| IAP Guidebook on Immunization |
| Table of Contents | Committee on Immunization | |
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| VPD Surveillance Surveillance is a French word which means ‘watching with attention, suspicion and authority’. Any satisfactory immunization programme should result in gradual decline of the vaccine preventable diseases concerned. The WHO had declared 3 distinct objectives for the year 2000 A.D. However, none of the targets have been achieved so far. The revised target for certification of polio eradication is by 2005.
The 3 different diseases have 3 different nomenclatures in their control because it is possible to eradicate poliovirus from the Globe, but it is not possible to eradicate the source of tetanus bacilli which is animal excreta and spores in the soil. However, by immunizing large number of all mothers with TT it is possible to eliminate neonatal tetanus. Although Measles can be eradicated in the future, at the present time the single dose Measles immunization can only prevent Measles mortality by preventing Measles in the vast majority of immunized children. Polio eradication consists of 4 stages namely: endemic, control, elimination and eradication. When there is a spurt of polio cases in the months between July to October, the disease is said to be endemic in that particular geographic area. When there is zero reporting for one year, it is called Elimination; and if the zero reporting is for 3 consecutive years it is known as Eradication. However, in the case of neonatal tetanus even with elimination there will be less than one case for every 10,000 births. In case of Measles there will be considerable reduction in cases as well as deaths due to complications when over 90% Measles vaccination coverage is reported. Acute Flaccid Paralysis (AFP) surveillance should be taken on a war footing and all professional bodies and its members should report in the case of AFP to the local Health authority. IAP is committed to this cause, and have since founded a Polio Eradication Committee with state and district level co-ordinators. All cases of vaccine preventable diseases should be reported to the local Health Authority within 48-72 hours for taking prompt field level action. Departments of Pediatrics in medical colleges should act as sentinel centres and co-ordinate periodically with the Health Authorities concerned. IAP is planning extensive research in VPD surveillance in collaboration with the Govt. of India, UNICEF and WHO where your active co-operation at your city/district/state level will be solicited from time to time. The achievements of the goals and objectives of 2005 A.D largely depend upon an effective surveillance network not only by the Govt. agencies but also by professional bodies like ours wherein each and every one of us will be playing a pivotal role. Vaccination in the Current Millenium Summary: VPD Surveillance
The current century would witness the introduction of several vaccines in the National Schedule. There would be invention of newer vaccines and hopefully the single major bullet of combination vaccine with depot effect would see the light of the day. Research is currently going on for the development of vaccines against Shigella and E. Coli. There is cautious optimism regarding the possibility of developing one or more vaccines against HIV infection or disease. The latter might be a “therapeutic” vaccine to retard the progression of HIV infection to HIV disease. For Hepatitis B virus carriers also, there is the need for `therapeutic’ vaccines to retard the progression towards chronic liver disease. We anticipate vaccines against several serotypes of pneumococci and group A Streptococci, to be in routine use in the early years of the current century. Newer types of vaccines/ vaccine delivery systems may also be expected. They include vector-based vaccines and plasmid (naked DNA) vaccine. In The Current Millenium
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