Vaccination schedule by age- India

The contribution of vaccination towards the development of herd immunity to infectious diseases and reduced infant mortality rate (IMR), the maternal mortality rate (MMR), increased life expectancy etc has been phenomenal. The world’s first vaccine was developed by Edward Jenner to treat smallpox in the year 1796 and his pioneering discovery eventually led to the global eradication of smallpox in 1980.

Since then, many vaccines have been discovered and distributed throughout the world to protect infants and children from various pathogens.

Table of content:

• What is a vaccine?
• What do you mean by vaccination and how does it work?
• Why is vaccination of infants necessary?
• What is the vaccination schedule by age in India?
• What precautions should be taken by parents during vaccination?
• Do vaccines have side effects?
• Are vaccines safe to use?

What is a vaccine?

According to its definition;‘vaccines are biological agents that elicit an immune response to a specific antigen derived from an infectious disease-causing pathogen’. In simpler words, vaccines provide active immunity against a particular pathogen (disease-causing agent) by sensitizing the body’s immune system. They are usually administered parenterally (by injection) but some are given using the oral route also. (eg: polio, flu)

What do you mean by vaccination?

Vaccination is the administration of a vaccine to facilitate the body’s immune system to develop protection from subsequent infection by that disease. It is a simple, safe and scientifically proven to be an effective method of providing immunity and protecting people from morbid diseases before it contacts them.

It works on the basic principle that:

Every time you fall sick, your body remembers the cause and how to destroy them. So, when attacked by the same pathogen another time, your immune cells can fight and destroy them before we become sick.

The mechanism of action is as follows:

• Vaccines are weakened pathogens that cause a particular disease.
• When introduced to your body, your immune system produces antibodies and memory cells. The former fight the pathogens. The latter remember how to.
• All this happens without the body becoming too sick because the pathogens administered are weak.
• Hence, on contact with the same pathogen later again, our body will have previously acquired the memory of how to fight them and protect itself.

Why is vaccination of infants necessary?

Infants (children between 0 - 1 year of age) do not have a fully matured immune system. So, many diseases that are manageable and produce mild symptoms in adults can cause fatal infections in newborns and infants.

Also apart from providing immediate protection, certain vaccines offer lifelong immunity. (eg: hepatitis B vaccine)

Vaccination of infants is necessary because:

• They are the safest way to guarantee the protection of your child from diseases.
• They even protect your child from preventable diseases without much effort.
• When many parents immunise their children, epidemics are easily prevented.
• When not vaccinated, your children can spread the disease to other people who cannot be vaccinated. (children too young to get vaccinated, old people)

What is the vaccination schedule by age in India?

• The first government initiative for mass immunisation was the Expanded Programme on Immunisation launched in 1978.
• The name was changed in 1985 into the Universal Immunisation Programme (UIP). UIP is one of the most cost-effective and largest public health programmes in the world and has been a part of the country’s National Rural Health Mission ever since its launch in 2005.
• Under UIP, free immunisation is provided to prevent 12 diseases:

1. 9 nationally- diphtheria, pertussis, tetanus, polio, measles, rubella, a severe form of childhood TB, hepatitis B, meningitis, pneumonia
2. 3 sub nationally- rotavirus diarrhoea, pneumococcal pneumonia, Japanese encephalitis

The revised 2020 edition of National Immunisation Schedule (NIS) for infants, children and pregnant women are:

For pregnant women:

For infants:

 For children:

*One dose if previously vaccinated within 3 years

Note:

JE Vaccine is introduced in select endemic districts after the campaign.

The 2nd to 9th doses of Vitamin A can be administered to children 1-5 years old during

biannual rounds, in collaboration with ICDS.

PCV in selected states/districts: Bihar, Himachal Pradesh, Madhya Pradesh, Rajasthan &

Uttar Pradesh (selected districts), and in Haryana as a state initiative.

• In India, a child is considered fully immunised if he/she has received all the vaccines listed under NIS within the first year of age.
• UIP’s 2 major milestones are:

1. Elimination of polio (2014)
2. Elimination of neonatal tetanus (2015)

What precautions should be taken by parents during vaccination?

• Strictly adhere to the immunization schedule provided and do not miss any vaccine. In the rare case that you do miss one, contact your paediatrician immediately.
• Mention to your doctor if your child :
• Has fever
• Had previously reacted to another vaccine in a bad way
• Experienced convulsions in the past
• Has any immune deficiency
• Some vaccines cause a mild fever to develop. If it does not recede after 24- 48 hrs visit your doctor.
• Keep a family member or your spouse to the vaccination, to better manage or distract the child.

 Do vaccines have side effects? Generally,y there are no side effects. However, very few infants might develop occasional harmless side effects such as:

• Infants may have pain at the site of injection in case of DPT vaccine.
• After the measles vaccine, the child may develop rashes

However, in some extremely rare conditions,s allergic reactions might develop and they need immediate attention.

Are vaccines safe to use?

Yes, Vaccines are extremely safe and reliable. They are made to undergo rigorous testing and modifications to be safe. Just like any other drug it undergoes animal, human and experimental tests to guarantee perfect security. Only then are they released to the public.

If any vaccine is termed unsafe while it is developing, it is not used at all.

Conclusion:-

Vaccines are arguably one of man’s greatest inventions; they have helped eradicate many deadly and incurable diseases from the world like smallpox, yellow fever etc. yet, they are always met with hesitation and suspicion as people look at vaccine safety before vaccine effectivity .recently due to an unproven link to autism, there were many protests to stop the use of vaccine altogether! Later, the doctor who had published the only paper suggesting such a link lost his medical license and his paper discredited.

However, the safety and effectiveness of a vaccine are always scientifically and experimentally proven before releasing it for public use.

Reference:-

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257027/#:~:text=Vaccines%20by%20definition%20are%20biological,cowpox%20to%20inoculate%20against%20smallpox.
3. https://www.ncbi.nlm.nih.gov/books/NBK513280/#:~:text=Active%20immunity%20functions%20as%20an,by%20the%20body's%20initial%20defense.
4. https://nhm.gov.in/index1.php?lang=1&level=2&sublinkid=824&lid=220
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831678/

By -
Dr. Ruchika Singh

14-April-2023