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The color, symbolizes the sun, the eternal source of energy. It spreads warmth, optimism, enlightenment. It is the liturgical color of deity Saraswati - the goddess of knowledge.
The shape, neither a perfect circle nor a perfect square, gives freedom from any fixed pattern of thoughts just like the mind and creativity of a child. It reflects eternal whole, infinity, unity, integrity & harmony.
The ' child' within, reflects our child centric philosophy; the universal expression to evolve and expand but keeping a child’s interests and wellbeing at the central place.
The name, "Maa Sharda;" is a mother with divinity, simplicity, purity, enlightenment and healing touch, accommodating all her children indifferently. This venture itself is an offering to her........
ABC Of Vaccines – 2
An article published in Family Physicians Association Magazine, Rajkot
15) What is the meaning of vaccine immunogenicity?
It is the ability of a vaccine to induce antibodies which may or may not be protective. The protective threshold for most vaccines is defined. However levels below the limits may sometimes be protective due to other reasons such as immune memory/ T cell immunity.
16) What is vaccine efficacy and vaccine effectiveness?
Vaccine efficacy is the ability of the vaccine to protect an individual.
VE = Disease in unvaccinated – Disease in vaccinated
Disease in vaccinated
Vaccine effectiveness is the ability of the vaccine to protect the community and is a sum of the vaccine efficacy and herd effect.
In short, vaccine efficacy is the protection at the individual level while effectiveness is at the community level.
17) What is epidemiological shift?
Epidemiological shift refers to an upward shift in age of infection/diseases in communities with partial immunization coverage. Owing to vaccination, the natural circulation of the pathogen decreases and the age of acquisition of infection advances. Also the severity of the disease worsens with advancing age. E.g. rubella, varicella, hepatitis A.
18) What is herd immunity?
Herd immunity is the proportion immune in a herd. Herd effect is the protection offered to unvaccinated members when good proportion (usually more than 85%) of the herd is vaccinated. An effective vaccine is a prerequisite for good herd effect.
19) What is contact immunity?
After administration of live vaccines, the vaccine particles may be excreted in body fluids like nasal secretions or passed out in feces. They may induce immunity in unvaccinated close contact if they reach in a sufficient quantity. This is called contact immunity. Theoretically any live vaccine can induce contact immunity but practically it is rare.
20) What is herd protection?
Immunized people provide protection to the unimmunized individuals
Without inducing immunity, virtually by breaking the transmission of the
infection or lessening the chances of susceptible individuals coming in
contact with infective individual. This is called herd protection. It is the
major beneficial component of immunization for the unimmunized
population.
21) What is national immunization schedule?
| AGE | VACCINES |
| Birth | BCG, OPV-0 |
| 6 weeks | DTP-1, OPV-1 (BCG if not given) |
| 10 weeks | DTP-2, 0PV-2 |
| 14 weeks | DTP-3, OPV-3 |
| 9 months | Measles |
| 16-24 months | DTP-1ST BOOSTER, OPV |
| 5-6 years | DT* |
| 10 years | TT** |
| 16 years | TT |
* A second dose of DT vaccine should be given at an interval of one month if there is no clear history or evidence of previous immunization with DTPw.
** A second dose of TT vaccine should be given at an interval of one month if there is no clear history or documented evidence of previous immunization with DTPw, DT, or TT vaccines.
22) What is IAP schedule for immunization?
| AGE | VACCINES | NOTE |
| Birth | BCG
OPV-0 Hepatitis B -1 |
|
| 6 weeks | OPV -1+IPV-1 / OPV -1
DTPw -1/DTPa -1 Hepatitis B -2 Hib -1 |
OPV alone if IPV cannot be given |
| 10 weeks | OPV -2+IPV -2 / OPV-2
DTPw -2 / DPTa -2 Hib -2 |
OPV alone if IPV cannot be given |
| 14 weeks | OPV -3+IPV -3 /OPV -3
DPTw -3 / DPTa -3 Hepatitis B -3 Hib -3 |
OPV alone if IPV cannot be given
Hepatitis B -3 can be given at 6 months of age |
| 9 months | Measles | |
| 15-18 months | OPV -4+IPV -4 /OPV -4
DPTw booster -1 / DPTa booster -1 Hib booster MMR -1 |
OPV alone if IPV cannot be given
|
| 2 years | Typhoid | Revaccination every 3-4 years |
| 5 years | OPV -5
DPTw booster -2 / DPTa booster -2 MMR -2 |
The second dose of MMR can be given at any time 8 weeks after the first dose |
| 10 years | Tdap
HPV |
Only girls, three doses at 0, 1or2 and 6 months |
Vaccines that can be given after discussion with parents
| AGE | VACCINES | NOTE |
| More than 6 weeks | Pneumococcal conjugate | 3 primary doses at 6, 10, and 14 weeks, followed by a booster at 15-18 months |
| More than 6 weeks | Rotaviral vaccines | 2/3 doses (depending on the brand) at 4-8 weeks interval |
| After 15 months | Varicella | 2nd dose is recommended at 5-6 years
If age more than 13 years: 2 doses at 6-8 weeks interval |
| After 18 months | Hepatitis A | 2 doses at 6-12 months interval |
23) Why is National schedule different from IAP schedule? Which one to follow?
Vaccines recommended under National Immunization Schedule are provided free. But due to limited resources, government cannot provide all the vaccines which are required. On the other hand IAP recommends vaccines depending upon availability of vaccines and disease burden. Ultimately parents have to decide which vaccines they would like to or afford to provide to their child. It is our duty to educate and guide them but not to force them.
24) If a Western/ NRI child comes and settles in India, which schedule to follow-native or Indian?
The child should be vaccinated as per the Indian schedule. For example if a 6 years old child has migrated from UK or USA he should be administered BCG after a Mantoux test.
25) How do we plan for a child who has not received any vaccination?
| Visit | Suggested schedule |
| First | Measles (MMR if more than 12 months)
DTwP1/DTaP1(Tdap if 7 years or more) OPV1/IPV1 (only if less than 5 years) Hib1(only if less than 5 years) Hep B1 |
| Second visit (after 1 month of first visit) | BCG (Only in less than 5 years)
DTwP2/DTaP2(TD if 7 years or more) OPV2(if OPV given earlier) Hep B 2 Hib2 (if less than 15 months) |
| Third visit (after 1 month of second visit) | OPV3/IPV2
MMR (if more than 12months) Typhoid (if more than 2 years)
|
| Fourth visit (6 months after first visit) | DTwP3/DTaP3 (Td if 7 years or more)
OPV4/IPV3 HepB3 |
PS: This article was part of series of articles on practical points on vaccination in FPA times, 2013-14.
Dr. Neema Sitapara
MD (Ped), PGDip. (Adolescent Pediatrics)