ZILLA SWASTYA SAMITI, SUNDARGARH ILR LEVEL MONTHLY REPORTING FORMAT, ODISHA ALTERNATE VACCINE DELIVERY SYSYEM

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3 ZILLA SWASTYA SAMITI, SUNDARGARH ILR LEVEL MONTHLY REPORTING FORMAT, ODISHA ALTERNATE VACCINE DELIVERY SYSYEM DISTRICT: BLOCK: ILR POINT: NUMBER OF SC: MONTH, YEAR: FID No of IPs with FID according to the microplan No of IPs with vaccine delivery planned through AVDS No of IPs where vaccine and logistics actually delivered through AVDS No of IPs from which unused/ used vaccine vials return back to the ILR Point on the day of immunization No of IPs from which tally sheets returned back to the ILR Point on the day of immunization No of IPs where Immunization waste returned back to the ILR Point through AVD mechanism Any other Remarks 1 st Wed Day 2 nd Wed Day 3 rd Wed Day 4 th Wed Day Other Day(please mention day/s) Total Name/ names of organization/ individuals implementing AVDS at the ILR point: Date of reporting: Signature of ILR point in-charge: Signature of MO I/C: This format has to be filled for each month and sent to the district latest by the 5 th of the next calendar month.

4 ZILLA SWASTYA SAMITI, SUNDARGARH AVDS Weekly Reporting Format, Odisha District: Block: ILR POINT: Month FID (Wed) 1 st /2 nd /3 rd /4 th /Other Date: Name of Volunteer: Name of the organization undertaking AVDS Mode of vaccine delivery: Bike/ Auto/ Private four wheeler/ Govt. vehicle/ others(specify) To be filled by LHV/ ILR Point in-charge Vaccine and Logistic supplied (Y for yes, N for No, NA for Not applicable) Signature From ILR point to IP From IP to IRR pt Time All vaccines and diluents as per passbook indent AD & 5ml Syringes as per passbook indent Tally sheet Pass book Red bag & black bag Hub cutter LHV Volunteer To be filled by whoever receives the vaccine carrier ANM/AWW/ASHA) Time of arrival Designation and Details of return of immunization materials from at IP Signature of the ANM/ IP AWW/ASHA Session 1 Session 2 Session 3 Session 4 Session 5 Time of return Used/ unused vials (tick if yes) Tally sheet (tick if yes) Imm. waste Including hub cutter waste (tick if yes) Designation and Signature of the ANM/ AWW/ASHA Note: One volunteer will not be able to deliver vaccines to more than 5 sessions. Signature of the Volunteer: Signature of LHV/ILR point I/C:

5 Date: Session Site: Name-Based List of Due Beneficiries and TALLY SHEET PHC/CHC: (ZILLA SWASTYA SAMITI, SUNDARGARH) Block: District: Vaccination and Vitamin A given Sl no Name of Beneficiary( previously drop out and new due cases) Previousl Age in y Due / Sex M/F months New Due Name of Father/ Mother Village Vaccine Due TT (PW) BCG OPV DPT Hep-B Measles 1 2 B B B DPT 5 to 6 Yrs 10 Yr TT 16 Yr Vit A Full immunizati on Reason for Drop out TOTAL LESS THAN 1 YEAR MORE THAN 1 YEAR MALE FEMALE MALE FEMALE ITEM 0.5 ml ADS 0.1 ml ADS 5 ml Syringe 0.1 ml ADS BCG vials DPT vials/ Doses OPV vials/ Doses Measles vials TT vials/ Doses Hep B vials/ Doses Received Utilized Return opened Return unopened Name of the SC Number of benificiaries due Number of benificiaries immunized Name of the session site Number of infant (0-1yr) fully immunized Number of children (16-24months) fully immunized Signature of ANM: Signature of AWW Signature of ASHAs:

