INTRODUCTION:

Immunity enables the body to defend itself against disease caused by certain microorganism. Immunity may occur on its own (when people are exposed to bacteria and viruses) or by vaccination. Vaccination is one of the well-known and effective methods of preventing childhood diseases¹. With the implementation of the Universal Immunization Programme (UIP) by the government of India, significant achievements have been made in preventing and controlling vaccine preventable disease (VPDs).

Every year an immunization week is being celebrated in last week of April with main aim to promote use of vaccines, to protect people of all ages against diseases. Immunization saves millions of lives and is widely recognized as one of the world’s most successful and cost effective health intervention. Immunization helps to prevent all children of the world against seven vaccine preventable disease namely - Diphtheria, Whooping cough, tetanus, polio, tuberculosis, measles, and hepatitis B. Interruption of the schedule with delay between vaccine doses does not interfere with the final immunity achieved². One effective way of controlling the spread of infection is to strengthen the host defenses. Under certain circumstances active immunization, which is one of the most powerful and cost effective weapons of modern medicine may accomplish this. There are some infectious disease whose control is based on active immunization e.g. polio, tetanus, diphtheria and measles. Vaccine is an immuno- biological substance designed to produce specific protection against a given disease. It stimulates the production of protective antibody and other immune mechanism⁵. Vaccines may be prepared from live modified organisms, inactivated or killed organisms, extracted cellular fractions, toxoids or combination of these. Most recent preparations are subunit vaccines and recombinant vaccines.

STATEMENT OF THE PROBLEM:

A Study to assess the effectiveness of self- information leaflet on knowledge regarding immunization among II^ndyear B.Sc. Nursing students of BIMR Nursing College Gwalior.

OBJECTIVES:

· To assess the existing level of knowledge regarding immunization among II^ndyear B.Sc. Nursing students.

· To evaluate the effectiveness of self- information leaflet on knowledge regarding immunization among II^ndyear B.Sc. Nursing students.

· To determine the association between post-test knowledge score with certain demographic variables like age, sex, previous knowledge on immunization and source of information.

RESEARCH HYPOTHESIS:

H₁- there is significant difference between pre and post test knowledge score of the students regarding immunization.

H₂- there is significant association between post-test score and selected demographic variables.

Conceptual framework-

Based on Imogene king goal attainment theory.

METHODOLOGY:

Research methodology is the means by which we collect data to answer research questions or to test hypothesis. Research methodology is a way to systematically solve the research problem. It may be understood as a science of studying how research is done scientifically⁷. (C.R.Kothari)

Research Approach:

Quantitative evaluative approach was considered the most appropriate to achieve the objectives of study.

Research Design:

Pre- Experimental Design (one group Pre- test and Post- test design)

Setting:

“Setting is the physical location and condition in which data collection takes place in a study”⁶. The present study was conducted in BIMR Nursing College, Gwalior. The investigator found the setting appropriate to conduct the study for following reasons such as availability of study subjects, the proximity of selected area, permission granted from higher authority.

Population:

The population of this study comprised of nursing students.

Sample-size:

30 B.Sc (Nursing) students

Sampling technique:

Sampling technique refers to the process of selecting a subset of the population in order to obtain information regarding phenomenon in a way that represents the entire population.

Purposive Sampling technique adopted by the investigator is to have adequate subjects to participate in the study with set inclusion criteria. In addition, this technique was suitable to complete the study within the stipulated time.

Sample Inclusion Criteria:

· Able to read and write in English.

· Willing to participate in study

· Present at the time of data collection

Exclusion Criteria:

· Ill during the time of study

· Not willing to participate.

Method of Data-collection:

· Self- Structured questionnaire to assess the knowledge regarding immunization schedule, cold-chain, adverse reaction^3,4

Data Collection Procedure:

Pretest was conducted by using self- structured questionnaire to assess the knowledge regarding immunization.

Immediately after Pretest, Self-information leaflet was given to the students to read about immunization-schedule, cold-chain, adverse-reaction.

