Birth dose vaccinations at health facilities would continue irrespective of the categorisation of zones amid the COVID-19 pandemic, the government said on Thursday.
According to the "Guidance note for immunisation services during and post COVID outbreak" released by the Union Health Ministry, an area exiting a containment or a buffer zone category can start facility-based and outreach immunization activities only after a minimum gap of 14 days.
The document said that in alignment with the area categorisation, immunization services will be classified under two heads -- immunization in containment and buffer zone and immunization in areas beyond the buffer and green zone.
As a standard practice, immunization services are delivered through the modes of birth dose vaccinations at delivery points in health facilities, health facility-based sessions, and outreach sessions as part of urban/village health sanitation and nutrition days services, it said.
The document specified that in the context of the COVID-19 outbreak, delivery of immunization services for different zones will follow three key principles irrespective of zone.
Guidelines from the Ministry of Home Affairs and the Health ministry pertaining to COVID-19 and related updates will be the primary reference points and no state should violate any COVID-19 guidance, it said.
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Practices of social distancing, hand washing, and respiratory hygiene need to be maintained at all immunization sessions irrespective of zones or district categorisation by all (i.e. beneficiaries and service providers) in all sessions, the guidance document said.
Birth dose vaccination at health facilities would continue irrespective of zones, it said. Immunization services in containment and buffer zone would involve no active mobilization to the health facility.
Every opportunity is to be utilized for vaccinating beneficiaries if they have already reported at the facilities, the document said.
Noting that the list of areas under 'containment zone' and 'buffer zone' in a district is updated on a weekly basis, it said any area exiting a 'containment or buffer zone' can start facility based and outreach immunization activities as in areas 'beyond buffer zone' after a minimum gap of 14 days following de-listing of that area as containment or buffer zone.
However, the state and district administration should make a local assessment of COVID-19 risk before starting the outreach or health facility-based immunization with mobilization of beneficiaries, it added.
Similarly, an area enlisted as a 'containment or buffer zone' should stop health facility-based sessions and outreach sessions, the government said.
All areas beyond the buffer zone and in the green zone follow the same guidelines and birth dose, health facility-based session and outreach session immunization are allowed in them, the document said.
One outreach session will be planned for less than 500 population to limit the total beneficiaries to 10 to 15 per session and a staggered approach will be followed for each session to avoid crowding, it said.
At any given time during the session, not more than five persons should be present at the site with at least one-meter distance between each, the guidelines said.
The organisation of such a session will be at the discretion of district administration with clear planning for social distancing and hand washing at the session site, it said.
Birth dose vaccination should be continued at all health facilities with delivery points after ensuring due cold chain, the document said.
A health facility should continue immunization services with arrangements such as pre-identification of a well-ventilated seating area with demarcated seating location one meter apart and an adequate number of pre-identified, fixed vaccination staff depending on the injection load and the required documentation.
Staff conducting vaccination should wear a three-layered surgical mask and gloves and sanitize their hands after vaccinating every child, the guidelines said.
Support staff to manage seating arrangement, queue management etc. for the pregnant women and caregivers, it said.
It should be ensured that hand sanitizer or hand washing units with chlorinated water are available for public use at the entrance to the health facility, the document said.
Disinfect the seating space after completion of the immunization session should be done, it said, adding that adequate availability of MCP card and due updating of records should be done.
Adequate availability of vaccines and logistics for the uninterrupted immunisation session must be maintained, it said while calling for displaying of visual alerts in clinics, such as posters, with information about COVID-19 disease and reminders on individual prevention strategies.