FIMDP 2013 DEPT OF COMMUNITY MEDICINE SRM MEDICAL COLLEGE,SRM UNIVERSITY & UNSW AUSTRALIA 9 TH & 10 TH JAN 2013

Transcription

1 FIMDP 2013 DEPT OF COMMUNITY MEDICINE SRM MEDICAL COLLEGE,SRM UNIVERSITY & UNSW AUSTRALIA 9 TH & 10 TH JAN 2013

2 Immunization Dr A Prema Prof. & HOD, Dept of Pediatrics SRM Medical College

3 Beginning of Vaccination. Vaccination ( Latin ; Vacca- Cow ) Edward Jenner used the term Vaccination Cow pox virus provided immunity in prevention of Small pox

4 Edward Jenner Vaccinating

5 Scientific Era of Vaccination. Louis Pasteur adopts the principles of Vaccination For his scientific work. Vaccination for prevention of Rabies creates awareness on Immunization with scientific fundamentals

6 Pioneers in Prevention of Poliomyelitis

7 Eradication of Small Pox WHO efforts with various Governmental and Social Organizations have changed History of Medicine

8 WHO included EPI globally in 1974 India one of the first to adopt in 1978 Inspite of advances VPD burden high VPD account for 25% of 10 million deaths annually ARI contribute to 18% Diarrheal disorder 11%

9

10 Vaccines and immunization can reduce under 5 mortality WHO & UNICEF global immunization vision strategy ( GIVS ) Specific goal to achieve 90% DTP3 coverage at national level, 80% at district level Decade of vaccine 64 WHA endorse global vaccine action plan In view of poor coverage in a few countries of SEAR Director declared 2012 year of intensifying RI

11 Vaccination performance Nation wide data by NFHS ICMR UNICEF Local bodies

12 National fully immunized (6 vaccines UIP) 12 to 23 months old 61% Tendency to present vaccination performance in terms average coverage rate raises issue of equity Averages often mask the wide disparity between extremes For example national average 61 % Tamil Nadu 81 % and Nagaland 21 %

13 NEW INTIATIVE UIP in India targets 27 million infants and 30 million pregnant women Since launch of NRHM 15 billion dollars in addition to health budget key focus on RCH including immuniztion

14 India introduced HB vaccine - extended to entire country Vaccine for Jap encephalitis 15 states HIB vaccine (pentavalent) 2 states Framing national vaccine policy

15 Barriers to achieve the RI rates Lack of vaccine related knowledge, fear of side effect Uncertainty of service provision Supply of vaccine shortage, vacant staff position Lack of training Inadequate monitoring Managerial, administrative, governance related inadequacies Weak VPD surveillance Lack of disease burden data

16 WHAT IS NEEDED? Address the barriers Increase the number of immunization delivery points in rural and remote areas Immunization booths especially in slums Members to be made accountable Complete immunization made mandatory to get admission in schools

17 Proper monitoring of the programme Impact / output Develop effective surveillance system eg. AFP AFIX : Assesment Feed back Incentive exchange of information

18

19

20

21

22 Issues in UIP 1. Switch from OPV to IPV 2. Two doses of MMR / Varicelle 3. Rota virus vaccine 4. Acellular Pertussis vaccine for adolescent and adults Tdap

23

24 Polio endgame refers to management of the post eradication risks due to OPV Vaccine associated paralytic polio ( VAPP ) Circulating vaccine derived poliomyelitis (cvdpvs) Working group meeting confirmed early universal IPV as early as October 2013, in a sequential manner Switch from topv to bopv, then IPV

25

26 Two doses of MMR and Varicella 12 to 15 months and at 5 years Rota virus vaccine -? Considering huge burden of rota virus diease, even low efficacy vaccine should translate into significant number of lives saved Cross protection and protection against nonvaccine strains proved Lack of data for acellular pertussis for adults

27 New vaccines available : Pneumococcus Meningococcus Rotavirus HPV (human papiloma virus) Zoster virus Swine flu (H1N1) Yellow fever

28 Vaccines under trial : Tuberculosis Malaria Dengu Chickungunya Filariasis Leishmaniasis

29 Leptospirosis Anthrax HFMD Dental caries ( streptococus mutans ) Edible vaccines

30 SUCCESS STORY COMPLETE ERADICATION OF SMALLPOX WHO PREDICTION : ERADICATION OF PARALYTIC POLIO THROUGHOUT THE WORLD SIGNIFICANT REDUCTION OF INCIDENCE OF DISEASES: DIPTHERIA, MEASLES, MUMPS, PERTUSSIS, RUBELLA, TETANUS

31 NEED OF THE HOUR SEARCH FOR EFFECTIVE VACCINES FOR DISEASES LIKE: MALARIA, TUBERCULOSIS AIDS / HIV IMPROVEMENT IN SAFETY AND EFFICACY OF PRESENT VACCINES LOW COST EFFICIENT DELIVERY TO NEEDY REDUCTION OF ADVERSE SIDE EFFECTS

32 Science Hopes a Vaccine for every Disease

33 Thank you