6 ZILLA SWASTYA SAMITI, SUNDARGARH MONITORING CHECK LIST OF ILR/FREEZER Name of the Monitor with Designation Place of Installation.. District....State.... EQUIPMENT : Tick in the Model no: MK-300 ILR 280-lt. Fzr (Indian) MK-304/MK-302 ILR (R134a) MK-140 ILR 200-lt Fzr (Indian) MK-144/MK-142 ILR (R134a) SB-300 ILR 130-lt Fzr (Indian) MF-304/SB-302 Fzr (R134a) SB-140 Fzr MK-074 ILR+Fzr MF-144/SB-142 Fzr (R134a) HBC 70 HBC 200 TCW-1151 ILR/Fzr TCW-1990 ILR+Fzr HBD 286 HBD 116 OBSERVATIONS: Please tick: Yes No A. External X 1 The exterior of the equipment is clean 2 It is firm on floor 3 It is properly leveled 4 The equipment is minimum 10 cm. away from any wall or any other object on all sides 5 It is away from direct sunlight 6 The room is well ventilated 7 Voltage stabilizer is connected (Separately ILR & DF) 8 The plug and socket connections are not loose B. Internal 9 Lid seals properly without gap 10 Ice lining is installed in the ILRs 11 Ice-lining lubes/ice packs are filled with water to proper level and there is no leak 12 Thickness of frost formation is not more than 6 mm (If 6 mm or more, advice for defrosting) 13 Different Vaccines preserved separately in neat rows 14 There is space between vaccine rows for air circulation 15 HepB,DPT and TT vaccines are kept in ILR only, in baskets and NOT at the bottom or touching any inside wall 16 No Expired vaccines or all vaccine with unusable stage of VVM are preserved in the equipment 17 The vaccine temperature indicated is within specified range. (Deep Freezer: C to 25 0 C and ILR: +2 0 C to +8 0 C) If not, advice to adjust to thermostat to obtain steady temperature within specified limits Ice-packs are kept frozen in the Deep Freezer for Emergency Storage of Vaccine 19 Temperature is recorded minimum twice a day 20 No diluents are stored in Freezer 21 No diluents are stored in ILR, diluents are taken into ILR beofe 24 hours of session day.

7 ILR/Freezer Check List contd.. C. Technical 21 Thermostat setting at the time of observation:>>> 22 It the cabinet temperature is NOT within specified limits, adjust the thermostat to obtain steady temperature within specified limits. Note present thermostat setting:>>> 23 Voltage stabilizer connected 24 Voltage stabilizer Input/mains voltage reading: 25 Output voltage reading: 26 Plug of voltage stabilizer fits properly and not loose on the power socket 27 Connections of equipment of voltage stabilizer proper and not loose 28 Compressor compartment and the components inside are clean 29 Electrical connections are proper 30 NO abnormal noise 31 Cooling fan (if any) working properly 32 Compressor and fan mounting bolts are tight 33 Pipe or components are NOT out of position and NOT touching others 34 Temperature recorded is minimum twice a day Stock Management The Stock Register of ILR point available 36 If available maintained & updated 37 The Issue Register of ILR point available 38 If available maintained & updated 39 Pass Book of LHV available 40 If available maintained & Updated D. Any other observations/remarks (Please write in detail) : E. Inventory all cold chain equipments at time of observations Name of the Equipments Nos. Name of the Equipments Nos. ILR(L) ILR(S) DF(L) DF(S) COLD BOX(L) COLD BOX(S) VOLTAGE STABILIZER VACCINE CARRIER THERMOMETER ICE PACKS Memo No Date Copy to Directorate of Family Welfare, SMCS Cell, Odisha for information and necessary action. Signature of the Monitor : Signature of the CCH

