ROUTINE IMMUNIZATION

 Delivering effective and safe vaccines through an efficient delivery system is one of the most cost effective public health interventions.  Immunization programmes aim to reduce mortality and morbidity due to vaccine preventable diseases (VPDs).

        Following the successful global eradication of smallpox in 1975 through effective vaccination programmes and strengthened surveillance, the Expanded Programme on Immunization (EPI) was launched in India in 1978 to control other VPDs. Initially, six diseases were selected: diphtheria, pertussis, tetanus, poliomyelitis, typhoid and childhood tuberculosis. The aim was to cover 80% of all infants.  Subsequently, the programme was universalized and renamed as Universal Immunization Programme (UIP) in 1985. Measles vaccine was included in the programme and typhoid vaccine was discontinued.  The UIP was introduced in a phased manner from 1985 to cover all districts in the country by 1990, targeting all infants with the primary immunization schedule and all pregnant women with Tetanus Toxoid immunization (see schedule below).

        The UIP envisages achieving and sustaining universal immunization coverage in infants with three doses of DPT and OPV and one dose each of measles vaccine and BCG, and, in pregnant women, with two primary doses or one booster dose of TT. The UIP also requires a reliable cold chain system for storing and transporting vaccines, and attaining self-sufficiency in the production of all required vaccines.

In 1992, the UIP became a part of the Child Survival and Safe Motherhood Programme (CSSM), and in 1997, it became an important component of the Reproductive and Child Health Programme (RCH). The Cold-chain system was strengthened and training programmes were launched extensively throughout the country. Intensified polio eradication activities were started in 1995-96 under the Polio Eradication programme, beginning with National Immunization Days (NIDs) and active surveillance for acute flaccid paralysis (AFP). The Polio Eradication Programme was set up with the assistance of the National Polio Surveillance Project