FIMDP 2013 DEPT OF COMMUNITY MEDICINE SRM MEDICAL COLLEGE,SRM UNIVERSITY & UNSW AUSTRALIA 9 TH & 10 TH JAN 2013
Immunization Dr A Prema Prof. & HOD, Dept of Pediatrics SRM Medical College
Beginning of Vaccination. Vaccination ( Latin ; Vacca- Cow ) Edward Jenner used the term Vaccination Cow pox virus provided immunity in prevention of Small pox
Edward Jenner Vaccinating
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
Pioneers in Prevention of Poliomyelitis
Eradication of Small Pox WHO efforts with various Governmental and Social Organizations have changed History of Medicine
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%
Vaccines and immunization can reduce under 5 mortality WHO & UNICEF global immunization vision strategy ( GIVS ) 2006 2015 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
Vaccination performance Nation wide data by NFHS ICMR UNICEF Local bodies
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 %
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
India introduced HB vaccine - extended to entire country Vaccine for Jap encephalitis 15 states HIB vaccine (pentavalent) 2 states Framing national vaccine policy
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
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
Proper monitoring of the programme Impact / output Develop effective surveillance system eg. AFP AFIX : Assesment Feed back Incentive exchange of information
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
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
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
New vaccines available : Pneumococcus Meningococcus Rotavirus HPV (human papiloma virus) Zoster virus Swine flu (H1N1) Yellow fever
Vaccines under trial : Tuberculosis Malaria Dengu Chickungunya Filariasis Leishmaniasis
Leptospirosis Anthrax HFMD Dental caries ( streptococus mutans ) Edible vaccines
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
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
Science Hopes a Vaccine for every Disease
Thank you