8 ZILLA SWASTYA SAMITI, SUNDARGARH ( _ ) / _ / / _ / (not to be filled by monitor) Block/ PHC Level Monitoring Format for Routine Immunization Encircle appropriate options. For (*) marked questions multiple responses may be applicable; Name of Monitor: Date: dd / mm / yy Organization: WHO / Govt / UNICEF / IPE / Others Designation: State: District: Block/ Urban Local Body: Planning Unit: Setting: Rural / Urban Type of Health Facility: CHC / PHC / Urban Health Post /Other (specify) HR Block as per EPRP: Yes /No Check records and observe at Block Health Facility 1 Current staff position Medical Officer LHV + Other Health Staff Total ANMs (1st + 2nd) ASHA / Link Worker (Regular + Contractual) Number Sanctioned Number in place 2 Number of sub centres with: No ANM One ANM Two ANMs 3* Components of RI Microplan available : ANM Roster Yes / No Map of Catchment area Yes / No Number of Beneficiaries Yes / No Injection Load Yes / No Estimation of logistics and vaccines Yes / No Alternate Vaccine Delivery Plan Yes / No Supervision Plan Yes / No Communication / Mobilization Plan Yes / No Waste management plan Yes / No 4 Status of Polio High Risk Areas tagging in RI micro-plan Construction Settled Slums Nomads Brick kilns Others Site (Non-Migratory) (a) Number of HRAs identified in block (b) Number of HRAs included in RI plan 5 Is the alternate plan for vacant sub centres available Yes / No / NA 6 Updated RI Coverage Monitoring Chart available at health facility Yes / No 7 Is at least one ILR and one Deep Freezer functional ILR Deep Freezer Yes / No Yes / No 8 Is any vaccine kept in deep freezer Yes / No If yes, specify _ 9 Have sufficient number of diluents been stored inside ILR Yes / No 10 Frozen DPT / TT / Hepatitis B / Pentavalent vaccines present inside ILR Yes / No If yes, specify _ 11 Expired vaccine vials present inside ILR Yes / No If yes, specify _ 12 Other medicines stored inside ILR with Vaccines Yes / No If yes, specify _ 13 Are updated Temperature log books for all functioning ILRs & DFs available Yes / No 14 Are updated Stock Registers available for a) Vaccine Yes / No b) Diluents Yes / No c) Other Yes / No 15* Shortage of any vaccine experienced in last 3 months Yes / No If yes,duration of shortage (in days): BCG Hep B topv DPT Measles TT Pentavalent JE Stock-out Inadequate stock 16* Which of the vaccines / diluents are NOT available in quantities sufficient BCG topv Pentavalent for next one week BCG Diluent JE DPT JE Diluent Measles Hepatitis B Measles Diluent TT 17* Which of the logistics are NOT available at block level AD (0.1ml) Syringes Plastic Spoon / cap for Vitamin-A AD (0.5 ml) Syringes Red & Black bags 5ml Reconstitution Syringes Paracetamol Blank RI / MCP Card Zinc Tablet / Syrup Vitamin-A Solution IFA Tablet ORS Packet AEFI management kit 18 What is the mechanism for immunization waste disposal Sharp disposal pit / Outsourced / None 19 HMIS report for previous month sent to district Yes / No 20 Status of updating MCTS database of last completed month #Doses given as per monthly report #Entered for the month in MCTS DPT3 MCV

