Find out from Immunization Card MCH Register Caregiverbeneficiary

Find out from Immunization Card MCH Register Caregiver/beneficiary Photo: WHO

1. How many TT injections has she received till today? 2. When was the last TT injection received before today?

1. How old is the child? 2. Which vaccines has the child already received till today? 3. Have at least 4 weeks passed since the last DPT, OPV, or Hep. B was given? Photo: WHO

Photos: WHO, UNICEF Click on buttons for details Tuberculosis • history of contact with suspected/confirmed case of pulmonary TB • Weight loss, cough and wheeze not responding to ARI antibiotics

Remember • After BCG injection, a small raised lump appears at injection site (a normal result of BCG) that usually disappears within 30 minutes. • After about 2 wks, a small red sore forms. that remains for another 2 wks and then heals. • A small scar, of about 5 mm, remains. (Process of scar formation takes about 10 weeks) Photo: , UNICEF do NOT repeat BCG if given once, even if the eschar /scar does not appear. do NOT give BCG if child is over one year old.

Photos: WHO, UNICEF Click on buttons for details Dose: 2 drops; Vial: 20 doses

Photos: WHO, UNICEF Click on buttons for details Dose: 0. 5 ml; Vial: 10 doses

Remember Giving DPT in buttocks (gluteal region) may injure the sciatic nerve and cause paralysis. Never give DPT in buttocks Always give DPT in outer mid thigh (Antero-lateral Thigh in vastus lateralis muscle)

Remember 28 • Wait at least 4 weeks (one month) after previous dose of DPT-OPV before giving next dose. • If child comes after gap of more than 4 weeks for its next dose of DPT-OPV, give next dose of series. Do NOT repeat previous dose, as there is no maximum interval between doses. • Give DPT and OPV Booster dose at 16 months till 24 months (Wait at least 6 months after OPV 3 & DPT 3) • If a child does not receive any DPT till 2 years of age, give two doses of DT one month apart as soon as possible, along with OPV. • Give DT at 5 years of age • If no DPT / DT is given till 5 years, give 2 doses of TT one month apart as soon as possible Photo: UNICEF

Photos: WHO, UNICEF Click on buttons for details Dose: 0. 5 ml; Vial: 10 doses

Click on buttons for details 45° Angle Skin Subcutaneous Tissue Photos: WHO, UNICEF Muscle Subcutaneous Injection

Click on buttons for details p o n tio once u a ec eeks r P w -8 6 hin it w e Us 100, 00 IU/1 ml (9 months completed to 12 mths) 200, 000 IU/2 ml (over 1 years). Give correct dose Inputs and Photos: CD&N Section, UNICEF Lucknow ed n e

Photos: WHO, UNICEF Click on buttons for details Dose: 0. 5 ml; Vial: 10 doses

Remember • Give TT Booster only if already received at least two TT injections within last 3 years • Try to give TT 2 or TT Booster at least one month before Expected Date of Delivery. However, give even if less than 1 month remains. • Give TT at 10 years and 16 years

Remember OPV (oral) Measles (subcutaneous) Hepatitis B (intramuscular) Vit A (oral) All due vaccines can be given at same time but in different limbs (sites) BCG (intradermal) DPT (intramuscular) e. g. it is safe and effective to give BCG, DPT, OPV, Hep. B, Measles & Vit. A at same time to a 9 month old child who has never been immunized

Illustrations: UNICEF India For the Infant and Child Doses Birth - 15 days OPV 0 BCG DPT 1 OPV 1 Hep B 1 ½-1½ months 1 ½ to 9 months 9 - 12 months 1 - 2 years Give as early as possible in the first 12 months Give at 1 ½ months or as soon as possible after 1 ½ months Give at 2 ½ months or as soon as possible after 2 ½ months (wait at least 1 month after DPT 1 , Hep B 1 & OPV 1 to give DPT 2, He B 2 & OPV 2) DPT 3 OPV 3 Hep B 3 Give at 3 ½ months/ as soon as possible after 3 ½ months (wait at least 1 month a fter DPT 2, Hep B 2 & OPV 2 to give DPT 3, Hep. B 3 & OPV 3) DPTOPV Booster DT Give at completion of 9 mths/ as soon as possible after completion of 9 mths. If a child does not receive Measles by 1 yr, give as soon as possible before 5 yrs Give at 16 months (wait at least 6 months after OPV 3 & DPT 3) Give at 5 yrs/ school entry Give at 10 and 16 years TT Vitamin A 10 & 16 years Give in first 15 days only DPT 2 OPV 2 Hep B 2 Measles 5 th year Give at 9 mths with Measles, 16 mths with DPT booster, then 1 dose every 6 months up to 5 years

Right Advice at Right Time: Pregnancy (TT) • Preparation for Exclusive Breastfeeding (EBF) At birth (BCG / OPV) • Early initiation of Breastfeeding (<1 hr) • + Colostrum feeding • + EBF 1½ Months (DPT 1/ OPV 1) • Continuing EBF (No water) 2½ Months (DPT 2 / OPV 2) • Continuing EBF (No water) 3½ Months (DPT 3 / OPV 3 9 Months (Measles) • Continuing EBF (No water) + Preparing for semi-solid feeding (starting after 6 mths of age) + Continuing breast milk • Complementing feed • (check if semi-solid given in sufficient quantity) + Continuing breastmilk Inputs: CD&N Section, UNICEF Lucknow Illustrations: CARE India Linking Immunization to Infant & Young Child Feeding

Remember Give these 4 Key Messages to the Care-giver: 1. What vaccine was given and what disease it prevents (e. g. BCG for preventing TB) 2. When to come for the next visit. 3. What are the minor side-effects and how to deal with them. 4. To keep the vaccination card safe and to bring it along for the next visit • Even if the child is suffering from diarrhea, mild fever or malnutrition, it should be vaccinated. • Unless a child is so sick that it has to be taken to hospital, do not stop its vaccination. The goal is to fully immunize each child before its 1 st birthday i. e. give BCG, 3 doses of DPT, 3 doses of OPV and Measles before 1 year of age