Immunization in Uganda

PRESENTER: Muyimbo Timothy

MBchB111
paed rotation

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Over view:
 Dfns
 Cold chain and failure of the vaccine programme
 Introduction
 Types of immunity
 Types of vaccines
 Moa
 Importance of immunization
 Childhood immunisable ds in Ug
 Immunization schedule
 Other immedicable ds and routine drugs
 Constraints to immunization
 Adverse effects of vaccines
 Cautions and C/Is
 conclusion

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Dfns:

 Immunization: pcs of admin Abs or Ags to someone to make them

resistant to a particular ds.
 Immune: means someone has the Abs to fight and kill
microorganisms that cause a particular ds.
 Immunity: ability of the body to fight ds caused by a particular
organism
 Vaccine: the formulation containing the Abs or Ags. (they are
different from other drugs b’se they only survive under cold condtns
hence the need for the cold chain)

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Cold chain and failure of the vaccine programme :

 Dfn: cold chain refers to the transportation of vaccines from the

manufacturer to the client at the required temp.
 This is applied to @ vaccine according to their sensitivity to heat,
live attenuated vaccines needing cooler temperatures

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Introduction:

 Greatest medical achievement in human history.

 Has prevented many serious childhood ds.
 Small pox eradicated, polio is next, measles and neonatal tetanus
are due for elimination thru immunization.
 This has saved many lives.
 Every one needs to support immunization!

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Types of immunity:

 2 types, active or passive

 > active immunity; a person makes his own Abs against a ds.
 > passive immunity; ready made Abs are given to a person.
 @ of the types can be either natural or artificial
□ herd immunity:
Protection of the minority unimmunised by the majority immunsed
due to lack of ds reservoir in the popn.

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Types of vaccines:

1. Inactived whole orgs eg pertusis,IPV

2. Inactived toxins (toxoids) e.g tetanus ,diphtheria
3. Polysaccharides from surface memb e.g pneumococcal
4. Surface protein e.g influenza(haemagglutinin)
5. Live attenuated (weakened) vaccines e.g yellow fever, measles
and BCG

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MOA:

 By prdtn of Abs , cell mediated responses later immunologic memory.

 Immunologic memory enables the immune system to recognise and
rapidly respond to exposure to a natural infection at a later date and
thus to prevent or modify the ds

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Importance of vaccination:

1. Offers effective protection against some serious ds

2. Prevents spread of ds
3. Provides hope for eradicating or eliminating some imptnt ds
4. Saves many childrens’ lives

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Are these immunisable ds?

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Childhood immunizable ds in Ug:
 Tb caused by M. tuberculosis, vaccine is BCG
 Poliomyelitis, crippling dse caused by polio virus, oral polio vaccine
given
 Diphtheria, caused by corynebacteriae diphtheriae, vaccine is DPT
 Tetanus, caused by clostridium tetani, vaccine is TT a combtn in
DPT
 Hepatitis B ,caused by virus which affects liver, HepB vaccine is
given
 Haemophilus influenza type B meningitis and pneumonia, Hib
vaccine is given
 Measles, caused by measles virus, measles vaccine is given.

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 Childhood immunisable ds in Ug and vaccine summary:

Vac Ag dosage doses Min Min age Mo Site of Storage remarks

interval at start admin admin temp
1.1 dose

BCG 0.05ml up 1 none Birth or 1st Intra dermal Rt upper +2-+8 Only use
to 11/12 contact after arm diluent
0.1ml birth provided.
after
11/12

DPT 0.5ml 3 4 weeks After 6wks or I.M Lt thigh +2-+8 Don’t freeze
1st contact upper outer
Hep+Hib after 6wks aspect

polio 2 drops 3 4 weeks Birth and oral mouth +2-+8 Use spare
6wks or 1st method
contact

measles 0.5ml 1 none 9/12 or 1st subcut Lt upper +2+8 Only use
contact after arm diluent
9/12 provided.

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Immunization schedule:

Timing vaccine

birth BCG
Polio 0

6 weeks Polio 1
DPT,HepB+Hib 1

10 weeks Polio 2
DPT,HepB+Hib 2

14 weeks Polio 3
DPT,HepB+Hib 3

9/12 measles

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Other immunisable ds and routine drugs:

 Other immunizable ds:

 Mumps
 Rubella
 S. pnuemonae( pneumonia, meningitis, URTIs)
 Papilloma virus( Ca,warts)
 VZV
 Other routine drugs:
 Vit A
 Deworming (mebendazole)

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Constraints to immunization:
 Administrative challenges:
• Lack of storage facilities
• Inadequate transport facilities
• Lack of personnel to organise and manage programmes
• Inadequacies in supply of vaccines
• Insecurity affecting out reach programmes
 Health care workers:
o Lack of proper communication and adequate information
o Staff shortage bse of too many other responsiblities
o Lack of knowledge
 Community:
 Poor community mobilization
 Long distance to immunization centres
 Ignorance and some negative societal beliefs about vaccines
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Adverse effects of vaccines:
 Signs of inflmn
 Anaphylaxis
 Fainting
 Injection abscesses if sterility is neglected
 Vaccine assoc ds (VAD)
 Hypersensitivity rxtns
 fever

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Cautions and C/Is:
 Cautions:
 Never use vaccine after their expiry dates
 Don’t use un labeled vaccines
 BCG not given to children with AIDS
 Open one vial at a time
 Opened vaccines should be used within 6 hrs
 Don’t use frozen vaccines
 Maintain cold chain system
 C/Is:
 Previous anaphylaxis to vaccines
 Vaccines cultured on egg to those who have had previous
anaphylaxis to egg cultured vaccines e.g influenza, yellow fever.
 Live vaccines in pts who are immunosupressed or pregnant. p’ple
who had chemotherapy in last 6/12 and those taking high dose
steroids
 Postpone immum if child has a febrile illness.
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 Conclusion:

Immunization provides the most cost effective means of preventing

ds
Vaccines are free of charge in all heath units in uganda
Only when a ds has completely been eradicated world wide can it’s
vaccination safely be discontinued
All children have a right to basic health care - immunization is one
basic heath care
Immunization is safe and every infant should be immunised in order
to grow into healthy intelligent individuals.

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