9 House to House Monitoring Format for Routine Immunization (ZILA SWASTYA SAMITI, SUNDARGARH) Encircle appropriate options. For (*) marked questions multiple responses are allowed; Name of Monitor: Organization: WHO / Govt / UNICEF / IPE / Others Designation: Date: dd / mm / yy ( _ ) / _ / / _ / (not to be filled by monitor) State: District: Block/ Urban Local Body: Planning Unit: Setting: Rural / Urban Name of session site catering to area : Sub centre / Urban health post : At least one session held for this area in last 3 months: Yes / No / Not Known Reason for monitoring this session site*: Polio HRA / Measles Outbreak in last 1 year / Other VPD outbreak in last 1 year / Area under vacant sub-centre / Others Name of village/mohalla: If Polio HRA, type: 1- Slums with migration / 2 Nomads / 3 Brick kiln / 4 Construction site / 5 Other migratory high risk areas / 6- non migratory (settled population) high risk areas Sl. Particulars / Questions House-1 House-2 House-3 House-4 House-5 House-6 House-7 House-8 House-9 House-10 1 Name of the selected Child (0-35 months) 2 Name of the Father 3 Religion (H=Hindu / M=Muslim / O=Others) H / M / O H / M / O H / M / O H / M / O H / M / O H / M / O H / M / O H / M / O H / M / O H / M / O 4 Does the family have Below Poverty Line (BPL) card? Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No 5 Is RI / Mother and Child Protection Card available? Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No 6 Sex of the selected child (M=Male / F=Female) M / F M / F M / F M / F M / F M / F M / F M / F M / F M / F 7 Date of Birth ( if not known, write age in months & days) ) Vaccination status of the youngest child in the house-hold: From RI card write Date for each vaccine received. If Date is not available from any source, ask care-givers. Write Y for doses received and N for missed doses. 8 BCG OPV-0 dose Hep B Birth dose DPT 1 OPV 1 Hep B1 Pentavalent 1 DPT 2 OPV 2 Hep B2 Pentavalent 2 DPT 3 OPV 3 Hep B3 Pentavalent 3 Measles 1 st dose JE Vaccine 1 st dose (in select districts) OPV Booster DPT Booster Measles 2 nd dose JE Vaccine 2 nd dose (in select districts) 9* If not vaccinated as per age, only then ascertain the reason 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / 1 / 2 / 3 / 4 / for missing the due vaccine doses (see keys) 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 5 / 6 / 7 / 8 / 9 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / 99 / 10 / 88 / Does the family know the timing of visit for next vaccine due? Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Keys for Question 10: 1= Not aware of need for immunization; 2= Aware but did not know where or when to go to get immunization; 3= As child was sick care-giver did not go for vaccination; 4= As child was sick health worker did not vaccinate; 5= Fear of AEFI; 6= Adverse media reports; 7= Session time/ location/ long waiting time not convenient; 8= Vaccinator s behaviour not friendly; 9= Non-availability of vaccine at centre; 10= Child was travelling/ away from residence; 88= Other ; 99= Do not know why. To calculate due doses, refer to ready-reckoner on back of the format ; In select states Pentavalent replace both DPT 1,2,3 and Hep B 1,2,3

10 Ready Reckoner to analyze whether the child has received all due doses of vaccines Age Ideal Vaccination Status by age as per National Immunization Schedule (In completed months) BCG OPV DPT Hep-B Measles dose DPT Booster OPV Booster 0 BCG OPV-0 (upto 15 Birth dose days from birth) 1 BCG 2 BCG OPV-1 DPT-1 Hep-B-1 3 BCG OPV-1,2 DPT-1,2 Hep-B-1, 2 4 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 5 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 6 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 7 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 8 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 9 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1st dose 10 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1st dose 11 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1st dose 12 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1st dose 13 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1st dose 14 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1st dose 15 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1st dose 16 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 17 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 18 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 19 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 20 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 21 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 22 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 23 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 24 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 25 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 26 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 27 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 28 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 29 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 30 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 31 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 32 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 33 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 34 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster 35 BCG OPV-1,2,3 DPT-1,2,3 Hep-B-1,2,3 Measles 1 & 2 dose DPT Booster OPV Booster In select endemic districts, JE vaccine is proposed to be given at 9 months (1 st dose) and after 16 months of age (2 nd dose).

