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Immunization Programme

Tamil Nadu started the immunization programme against six vaccine preventable diseases in 1978. In order to strengthen the programme further Universal Immunization Programme was launched in 1985. Annually, around 12 lakh pregnant women and 11 lakh infants are being covered under this programme. Pregnant mothers are immunized every year with tetanus toxoid injection for prevention of tetanus infection during delivery.

All pregnant women and their newborns need to be protected against Vaccine preventable Diseases. Immunization Programme aims to reduce mortality and morbidity due to Vaccine Preventable Diseases (VPDs), particularly for children. Under the Immunization Programme, vaccines used to protect children and pregnant mothers includes TB, Diptheria, Pertussis, Hepatitis-B, Haemophilus influenza B, Tetanus, Polio, Measles and Rubella.

Pentavalent vaccine was introduced in Tamil Nadu from 21st December, 2011 onwards. Pentavalent vaccine gives protection against five vaccine preventable diseases namely diphtheria, pertussis, tetanus, Hepatitis-B and Haemophilus influenza-B with fewer needle pricks to a child.

Japanese Encephalitis

Pentavalent vaccine was introduced in Tamil Nadu from 21st December, 2011 onwards. Pentavalent vaccine gives protection against five vaccine preventable diseases namely diphtheria, pertussis, tetanus, Hepatitis-B and Haemophilus influenza-B with fewer needle pricks to a child.

Acute Flaccid Paralysis Surveillance

South East Asian region including India was certified as Polio Free on 27th March 2014. However there is still active polio transmission in two neighbouring countries of Pakistan & Afghanistan. Global importation is a major risk to Polio Eradication initiative. Reporting of Acute Flaccid Paralysis (AFP) cases for surveillance should be continued till Global Polio free certification.

Acute flaccid paralysis case is defined as sudden onset of weakness and floppiness in any part of the body in a child < 15 years of age or paralysis in a person of any age in whom polio is suspected.

AFP surveillance helps to detect reliably areas where poliovirus transmission is occurring. Thus AFP surveillance helps us to identify areas of priority for focusing immunisation activities. It is the most reliable tool to measure the quality and impact of polio immunisation activities.

Polio surveillance for a case of disease in a child that “looks like polio” alone is not sufficient because it is impossible to precisely identify all cases of paralytic polio clinically due to confusing and ambiguous clinical signs and variable clinical knowledge and skills of doctors. To ensure that no cases of polio are missed, all cases of AFP are reported and investigated.

Differential Diagnosis of Acute Flaccid Paralysis in addition to Polio includes:

All these AFP cases to be notified immediately to the DDHS. Preferably the child should be admitted to the nearest health facility (Reporting Units).

The Nodal Person of the health facility will investigate the case using standard Case investigation form (CIF) & initiate the process of collecting two stool specimen from the affected child and send the specimen to King Institute Laboratory, Guindy, Chennai for virological analysis.

After the sample collection steps to provide one additional dose of OPV to all children below 5yrs in the affected village to be undertaken along with community search for additional AFP Cases.

The incidence of other Vaccine Preventable Diseases is also on the decline

Pulse Polio Immunization (PPI)

The State is polio free since 2004. For the eradication of poliomyelitis, Pulse Polio Immunization campaign was introduced in the year 1995-96, which along with efficient routine immunization coverage has successfully eliminated the dreaded disease from the State. During 2017, two rounds of pulse polio immunization campaigns are planned to be conducted on 2.04.2017 and 30.04.2017 as part of the Nationwide Intensified Pulse Polio Immunization campaign in order to prevent the importation of polio virus and to sustain the zero polio status.

Success of Immunization programme

Due to successful implementation of immunization programme for more than two decades, vaccine preventable diseases like neo-natal and maternal tetanus, diphtheria, whooping cough have disappeared from the State. Polio free status is maintained for the past Thirteen years. There has also been a significant reduction in measles cases.

Mission Indradhanush

The Ministry of Health & Family Welfare (MoHFW) GoI, launched Mission Indradhanush in December 2014 to achieve more than 90% full immunization coverage in the country by 2020 (from 65% to 90%). A special drive to vaccinate all unvaccinated and partially vaccinated children below 2 years and Pregnant Women under UIP. In Tamil Nadu all districts have been covered under Mission Indradhanush.

Flood affected Area – Special Measles vaccination campaign

Special Measles vaccination campaign is being conducted in flood affected High risk areas namely Chennai, Kancheepuram, Tiruvallur, Cuddalore and Tuticorin districts to cover 9 months to 15 years children.

Switch from tOPV to Bopv

The Oral polio vaccine contains type 1,2,3 viruses. As a global initiative, GoI have switched from tOPV to bOPV from 25th April 2016 since type 2 polio virus has been eradicated. In Tamilnadu, the switch from tOPV to bOPV was implemented on the same day. The bOPV contains only type 1 and 3 virus.

Introduction of IPV

Inactivated Polio Vaccine (IPV) contains polio virus strains of all 3 polio virus sero-types. IPV was introduced from 22nd June 2016. Combined use of IPV and bOPV provides strong intestinal immunity and antibody protection against all 3 sero types. IPV is a liquid vaccine, no reconstitution required. IPV is being administered along with Penta 1 and Penta 3 at 6th and 14th week of infancy.

Introduction of Measles-Rubella vaccine

As per the National Technical Advisory Group on Immunization (NTAGI) recommendation, MR vaccination campaign has been conducted during the month of February 2017 and extended upto March 15th 2017 targeting all children aged 9 completed months to <15 years with a simultaneous switch from measles to MR vaccine in the National Immunization Schedule once the campaign is completed.

When rubella infection occurs during early pregnancy which leads to Congenital Rubella Syndrome (CRS) i.e. congenital cataract, congenital glaucoma, congenital deafness, congenital cardiac defects and microcephaly. There is no specific treatment for rubella and the disease can be only prevented through immunization.