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Case of Immunization

Case Scenario:

A newborn delivered at term through cesarean section in a local hospital was administered BCG vaccine at birth. Three week later he was brought to the hospital with a small painful lump on the injection site. Diagnosis of local reaction to the BCG vaccine was made.


  1. What are the types of vaccines?
  2. What is the EPI schedule? Name 5 non vaccine interventions introduced in the EPI programme.
  3. What are the various hazards of immunization?


By the end of the session the participants would be able to know the:

  1. EPI schedule along with the non-vaccine interventions and their importance.
  2. Types of vaccines and immunizing agents.
  3. Hazards of immunization.
  4. Cold chain and its importance.
  5. Herd immunity


Types of vaccines

  • Live attenuated vaccines
  • Inactivated or Killed vaccine
  • Toxoids
  • Combined

Live attenuated vaccines

Organisms are alive and they have the power of multiplication although they are attenuated.

E.g. oral polio, yellow fever

Inactivated or Killed vaccine

Organisms are killed by heat, formalized by other chemicals.

E.g. typhoid, cholera


Exotoxins produced by other organisms and are defoliated by treating with formalin

E.g. tetanus, diphtheria


One or more types are mixed

E.g. DPT, DT

EPI Schedule

EPI was started by WHO in 1974, Pakistan started the programme to control six communicable diseases by conducting a field survey in June, July 1978 with the help of WHO and UNICEF.

Non Vaccine interventions

  • Vitamin A supplementation with OPV to prevent night blindness
  • Height monitoring
  • Weight monitoring
  • Health education
  • Disease surveillance

Various hazards of immunization

a. Local reactions

  • Pain
  • Swelling
  • Redness
  • Tenderness
  • Sterile abscess

b. Reaction due to faulty techniques
c. Reactions due to hypersensitivity
d. Provocative reactions

e. General reactions

  • Fever
  • Malaise
  • Headache

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