Although the vaccines included in the National Immunization Schedule of India have not changed, there are some modifications in the immunization schedule. This article will describe the revisions.

Background Information:

The National Immunization Schedule is a schedule of vaccines that are offered as part of the Universal Immunization Program (UIP). In addition to the names of vaccines, it describes the timing, dose, route of administration, site of administration, and diluents used to reconstitute the vaccines.

Key Messages:

The following vaccine preventable diseases are covered under the Universal Immunization Program:

1. Diphtheria
2. Pertussis
3. Tetanus
4. Polio
5. Measles
6. Hepatitis B
7. Japanese Encephalitis
8. Encephalitis
9. Tuberculosis
10. Pneumococcal disease
11. Haemophilus influenza type B related illnesses
12. Diarrhoea caused by Rotavirus
13. Rubella

The updated National Immunization Schedule now includes information on the maximum age for administration of specific vaccines.

A fully immunized child should have received

By 1 year age

• 3 doses of OPV,
• 3 doses of Rotavirus (where applicable),
• 3 doses of Pentavalent,
• 3 doses of PCV (where applicable),
• 2 doses of fractional IPV,
• MR vacccine -1st dose ,
• JE 1st dose (where applicable)

By 2 years age (in addition to the above)

• MR vaccine – 2nd dose,
• JE 2nd dose (where applicable),
• DPT booster, and
• Polio booster  

Immunization Schedule for Pregnant women:

The second dose of TT/ TT Booster dose is supposed to be administered before 36 weeks of pregnancy. However, it may be administered even after 36 weeks have lapsed (if the woman has not received it by then).

If a woman has previously not been immunized with TT and comes in labour, she must be administered a dose of TT during labour.

Immunization Schedule for Infants:

Pentavalent vaccine (containing Diphtheria+Pertussis+Tetanus+Hepatitis B+Hib) has replaced the separate DPT and Hepatitis B vaccines administered at 6, 10, and 14 weeks respectively.

Both Oral Polio Vaccine (OPV) and Inactivated Polio Vaccine (IPV) are administered as part of the National Immunization Schedule. While OPV continues to be administered at birth (0 dose), then at 6, 10, and 14 weeks; IPV is administered at 6 and 14 weeks. In due course, OPV will be phased out completely, and only IPV will be administered (either as a standalone vaccine, or as part of a multivalent vaccine).

Immunization Schedule for Children:

In Kerala, the Measles vaccine between 9-12 months has been replaced with Measles/Rubella (MR) vaccine as mentioned above. However, instead of the second dose of MR vaccine between 16-24 months, children receive the Measles/Mumps/Rubella (MMR) vaccine (this was being administered even before the MR vaccine was introduced).

The National Immunization Schedule by age of recipient/duration of pregnancy:

Pregnancy:

TT-1: Preferably at the first visit, or as early as possible

TT-2: Four weeks after TT-1, or preferably before 36 weeks of gestation

TT booster: For women who have received TT-2 within the last 3 years

Infants and Children:

Birth: OPV-0, BCG, Hepatitis B

6 weeks: OPV-1, Fractional IPV, Pentavalent, Rotavirus (where applicable), PCV (where applicable)

10 weeks: OPV-2, Pentavalent, Rotavirus (where applicable)

14 weeks: OPV-3, Fractional IPV, Pentavalent, Rotavirus (where applicable), PCV (where applicable)

9 completed months: PCV Booster (where applicable), Vitamin A (1st dose)

9-12 months: MR 1st dose, Japanese Encephalitis 1st dose

16-24 months: MR 2nd dose, DPT Booster-1, Japanese Encephalitis 2nd dose, OPV Booster

16 months- 5 years: Vitamin A 2nd to 9th dose

5-6 years: DPT Booster-2

10 years: TT

16 years: TT

Useful Links:

Link to the updated Immunization Handbook for Medical Officers (contains updated National Immunization Schedule):

http://www.searo.who.int/india/publications/immunization_handbook2017/en/

Link to National Immunization Schedule 2017:

Click to access 245453521061489663873.pdf

Link to article on National Immunization Schedule 2017:

https://communitymedicine4asses.com/2018/01/01/national-immunization-schedule-2017-india/