Total population 1,265,308,000. Live births (LB) 27,016,000. Children <1 year 25,928,200. Children <5 years 23,818,000. Children <15 years 25,639,000

Transcription

1 India 4 Immunization system highlights There is a comprehensive multiyear plan (cmyp) for immunization covering 3-7. National technical advisory group on immunization (NTAGI) exists and formal written terms of reference are in the process of being adopted. A national system to monitor adverse events following immunization (AEFI) exists. A national policy for health care waste management including waste from immunization activities exists. All 36 States and Union Territories have achieved MNT elimination status by May 5. 78% spending on vaccines financed by the government. 78% spending on routine immunization programme financed by the government. JE campaign conducted in March 4-January 5, targeting 5,37,773 children of -5 years of age, and coverage was 87%. No stock-out of vaccines reported in 4. Effective vaccine management assessment done in states. In 4 eleven states/ UTs conducted validation of maternal and neonatal tetanus elimination. Introduced polio vaccination policy for travellers to and from polio endemic/infected countries in 4. Post introduction evaluation for DTP-Hib-HepB and MCV was conducted in six states / UTs in 4. Plan to introduce IPV in October 5 and Rubella & Rotavirus vaccines in 5. Mission Indradhanush to immunize all children against 7 VPDs was launched in December 4. Table : Basic information 4 Total population,65,38, Live births (LB) 7,6, Children < year 5,98, Children <5 years 3,88, Children <5 years 5,639, Pregnant women 9,78, Women of child bearing age (5-49 years) Neonatal mortality rate Infant mortality rate Vaccine BCG HepB OPV DTP DTP-Hib- HepB Measles JE TT Vitamin A Age of administration At birth At birth, 6th, th and 4th weeks At birth, 6th, th, 4th weeks and 6-4 months 6th, th, 4th weeks, 6-4 months and 5-6 years 6th, th, 4th weeks (selected states) 9 months and 6-4 months 3,46,3 9 (per, LB) 4 (per, LB) Under-five mortality rate 5 (per, LB) Maternal mortality ratio 78 (per, LB) SEAR annual EPI reporting form, 4 and WHO, World Health Statistics 4 Table : Immunization schedule, 4 9- months and 6-4 months (JE endemic districts) years, 6 years and doses/booster for pregnant women 9 months, 8 months and 6 months interval till age 5 years Source: WHO/UNICEF joint reporting form (JRF) 4 Division/Province/State/Region 36 District 674 Block 5958 Population density (per sq. km) 38 Population living in urban areas 3% Population using improved drinking-water sources 93% Population using improved sanitation 36% Total expenditure on health as % of GDP 3.9% Births attended by skilled health personnel 3 67% Neonates protected at birth against NT 87% 3 Institutional births (WHS, 4) EPI history Vaccination practiced in India since the early 9s. BCG introduced in 96. EPI was launched in 8 with DPT, OPV, BCG and typhoid. TT immunization of pregnant women was introduced in 3. Measles was introduced in 5. HepB piloted in and made universal in. MCV introduced in. Hib Pentavalent (DTP-Hib-HepB) introduced in two states in and gradually expanded to eight states in 3. Two doses of JE (9- months and 6-4 months) introduced in 3 in endemic districts. Open vial policy introduced in 3. Source: cmyp 3-7 and EPI/MoHFW Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. World Health Organization SEARO/FHR/IVD July 5 Immunization and Vaccine Development South-East Asia Region

