Advisory for restarting immunization activities regarding Universal Immunization Programme in the state

As per the minutes of the meeting conducted by Expert Committee on Covid 19 control, on 5th April 2020 chaired by Dr Ekbal Chairman State Expert Group, it was decided that "Health Services should re establish immunization programme as early as possible. Those private hospitals that provide immunization services should also restart it"

Minutes of the State Technical Advisory Group on Immunization (STAGI) meeting regarding restarting immunization activities during extension of Lockdown period due to Covid 19 conducted online on 15-04.2020 at 2.30 pm, it was decided to restart the immunization under the Universal Immunization Programme.

Earlier, all Immunization sessions except the birth dose, were withheld for the period of lockdown. It was presumed there is less risk to the children regarding the Vaccine Preventable Diseases as long as they are in the home premises and not in contact with the community. During the lockdown period the members in the family are also at the home and there is no contact with other persons in the community. As the lockdown is getting extended, if the immunization activities are not resumed promptly there will be a large cohort of inadequately immunized children getting exposed to the post lockdown scenario. In such a setting there is a risk of increase in the occurrence of vaccine preventable diseases

The following guidelines for the immunization were prepared after discussing in the STAG meeting

1. The line list of the unimmunized and partially immunized children shall be prepared and parents may be informed regarding the date, time and place of the of the immunization session well in advance by the JPHN
2. The immunization sessions can be restarted both in public and private institutions with strict directions to the intuitions for practicing all the components of the 'break the chain' instructions and strictly maintaining the social distancing without fail.
3. The JPHN in consultation with other field staff, ASHA, Anganwadi worker etc may allot separate time slot for the children for vaccination to avoid overcrowding.
4. The outreach sessions of Immunization in the sub centre may be conducted in such a way that there is no overcrowding at the immunization site.
5. Social distancing shall be strictly followed in the waiting area, vaccination room as well as the observation room.
6. The immunizations given at the time of birth- BCG, OPV and Hep B vaccines may be continued without any interruption during all the phases of the pandemic.
7. In hospitals, immunization may be provided in an area away from the OP and IP wing.
8. Those children brought for immunization need not take an OP ticket and they may directly go to the immunization area. Prior clinical examination by a doctor is needed only if child has any complaints needing medical attention.
9. Preferably a separate entrance away from the general patient entry may be arranged for the immunization area.
10. Usually immunization sessions are conducted every Wednesday in RHO / CHC and government hospitals. In some hospitals immunization is conducted in more days per week. The time of the session is usually from 9 am to 1 pm. The ASHA/JPHN/ AWW may divide the time to eight slots (30 minutes each) and allot 5 children each in these slots so that proper social distancing can be maintained.
11. Increasing the number of immunization days in hospitals may be considered so as to reduce the crowding.
12. Allow only one bystander to the immunization area with each child.
13. Hand washing facility with soap and water /hand sanitizer shall be available in the immunization site.
14. Bystander and JPHN performing vaccination and other heath staff in the immunization area shall use three layer surgical mask. JPHN performing vaccination preferably may wear a face shield also.
15. JPHN shall sanitize her hands after immunizing each child
16. In the waiting area the chairs shall be kept at a distance of 1 meter from each other.
17. No mass vaccination campaigns to be conducted till the pandemic subsides.
18. Catch up campaigns may be needed once the pandemic is over. 19.The public may be encouraged to take vaccines from the nearest available facility. All doctors shall promote the vaccination from the nearest facility (either public or private).
19. The distribution of UIP vaccines to the private health care facilities should be maintained without any interruptions.
20. Children from homes where Covid 19 confirmed or suspected are present may be immunized only after the Quarantine period is over.
21. lmmunization activities in Designated Covid hospitals shall remain withheld. Hence the concerned ,JPHN may arrange immunization of children of such hospitals in the nearby peripheral institutions.
22. Need to plan catch up vaccination sessions once the pandemic is over since there would be a cohort of children who may have missed doses due to various reasons during the pandemic.
23. 1n the event of the pandemic situation getting worse appropriate modifications in these guidelines shall be recommended by the STAG and subsequent advisory will be issued.

Ref:
COVID-19 Outbreak Control and Prevention State Cell Health & Family Welfare Department
Government of Kerala
Advisory for restarting immunization activities regarding Universal
Immunization Programme in the state
NO: 31/F2/2020/Health- 16th April 2020