979 with DPT and BCG in 3 districts.
• By 1989 EPI operating in 75 districts.
• MCH clinic started at Bir Hospital in 1965 with the vision of increased awareness for the desirability of immunization in children.

IMMUNIZATIONS RECOMMENDED

Hepatitis B:

• Causative agent:- Hepatitis virus.
• Hepatitis B virus is transmitted from one person to another through blood and body fluids and primarily infects the liver.
• Dose:- At least 3 doses of hepatitis B vaccine is recommended at the interval of 1 month then after 6 months.

Route of administration:-  Intramuscular

MEASLES, MUMPS AND RUBELLA(MMR):

Dose:

   For those who were born in 1957 or later without serological evidence of immunity:-  2 doses of MMR at the interval of 4 weeks is recommended.

For those who were born before 1957, three criteria are given as follows:

• In case of no laboratory evidence of disease or immunity to measles or mumps:- 2 doses.
• In case of no laboratory evidence of disease or immunity to rubella:-1 dose.
• In case of no evidence of immunity:- 2 doses during an outbreak of measles and mumps and 1 dose during an outbreak of rubella.

TETANUS,DIPHTHERIA AND PERTUSIS:-

• Causative agent:- Clostridium Tetani.
• Vaccines:-
• Tetanus toxoid:- It is an inactive vaccine used to prevent tetanus.
• Tetanus immunoglobulin:- It contains antibodies against tetanus toxin.
• Dose:-
• For those who are unimmunized: 1 dose of TdaP.
• For pregnant:- 1 dose (At each pregnancy.)
• Then booster dose after every 10 years.

Influenza(Flu):-

• Causative agent:- Influenza virus.
• Vaccines:- Two types:-
• Inactivated vaccine:- It contains killed virus.

     Route:- Intramuscular.

• Live attenuated vaccine:- It contains live attenuated virus so has a potential to produce mild signs and symptoms related to influenza virus infections.

     Route:- intranasal

• Dose:- 1 dose of influenza vaccine every year.

 Varicella

• Immunization against chicken pox. Dose:- 2 dose of varicella vaccine given at least at the interval of 28 days.
• NEPAL PAEDIATRIC SOCIETY

Vaccines	Time of vaccination	Booster dose
Hib	1st dose at 6 weeks, 2nd dose at 10 weeks, 3rd dose at 14 weeks	18 months
MMR	1st dose at 18 months	During Tetanus booster
Varicella	One year
Hepatitis A	One year	18 months
Meningococcal AC	Two years	Every three year
Typhoid (Vi antigen)	Two years	Every three year

NATIONAL IMMUNIZATION SCHEDULE

For infants
at birth	BCG
6 weeks	DPT-Hep.B- Hib-1st, OPV-1st,
10 weeks	DPT-Hep.B-Hib-2nd, OPV-2nd
14 weeks	DPT-Hep.B-Hib-3rd, OPV-3rd
9 months	MEASLES
For pregnant women	TT-1, TT-2(after 1 month)
At one year	JE (for child residing at endemic region)

---

---

Kajol Shah
BPKIHS, BP Koirala Institute of Health Sciences