11 Session Monitoring Format for Routine Immunization (ZILLA SWASTYA SAMITI, SUNDARGARH) Encircle appropriate options. For (*) marked questions multiple responses are allowed; ( _ ) / _ / / _ / (not to be filled by monitor) Name of Monitor: Organization: WHO / Govt / UNICEF / IPE / Others Designation: 'Date (dd/mm/yy): / / State: District: Block/ Urban Local Body: Planning Unit: Setting: Rural / Urban Sub centre / Urban Health Post: Name of session site with Village / Mohalla : Reason for monitoring this session site*: If Polio HRA, type of HRA: Location of Session Site: Polio HRA / Measles Outbreak in last 1 year / Other VPD Outbreak in last 1 year / 1- Slums with migration / 2 Nomads / 3 Brick kiln / 4 Construction site / 5 Other Distt. Hospital / CHC / PHC / Sub Centre / ICDS Centre / Others Session planned for vacant ANM subcentre / Others migratory high risk areas / 6- non migratory (settled population) high risk areas (Specify) 1a Is session held: Yes / No b) If session is not held, reason: A- Neither ANM/ Vaccinator nor vaccines/logistics is available / B- ANM/vaccinator present but vaccine/logistics not available / C- Vaccine / logistics available but ANM / vaccinator absent / D- Others (specify) If session is not held, please stop session monitoring and go for house-to-house monitoring 2 Is due list available with the ANM No list / list not updated / Updated list 10 Is ANM cutting each syringe with hub cutter just after use Yes / No / Not Observed 3* Is any mobilizer assigned to the session site ASHA/ USHA/ AWW/ Others/ None If No, why: A- Hub-cutter not available / 4 If due list available, is it with the mobiliser Yes /No / Not Observed / Not Applicable B- Hub-cutter not functioning / 5 Is mobilizer mobilizing the children to session site Yes /No / Not Applicable C- Untrained ANM / 6 Is any polio HRA tagged to this site Yes /No / Not Applicable D- Others 7 Who delivered vaccine / logistics to the site ANM / AVD / Teeka Express / Others 11 Is ANM marking ALL vials with date/time before first use? Yes / No 8* Which of the vaccines/diluents are available at session site? Any open vial re-issued? 12* Is any reconstituted vial in use after the specified time has lapsed? BCG / Measles / JE / None BCG: No/ Inadequate/ Adequate 13 Is ANM delivering all 4 Key Messages to the care-givers (see below) Yes / No / Not Observed BCG Diluent: No/ Inadequate/ Adequate 14 Is ANM advising the care-givers to wait for 30 mins after vaccination Yes / No / Not Observed DPT: No/ Inadequate/ Adequate Yes / No 15* Who has mobilized you to this session site (Interview Three Caregivers) / Not observed Hepatitis B: No/ Inadequate/ Adequate Yes / No Caregiver 1 Caregiver 2 Caregiver 3 Measles: No/ Inadequate/ Adequate ASHA / USHA/ ICDS Worker / ASHA / USHA/ ICDS Worker / ASHA / USHA/ ICDS Worker / Measles Diluent: No/ Inadequate/ Adequate ANM / CMC / Others/ None ANM / CMC / Others/ None ANM / CMC / Others/ None topv: No/ Inadequate/ Adequate Yes / No Q16 to Q20: Ask & Verify the records with ANM / vaccinator / ASHA (as applicable) TT: No/ Inadequate/ Adequate Yes / No 16 At which minimum age will you (ANM) give 2nd Measles dose? 9-12m / 16-24m / any other age JE: NA/ No/ Inadequate/ Adequate 17 Is the MCTS register maintained? Yes / No / Not Observed JE Diluent: NA/ No/ Inadequate/ Adequate 18 Has any supervisor visited this session today? Health Supervisor / MO / None / Others Pentavalent: NA/ No/ Inadequate/ Adequate Yes / No 19 Has the ASHA received the payment for previous RI Session Yes / No / Not applicable 9* Which Logistics are available at session site? 20 Has the ASHA received the payment for all Fully Immunized (FI) and For FI: Yes / No / Partial / NA AD (0.1ml) Syringes: No/ Inadequate/ Adequate Red & black bags No/ Inadequate/ Adequate Completely Immunized (CI) children upto last month For CI: Yes / No / Partial / NA AD (0.5 ml) Syringes: No/ Inadequate/ Adequate Vitr A spoon/ cap No/ Inadequate/ Adequate FI= BCG+ OPV3+ DPT3+ HepB3+ MCV1; CI= FI + OPV booster+ DPT booster+ MCV2 5ml Reconstitution Syringes: No/ Inadequate/ Adequate If any Vaccine or logistic is not available or ANM has been absent, please visit the PHC to ascertain the reason of non- Blank RI / MCP Card: No/ Inadequate/ Adequate availability: Vitamin-A Solution: No/ Inadequate/ Adequate 21 Why Vaccine or logistic has not been available Stock out / No AVD / Paracetamol tablet/ syrup: No/ Inadequate/ Adequate Others ORS Packet: No/ Inadequate/ Adequate 22 Why ANM has been absent Post got vacant / On leave / IFA tablet: No/ Inadequate/ Adequate Zinc Tablet/ Syrup: No/ Inadequate/ Adequate Others Message 1: What vaccine was given and what disease it prevents Message 3: What are the minor side-effects and how to deal with them 4 Key Messages Message 2: When to come for the next visit Message 4: To keep the immunization card safe and to bring it along for the next visit