UIP 1985

 

3.7 Universal Immunisation Programme (UIP)

Launched in 1985 by the Government of India, the UIP aims to provide free vaccines to all children and pregnant women. It became part of the Child Survival and Safe Motherhood Programme in 1992 and is now a key component of the National Rural Health Mission since 2005. The program covers routine immunization, special campaigns (e.g., Polio, Measles, JE), AEFI monitoring, vaccine logistics, strategic communication, and training.

Evolution of the Universal Immunisation Programme (UIP)

• 1978: Expanded Programme on Immunization (EPI) launched post-smallpox eradication; vaccines included BCG, DPT, OPV, Typhoid.
• 1985: UIP launched nationwide; Measles vaccine added.
• 1986: Technology Mission focused on infant coverage and monitoring.
• 1990: Vitamin A supplementation introduced.
• 1992: Merged with Child Survival and Safe Motherhood Programme.
• 1995: National Polio Immunization Days began.
• 1997: Integrated into Reproductive and Child Health (RCH I).
• 2005: Continued under RCH II and National Rural Health Mission (NRHM).
• 2011: Monovalent Hepatitis B and Pentavalent vaccines introduced.
• 2014: Inactivated Polio Vaccine (IPV) added.
• 2015: Mission Indradhanush launched to boost coverage.
• 2016: Rotavirus vaccine rollout began.
• 2017: Measles-Rubella (MR) and Pneumococcal Conjugate Vaccine (PCV) introduced.

Vaccines under UIP
Includes BCG, DPT, OPV, Measles, Hepatitis B, TT, JE (in select districts), and Pentavalent vaccine (DPT+HepB+Hib in select states).

Diseases Covered
Protects against Diphtheria, Pertussis, Tetanus, Polio, Tuberculosis, Measles, Hepatitis B, Japanese Encephalitis, Meningitis, and Pneumonia (due to Hib).

3.7.2 Goal
To reduce illness and death from vaccine-preventable diseases through quality immunization.

3.7.3 Key Objectives

• Improve equitable and efficient service delivery.
• Enhance awareness and access through advocacy.
• Strengthen disease and AEFI surveillance.
• Introduce new vaccines and technologies.
• Reinforce health systems.
• Support eradication of polio, measles, and neonatal tetanus.

3.7.4 Principles of UIP (Brief)

1. Universal Coverage: Immunize all eligible groups as per national schedule.
2. Equitable Access: Reach underserved and vulnerable populations.
3. High Quality & Innovation: Ensure quality in vaccine handling via cold chain and innovation.
4. Sustainability & Partnerships: Secure resources and build inter-sectoral collaborations.
5. Governance: Use decentralized, bottom-up planning.
6. Accountability: Ensure efficient, transparent implementation and monitoring.

Vaccine Vial Monitor (VVM) Indicator

• Start point: Square lighter than circle – Use vaccine.
• End point: Square matches circle – Do NOT use.
• Exceeded: Square darker than circle – Do NOT use.

·        3.7.5 Mission Indradhanush
Launched in 2014 to immunize unvaccinated or partially vaccinated children against 7 diseases (diphtheria, pertussis, tetanus, polio, TB, measles, hepatitis B). Aim: Full coverage of under-fives by 2020.
Intensified Mission Indradhanush (IMI) targets children under 2 and pregnant women, with vaccination for under-5s on demand. Drives run for 7 working days monthly.

·        3.7.6 Strategy and Policy
Cold Chain & Logistics: Maintains vaccine potency from manufacture to beneficiaries using cold boxes, vans, and ice-packed carriers. Syringes are centrally procured and distributed.

·        Injection Safety & Waste Disposal: Safe injection practices and proper waste disposal are ensured with AD syringes, hub cutters, training, and adherence to CPCB guidelines.

·        AEFI (Adverse Events Following Immunization): Events may result from vaccine reaction, program errors, coincidental causes, or anxiety. Timely detection and correction are essential.

