Notes · Community Medicine · 3 October 2026

Immunization Schedule in India

Definition

• Immunization Schedule: A time‑based plan that specifies the type, dose, and age of vaccination for individuals to achieve optimal protection against vaccine‑preventable diseases (VPDs).
• In India, the schedule is issued by the Ministry of Health & Family Welfare (MoHFW) under the National Programme for Immunization (NPI) and updated annually.

Rationale & Objectives

• Primary goal: Reduce morbidity, mortality, and economic burden of VPDs.
• Secondary goals:
  • Achieve herd immunity.
  • Prevent outbreaks (e.g., measles, polio).
  • Ensure equity in vaccine access across all population groups.
• Key metrics: Coverage ≥90 % for routine vaccines; ≥95 % for measles‑containing vaccines.

Epidemiology & Impact

• India’s burden:
  • Measles: 200,000–300,000 cases annually (pre‑COVID‑19).
  • Polio: 0 cases since 2014 (last wild‑type case 2012).
  • Hepatitis B: ~10 % of infants born to HBsAg‑positive mothers.
• Impact of schedule adherence:
  • 2019–2021: 10 % decline in routine coverage due to COVID‑19 disruptions.
  • Catch‑up campaigns restored coverage to >90 % by 2022.

Core Vaccines & Schedule

• Pentavalent = DTP + HepB + Hib.
• IPV = Inactivated Polio Vaccine (administered intramuscularly).
• PCV = Pneumococcal Conjugate Vaccine (PCV13).
• Rotavirus = Oral vaccine (2–3 doses).
• BCG = Bacille Calmette‑Guérin (intradermal).

Catch‑Up & Revaccination

• Catch‑Up: For children who missed doses, administer all missed doses as soon as possible, then continue the routine schedule.
• Revaccination:
  • Measles: 2 doses ≥4 wk apart if ≥12 mo.
  • Polio: 3 doses of IPV if ≥4 wk after last OPV dose.
  • Td/Tdap: Every 10 yrs for adults.

Contraindications & Precautions

• Absolute:
  • Severe anaphylaxis to a vaccine component.
  • Live vaccine–specific: active HIV infection (CD4 < 200 cells/µL), severe immunosuppression, pregnancy (except BCG, HepB).
• Relative:
  • Mild febrile illness, mild eczema.
  • Recent blood transfusion (delay 1 wk).
• Precautions:
  • Use separate syringes for live and inactivated vaccines.
  • Observe 30 min post‑vaccination for immediate reactions.

Adverse Events & Monitoring

• Common: Local pain, swelling, low‑grade fever.
• Serious: Anaphylaxis, febrile seizures (measles), Guillain‑Barré (influenza).
• Surveillance:
  • Vaccine‑Adverse Event Reporting System (VAERS) – mandatory for all health facilities.
  • National Pharmacovigilance Programme – monitors safety signals.

Documentation & Record Keeping

• Individual Card: “National Immunization Card” (NIK) – updated at each visit.
• Electronic Records: Integrated Child Development Services (ICDS) portal, e‑Health initiatives.
• Key Fields: Date of birth, vaccine name, batch number, lot, dose number, vaccinator ID.

Key Guidelines (2024)

• National Immunization Schedule (NIS) 2024 – updated by MoHFW.
• WHO‑UNICEF Joint Reporting Form (JRF) – for national coverage reporting.
• COVID‑19 Booster Policy – 2nd booster for ≥60 yrs and high‑risk adults.
• Travel Vaccination – Yellow fever, Typhoid, Hepatitis A/B, Rabies (pre‑exposure) as per destination risk.

High‑Yield Exam Points

• BCG: Administer at birth; contraindicated in pregnancy.
• OPV: Oral polio vaccine; switched to IPV in 2016 for routine use.
• Pentavalent: 3 doses at 6, 10, 14 wk; covers DTP, HepB, Hib.
• Measles‑Rubella: 2 doses; 1st at 9 mo, 2nd at 15–18 mo.
• HPV: 2 doses for girls 9–14 yrs; 6‑month interval.
• Td/Tdap: Tdap for pregnant women at 27–36 wk; Td booster every 10 yrs.
• Catch‑Up: Do not delay routine schedule after catch‑up; continue as per age.
• Adverse Event Reporting: All serious events must be reported within 24 hrs.

Practice Questions

1. A 3‑month‑old infant receives BCG at birth. Which of the following is the next vaccine to be given at 6 weeks?

   • A) Measles
   • B) Pentavalent
   • C) Hepatitis A
   • D) Rotavirus
     Answer: B – Pentavalent is scheduled at 6 weeks (first dose).

2. Which vaccine is contraindicated in a pregnant woman with a history of severe anaphylaxis to a vaccine component?

   • A) BCG
   • B) Hepatitis B
   • C) Measles‑Rubella
   • D) Polio (IPV)
     Answer: C – Live measles‑rubella vaccine is contraindicated in pregnancy.

3. A 12‑year‑old boy missed his 5‑year‑old DTP booster. What is the recommended schedule for catch‑up?

   • A) One dose of DTP now, then routine schedule
   • B) Two doses of DTP 4 weeks apart, then routine schedule
   • C) No catch‑up needed; continue routine schedule
   • D) Administer only IPV
     Answer: B – Two doses of DTP 4 weeks apart, then resume routine schedule.

More in Community Medicine

AI-assisted study material for exam revision. Always confirm with standard textbooks and current guidelines; not medical advice.