National Immunization Schedule (NIS) 2024 – Complete Guide for Nurses | GKQuizNursing

National Immunization Schedule (NIS) of India – Complete 2024 Guide for Nurses

Updated and simplified National Immunization Schedule (NIS) for India – based on Ministry of Health & Family Welfare (MoHFW) and National Health Mission (NHM) guidelines for pregnant women, infants and children. Designed for nursing and medical competitive exams by GKQuizNursing.

Figure: National Immunization Schedule (NIS) – infographic used for quick revision in GKQuizNursing.

Remember: NIS is part of India’s Universal Immunization Programme (UIP) and Mission Indradhanush. It provides free vaccines to all pregnant women and children to prevent major vaccine-preventable diseases like tuberculosis, polio, diphtheria, pertussis, tetanus, hepatitis B, Haemophilus influenzae type-B, measles, rubella, rotavirus diarrhoea, Japanese encephalitis and pneumococcal disease.

Table of Contents

1. Goals of National Immunization Schedule
2. Schedule for Pregnant Women (Td)
3. Schedule for Infants (Birth to 1 year)
4. Schedule for Children (16 months to 16 years)
5. Important Notes, Memory Tricks & Nursing Tips
6. MCQs for Nursing Exams (with Answers)
7. Frequently Asked Questions

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1. Goals of National Immunization Schedule

• Provide free and universal vaccination to all eligible beneficiaries under UIP.
• Prevent childhood mortality and morbidity due to vaccine preventable diseases.
• Ensure at least 90% full immunization coverage in all districts (Mission Indradhanush target).
• Protect pregnant women and newborns from tetanus and other infections.

Beneficiaries under UIP: All pregnant women, all infants and children up to 16 years of age.

2. National Immunization Schedule for Pregnant Women (India)

Vaccine	When to Give	Dose	Route	Site
Td-1 (Tetanus & adult diphtheria)	Early in pregnancy (as soon as pregnancy is detected)	0.5 ml	Intramuscular	Upper arm
Td-2	4 weeks after Td-1	0.5 ml	Intramuscular	Upper arm
Td Booster	If woman has received 2 TT/Td doses in a pregnancy within the last 3 years – only 1 booster dose is needed	0.5 ml	Intramuscular	Upper arm

Nursing tip: Ideally give Td-2 or booster before 36 weeks of pregnancy, but give even later (including in labour) if doses were missed.

3. National Immunization Schedule for Infants (Birth–12 months)

At Birth

Vaccine	When to Give	Dose	Route	Site
BCG	At birth or as early as possible up to 1 year	0.1 ml (0.05 ml up to 1 month age)	Intradermal	Left upper arm
Hepatitis-B Birth Dose	At birth or within 24 hours	0.5 ml	Intramuscular	Antero-lateral side of mid-thigh (left)
OPV-0 (Oral Polio Vaccine)	At birth or within first 15 days	2 drops	Oral	Oral

At 6, 10 and 14 Weeks

Age	Vaccines	Remarks
6 weeks	OPV-1, Pentavalent-1 (DPT+HepB+Hib), Rotavirus-1, fractional IPV-1 (fIPV-1), PCV-1*	PCV in selected states/districts; rotavirus & PCV where introduced
10 weeks	OPV-2, Pentavalent-2, Rotavirus-2	Catch up allowed till 1 year
14 weeks	OPV-3, Pentavalent-3, Rotavirus-3, fractional IPV-2 (fIPV-2), PCV-2*	fIPV given intradermally in right upper arm

At 9–12 Months

Vaccine	When to Give	Dose	Route	Site
MR-1 (Measles–Rubella 1st dose)	9 completed months–12 months (can be given up to 5 years if missed)	0.5 ml	Subcutaneous	Right upper arm
JE-1** (where JE programme exists)	9–12 months	0.5 ml	SC or IM (as per vaccine type)	Left upper arm or antero-lateral thigh
PCV Booster*	9–12 months (after primary 6 & 14 week doses)	0.5 ml	Intramuscular	Antero-lateral thigh
Vitamin A 1st dose	At 9 months with MR-1	1 ml (1 lakh IU)	Oral	Oral

*PCV and **JE vaccines are given in selected states/districts as per Government of India guidelines.