2 E P I FAC T S H E E T Figure : DTP3 coverage, diphtheria and pertussis, BCG DTP3 OPV3 MCV Diphtheria Cases Source: WHO/UNICEF coverage estimates. Figure 3: DTP-Hib-HepB3 coverage, Pertussis Cases DTP3 Coverage WHO/UNICEF coverage estimates. WHO vaccine-preventable diseases: monitoring system 4 & JRF 4. Figure 4: TT+ coverage and NT, NT <7% 7% - 79% 8% - 89% TT+ Coverage Country official estimates, -4. WHO vaccine-preventable diseases: monitoring system 4 & JRF 4. > 9% Source: SEAR annual EPI reporting form, 4 (administrative data) Table 3: OPV supplementary immunization activities (SIA), -4 Start date Activity Children immunized (<5 years) Coverage based on independent monitoring (%) Start date Activity Children immunized (<5 years) Coverage based on independent monitoring (%) 5-Jan- 9-Feb- 8,77,574 7-Apr-3 7,746,34 68,69,78 6-Jun-3 7,3,7 8-Mar- 55,78,79 5-Sep-3 7,38,3 5-Apr- 68,,45 4-Nov-3 7,78,96 7-Jun- 7,89,49 9-Jan-4 67,89,448 9-Sep- 7,365,94 3-Jan-4 68,48,57 4-Nov- 7,455,848 6-Apr-4 46,879,86 -Jan-3 67,47,68 -Sep-4 7,8,98 4-Feb-3 68,5,3 6-Nov-4 7,564,88 Source: NCCPE reports and WHO/UNICEF JRF World Health Organization SEARO/FHR/IVD July 5 Figure : National immunization coverage, -4

3 Table 4: AFP surveillance performance indicators, 5-4 The last polio case due to wild polio virus (WPV) was reported on 3 January from West Bengal. Indicator AFP 7,49 3,94 4,54 45,585 5,45 55,785 6,54 6,9 54,66 54, Wild poliovirus confirmed Compatible AFP rate Non-polio AFP rate Adequate stool specimen collection percentage 8% 8% 84% 84% % % 84% 87% 86% 87% Total stool samples collected 5,56 6,649 8,64 88,36,648 8,7 7,774 9,39,4 5,939 % NPEV isolation % Timeliness of primary result reported Number of discarded AFP per, children under 5 years of age. Percent with specimens, 4 hours apart and within 4 days of paralysis onset. 3 5 to 7 result reported within 8 days and 8 onwards result reported within 4 days of sample received at laboratory. Figure 5: Non-polio AFP rate by district, 4 Figure 6: Adequate stool specimen collection percentage by district, 4 <. > No non-polio AFP case < 6% 6% 79% > 8% No AFP Source: Weekly Acute Flaccid Paralysis (AFP) data Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus) Source: Weekly Acute Flaccid Paralysis (AFP) data Table 5: Reported of vaccine preventable disease, 5-4 Measles Rubella Mumps Japanese Encephalitis Congenital Rubella Syndrome ,86 3, 8 (8%) 36,7 ND ND ND ND 6 676,4 3,88 65 (%) 64,85 ND ND ND ND ,8 46,674,76 (4%) 4,44 ND ND 4,7 ND ,7 43,6 876 (3%) 44,58 ND ND 47 ND 9 74 a 3,59 6,385 8 (4%) 56,88 ND ND 653 ND 4 b 3,434 4,58 5 (3%) 3,458 ND ND 555 ND c 4,33 39,9 734 (6%) 33,634 ND ND,4 ND d,55 44, (4%) 8,668,3 ND ND ND 3 e 3,33 3,89 45 (5%) 3,8 3,6 ND,78 ND 4 f 6,94 46,76 49(%) 4,7 487 ND 657 ND a Excludes two type VDPV and nineteen type VDPV b Excludes five type VDPV c Excludes six type VDPV and one type 3 VDPV d Excludes one type VDPV e Excludes five type VDPV f Excludes three type VDPV Source: WHO/UNICEF JRF ND=No data

4 Figure 7: MCV & MCV coverage and, -4 Figure 8: MCV coverage by province, Measles Cases MCV Coverage MCV coverage WHO/UNICEF coverage estimates. WHO vaccine-preventable diseases: monitoring system 4 & JRF 4. <7% 7% - 79% 8% - 89% > 9% Source: SEAR annual EPI reporting form, 4 (administrative data) Table 6: MCV supplementary immunization activities Table 7: Provinces with more than 95% MCV coverage Vaccine, geographic coverage, target group Target Coverage Achieved Number of provinces % M, sub-national, 9 months to years M, sub-national, 9 months to years M, sub-national, 9 months to years 3,845,686 87% 4,67,58 9% 76,73,639 9% Source: WHO/UNICEF JRFs Source: WHO/UNICEF JRF (multiple years) Figure 9: Sporadic and outbreak associated * by month and MR SIA coverage, -4 4 M, follow up (%) Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-3 Feb-3 Mar-3 Apr-3 May-3 Jun-3 Jul-3 Aug-3 Sep-3 Oct-3 Nov-3 Dec-3 Jan-4 Feb-4 Mar-4 Apr-4 May-4 Jun-4 Jul-4 Aug-4 Sep-4 Oct-4 Nov-4 Dec-4 Sporadic Outbreak associated *Includes laboratory confirmed and epidemiologically linked Source: SEAR Monthly VPD reports Immunization and Vaccine Development South-East Asia Region