3.7.7 Routine Immunization (RI) Implementation
RI aims to vaccinate 26 million newborns and 100 million children (1–5 years) annually with primary and booster doses, plus 30 million pregnant women with TT. Around 9 million sessions are held yearly, mostly at village level. ASHA and AWW mobilize beneficiaries, with ASHA receiving Rs. 150/session.

Infrastructure & Support

• 27,000+ cold chain points ensure vaccine potency.
• Continuous supply of safe injection equipment is maintained.
• Government supports training, monitoring, outreach, and logistics through the State Programme Implementation Plan (PIP).
• Additional support includes: alternate vaccine delivery, deploying retired staff, mobility aid for supervision, and printed materials.
• Central aid includes auto-disposable syringes, smaller BCG vials, cold chain maintenance, and vaccine van supply.

Immunization remains a vital, cost-effective public health strategy for preventing childhood illnesses and disabilities.

National Immunization Schedule (NIS)
For Pregnant Women:

• TT-1: Early pregnancy
• TT-2: After 4 weeks of TT-1
• Booster: If 2 TT doses given in last 3 years
  (All 0.5 ml, intramuscular, upper arm)

For Infants:

• BCG: At birth or till 1 year (0.1 ml, intradermal, left upper arm)
• Hep B: Birth dose within 24 hrs (0.5 ml, IM, thigh)
• OPV-0: At birth; OPV 1, 2, 3: 6, 10, 14 weeks (2 drops, oral)
• Pentavalent: 6, 10, 14 weeks (0.5 ml, IM, thigh)
• Rotavirus: 6, 10, 14 weeks (5 drops, oral)
• IPV: 6 & 14 weeks (0.1 ml, intradermal, right arm)
• MR, JE: At 9–12 months (0.5 ml, subcutaneous)
• Vitamin A: At 9 months (1 ml oral)

For Children:

• DPT Booster 1: 16–24 months
• MR 2, JE 2, OPV Booster: 16–24 months
• Vitamin A (2nd to 9th dose): Every 6 months till 5 yrs
• DPT Booster 2 & TT: 5–6 yrs and at 10 & 16 yrs
  (All appropriate doses via IM, SC, or oral routes)

This schedule ensures comprehensive protection for pregnant women, infants, and children against key vaccine-preventable diseases.

Indian Academy of Pediatrics (IAP) Immunization Schedule (Brief)

IAP supports the national schedule and adds more vaccines for broader protection.

At Birth: BCG, OPV-0, Hepatitis B-1
6 Weeks: IPV-1, DTwP-1, Hep B-2, Hib-1, Rotavirus-1, PCV-1
10 Weeks: DTwP-2, IPV-2, Hib-2, Rotavirus-2, PCV-2
14 Weeks: DTwP-3, IPV-3, Hib-3, Rotavirus-3, PCV-3
6 Months: OPV-1, Hep B-3
9 Months: OPV-2, MMR-1
9–12 Months: Typhoid Conjugate Vaccine
12 Months: Hepatitis A-1
15 Months: MMR-2, Varicella-1, PCV Booster
16–18 Months: DTwP/DTaP Booster-1, IPV Booster-1, Hib Booster
18 Months: Hepatitis A-2
2 Years: Typhoid Booster
4–6 Years: DTwP/DTaP Booster-2, OPV-3, MMR-3, Varicella-2
10–12 Years: Tdap/Td, HPV (for girls: 3 doses at 0, 1–2, 6 months)

This schedule ensures comprehensive immunization from birth through adolescence.

Achievements of the Immunization Program (Brief):

• Eradication of smallpox and elimination of wild poliovirus in India.
• Significant reduction in cases and deaths from vaccine-preventable diseases (VPDs).
• Coverage improvement from 1985–86 to 2014:
• BCG: 29% → 91%
• DPT (3 doses): 41% → 83%
• TT (pregnant women): 87%
• Measles: 83%
• OPV (3 doses): 82%
• Hepatitis B3: 70%
• Hib3: 20%