•It hits unexpectedly
•Events quickly spin out of control
•The outcome seems uncertain
•The whole programme is at risk!
Possible risks in Immunisation
ØToxic shock syndrome
ØAnaphylactic shock
ØAccidental use of another drug
ØInjection abscess
ØTraumatic neuritis
ØLymphadenitis following BCG vaccination
ØCNS complications due to pertussis vaccine
ØDeliberate contamination with criminal intention
REPORTING(To be reported immediately)
•Death / Hospitalization
•Anaphylaxis
•Toxic Shock Syndrome
•AFP
•Encephalopathy
•Sepsis
•Clustering of events
•Persistent screaming
•Hypotonic Hypo responsive episodes
•Injection site abscess
•Severe local reaction
•Seizures
•Brachial neuritis
•Thrombocytopenia
•Lymphadenitis
•Disseminated BCG infection
•Osteitis
Classification
•Vaccine reactions -True
•Program Errors - > 95% and easily Preventable
•Coincidental – Child getting Measles after DPT injection
•Injection reaction- Among older children
•Unknown
Program Errors - >95%
Practice AEFI
Un-sterile injection Abscess
Using reconstituted vaccine beyond 4 hours TSS
Wrong diluent Effect of the diluent
Wrong Medicine Effect of the Medicine
Frozen vaccine Sterile abscess
Do’s during immunisation sessions
ØGive BCG to infants less than 1 yr of age(never give
BCG to children above 1 year of age)
Ø If a child is brought late for a dose, pick up where the
schedule was left off. For example, if a child left with
DPT-2 and comes at 13 months give DPT-3, OPV-3
and Measles
Ø Check VVM label of OPV vial and Hepatitis B before
immunizing every child
ØWelcome beneficiaries
ØProvide adequate space and seating arrangements
Ø Verify the age of the child
Ø Check label of the vial and expiry date
Ø Lightly shake the vial of T-series vaccine before
drawing the dose
Ø Screen for contra-indications for vaccination
Don’ts during immunisation sessions
ØDo not vaccinate in case of severe illness and
hospitalized children
Ø Do not Leave vaccine carrier in sunlight
Ø Do not Keep the DPT,DT,TT and Hep. B vaccines on
direct contact with Ice packs
ØDo not draw air into AD syringes
Ø Do not touch any part of the needle
Ø Do not recap the needle
Ø Do not leave the needle inside the vial
Ø Never give IM injections in the gluteal area
ØDo not massage the vaccination site after vaccination
Ø DO not use OPV / Hep . B vaccine with VVM stage 3 or 4
Ø Do not use expired vaccines.
Records and Reports
ØCards and counterfoils filled correctly
Ø Proper filling of immunization cards and counterfoils
of beneficiaries on the day of immunization
Ø Correct recording in the immunization register
Behavior of the People
•If people have no fear of vaccines, but have fear of disease, they vaccinate their children.
• If people have no fear of vaccines, but no fear disease either, there is inertia.
• But if people have no fear of disease, but fear of vaccines, they refuse vaccinations.