5 Figure : Immunity against : Immunity profile by age in 5* Percent of population % 9% 8% 7% 6% 5% 4% 3% % % % Age (in years) Protected by maternal antibodies Protected by routine vaccination with nd dose Immune due to past infection Protected by routine vaccination with st dose Protected by SIAs Susceptible * Based on coverage data up to 4 with approximately 48% children aged 9 months to years reached with SIA between -. Source: Modeled using MSP tool ver Figure : Immunity against : Immunity profile by age in 6* Percent of population % 8% 6% 4% % % Age (in years) Protected by maternal antibodies Protected by routine vaccination with st dose Protected by routine vaccination with nd dose Protected by SIAs Immune due to past infection Susceptible * Assuming the schedule and coverage of Measles containing vaccine is unchanged in 5. Source: Modeled using MSP tool ver Figure : Confirmed (Lab and Epi linked) outbreak associated, by age, -4 Figure 3: Unimmunized confirmed (Lab and Epi linked) outbreak associated, by age, -4 8 n=84 n=8589 n=58 n=6485 n=4 n=765 n=355 n=79 n=3884 n=3758 (34%) (38%) (69%) (6%) (55%) < year -4 years 5-9 years -4 years 5+ years < year -4 years 5-9 years -4 years 5+ years Source: SEAR annual EPI reporting form (multiple years) Source: SEAR annual EPI reporting form (multiple years) Table 8: Suspected sporadic and Outbreak associated and rubella, -4 Routine/sporadic Outbreak associated suspected case death labconfirmed labconfirmed rubella suspected outbreak Outbreak Investigated case death outbreak* confirmed case* confirmed rubella outbreak* confirmed rubella * 7, , , , ,85 5 3,7 5,38,3 3, , ,34 6,86 3 6, , ,858 7, ,93 - -,69, 34, ,44 4,3 Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked

6 EPI FACT SHEET Table 9: Quality of field and laboratory surveillance for and rubella, -4 Case classification (number) Indicators Suspected Measles Lab-confirmed Measles Epi-Linked Clinically-confirmed Rubella Lab-confirmed Epi-Linked Discarded non- non-rubella Annual incidence of confirmed Measles per million total population Annual incidence of confirmed Rubella per million total population Proportion of all suspected and rubella that have had an adequate investigation initiated within 48 hours of notification Discarded non- non-rubella incidence per, total population Proportion of subnational administrative units reporting at least two discarded non- non-rubella per, total population Proportion of sub-national surveillance units reporting to the national level on time Target - - 8% 8% 8% 3, ,89, ,74 9 6,3-373,4, ,93 3,3, ,35, Source: SEAR Annual EPI Reporting Form, 4 ND=No data Table : Performance of Laboratory Surveillance, -4 % Serum specimen collected from suspected Total Serum Specimen received in Laboratory % serum specimens tested Specimen Positive for Measles IgM Specimen Positive for Rubella IgM % Results within 4 of receipt % Outbreak tested for viral detection Genotypes detected No. % No. % Measles Rubella D , D8 B ,473.73, D4,D8,B3 Source: SEAR Annual EPI Reporting Form, 4 ND=No data Figure 4: Network of WHO supported surveillance medical officers and laboratories, 4 Surveillance medical officers Laboratories: Polio Measles/rubella Polio and /rubella Japanese encephalitis IBD and Rotavirus reference Lab Source: WHO/NPSP and SEARO For contact or feedback: Immunization Division Ministry of Health and Family Welfare (MOHFW), New Delhi, India Tel/Fax : , pradeephaldar@yahoo.co.in Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi, India Tel: , Fax: SEAREpidata@who.int, World Health Organization SEARO/FHR/IVD July 5 Immunization and Vaccine Development South-East Asia Region