4. National Immunization Schedule for Children (16 months–16 years)

Age	Vaccine	Dose	Route	Site
16–24 months	DPT Booster-1	0.5 ml	Intramuscular	Antero-lateral thigh
	MR-2	0.5 ml	Subcutaneous	Right upper arm
	OPV Booster	2 drops	Oral	Oral
	JE-2** (where applicable)	0.5 ml	SC or IM	Left upper arm / thigh
	Vitamin A 2nd–9th doses	2 ml (2 lakh IU) each dose	Oral	Oral
5–6 years	DPT Booster-2	0.5 ml	Intramuscular	Upper arm
10 years	Td	0.5 ml	Intramuscular	Upper arm
16 years	Td	0.5 ml	Intramuscular	Upper arm

5. Important Notes, Memory Tricks & Nursing Tips

• Site rule:
  • BCG – intradermal, left upper arm
  • MR – subcutaneous, right upper arm
  • Hep-B & Pentavalent – IM, antero-lateral thigh
  • fIPV – intradermal, right upper arm
• “6–10–14” weeks formula: OPV, Pentavalent, Rotavirus (and PCV/fIPV where applicable).
• “9 months combo”: MR-1 + JE-1 (in endemic districts) + PCV booster + Vitamin A 1st dose.
• Vitamin A doses: 1st at 9 months (1 lakh IU), then 2nd–9th every 6 months till 5 years (2 lakh IU each).
• Pregnant woman already fully immunized in last 3 years: give only one Td booster.
• Open vial policy, cold chain, and AEFI (Adverse Event Following Immunization) should always be part of nursing counselling.

Exam memory line: “Birth – BHO (BCG, Hep-B, OPV-0), 6–10–14 – ‘PROPf’ (Pentavalent, Rotavirus, OPV, PCV, fIPV), 9 months – ‘MR JPV’ (MR, JE, PCV booster, Vitamin A).”

6. MCQs on National Immunization Schedule (for NORCET / Staff Nurse / CHO)

1. BCG vaccine under NIS is given at which site?
A. Right deltoid
B. Left upper arm intradermal
C. Right thigh IM
D. Left gluteal
Answer: B.
Nursing point: BCG always left upper arm intra-dermal – easy to remember: “B for BCG, L for Left.”

2. Which combination of vaccines is given at 6 weeks under NIS?
A. BCG + MR
B. OPV-1 + Pentavalent-1 + Rotavirus-1 + fIPV-1 (+ PCV-1 where applicable)
C. OPV-2 + MR-1
D. DPT-Booster + OPV-Booster
Answer: B.

3. Td vaccine for pregnant women is preferred because:
A. It covers only tetanus
B. It covers tetanus and adult diphtheria
C. It is oral vaccine
D. It is cheaper but less effective
Answer: B.

4. Vitamin A 2nd–9th doses are given:
A. Every month till 5 years
B. Every 3 months till 3 years
C. Every 6 months from 16–18 months to 5 years
D. Only at 9 months and 18 months
Answer: C.

5. OPV-0 should ideally be given:
A. Within first 15 days of life
B. At 6 weeks
C. At 10 weeks
D. At 9 months
Answer: A.

6. Under NIS, MR-1 is scheduled at:
A. At birth
B. 6 weeks
C. 9–12 months
D. 5–6 years
Answer: C.

7. Which of the following vaccines is given intradermally?
A. BCG and fIPV
B. Pentavalent and Hep-B
C. OPV and Rotavirus
D. MR and JE
Answer: A.

8. DPT Booster-2 under NIS is given at:
A. 16–24 months
B. 9–12 months
C. 5–6 years
D. 10 years
Answer: C.

9. For a 10-year-old child, which vaccine is recommended in NIS?
A. BCG
B. MR-1
C. Td
D. PCV Booster
Answer: C.

10. JE vaccine in NIS is:
A. Given to all children in India
B. Given only in selected endemic districts
C. Given only to adults
D. Not part of UIP
Answer: B.

7. Frequently Asked Questions (NIS for India)

Q1. What is the difference between UIP and NIS?

Answer: Universal Immunization Programme (UIP) is the national programme under MoHFW that provides vaccines. The National Immunization Schedule (NIS) is the list of vaccines with exact ages, doses, route and site recommended under UIP.

Q2. Is TT still used for pregnant women?

Answer: Current guidelines recommend Td (tetanus + adult diphtheria) instead of plain TT to give additional protection from diphtheria.

Q3. Are PCV and JE given to all children?

Answer: PCV and JE are given in selected states and endemic districts as per Government of India instructions. Always check your state immunization guidelines.

Q4. Can multiple vaccines be given in one visit?

Answer: Yes. For example, at 9 months a child can receive MR-1, PCV booster, JE-1 and Vitamin A together at different sites using separate syringes.

Q5. Which document should the nurse always carry for reference?

Answer: The latest National Immunization Schedule chart and Immunization Handbook for Medical Officers / ANMs issued by MoHFW & NHM.

Post created by GKQuizNursing for nursing and medical competitive exam preparation (NORCET, ESIC, NHM, Staff Nurse, CHO). Always cross-check with the latest MoHFW / NHM guidelines and local state circulars before clinical use.