2^nd day, posttest was conducted by using the same self- structured questionnaire to assess the knowledge.

Plan for data analysis:

Descriptive Statistics - Percentage, Mean, and Standard deviation.

Inferential Statistics - Paired t test and ANOVA test.

FINDINGS:

Section A-

Table I- Pre-test level of knowledge of students on immunization. n=30

Level of knowledge	Frequency	Percentage
Poor	12	40.0
Average	16	53.3
Good	2	6.7

Table-II Post-test level of knowledge of students on immunization n=30

Level of knowledge	Frequency	Percentage
Poor	4	13.3
Average	16	53.3
Good	10	33.3

Section B-

Table III- Evaluation of effectiveness of information booklet on immunization by using paired-t test.

Type of test	Mean	SD	Mean%
Pretest	8.57	3.287	28.56
Posttest	13.23	4.546	44.1

CONCLUSION:

Prior to implementation of self-information leaflet students had inadequate knowledge on immunization the effectiveness was evaluated by post-test score- the mean score had improved from 8.57 to 13.23 after implementation of self-information leaflet. It shows that leaflet was effective. The calculated t value is statistically significant at 0.05 levels as the calculated t value is more than the table t value of 2.05

Immunization Schedule

Name of vaccine	Prevent from Disease	Time	Dose	Route	Site
For Infants
BCG(Bacillus Calmette Guerin)	Primary complex, Tuberculosis	At birth as early as possible till one year of age	0.1ml	Intra-dermal	Left upper arm
OPV-0dose	Poliomyelitis	At birth as early as possible within the first 15 days	2 drops	Oral	Oral
OPV-1,2 and 3 dose	Poliomyelitis	At 6, 9 months and 4-6 year	2 drops	Oral	Oral
IPV-1,2 and 3 dose	Poliomyelitis	At 6,10 and 14 weeks	05ml	Intramuscular	Antero-lateral side of mid thigh
DPT- 1,2 and 3 dose	Diphtheria, Pertussis and Tetanus	At 6,10 and 14 weeks	0.5ml	Intramuscular	Antero-lateral side of mid thigh
Hepatitis-B 0, 1,2 and 3 dose	Hepatitis B virus	0 dose at birth. Then at 6,10 and 14 weeks	0.5ml	Intramuscular	Antero-lateral side of mid thigh
Hib (Haemophilus influenzae type b)	Influenza virus (meningitis)	At 6,10 and 14 Weeks Booster dose at 16-18 months	0.5ml	Intramuscular	Antero-lateral side of mid thigh
PCV(Pneumococal Conjugate Vaccine)	Pneumonia	At 6,10 and 14 weeks and Booster dose at 15 months	0.5ml	Intramuscular	Deltoid Muscle
Rotavirus	Diarrhea and Vomiting	At 6, 10 and 14 weeks	Rotarix- 1ml Rotateq- 2ml	Oral	Oral
MMR	Measles, Mumps and Rubella	9 completed months. Booster dose at 16-24 months	0.5ml	Subcutaneous	Right upper arm
Vitamin- A	Night Blindness	At 9 months with measles	1ml (1lakh IU)	Oral	Oral
Varicella	Chickenpox	First Dose -15months Second Dose- 5years	0.5ml	Subcutaneous	Right Upper arm
Hepatitis- A	Hepatitis A Virus (liver disease)	First Dose -12 months Second dose -18 months	0.5ml	Intramuscular	Deltoid muscle of arm
*For Children*
DPT Booster and OPV Booster dose- 1	Diphtheria, Pertussis, Tetanus and Poliomyelitis	16-24 months	0.5ml 2 drops	Intramuscular and Oral	Antero-side of mid thigh and Oral
Vitamin A (2^nd to 9^th dose)	Night Blindness	One at 16-24 months with DPT/OPV Booster. Then Every 6 months up to 5 years	2ml (2lakh IU)	Oral	Oral
Typhoid	Typhoid fever	First Dose- 9months Second Dose-2 years	0.5ml	Intramuscular	Deltoid /Antero- lateral thigh
DPT and OPV Booster dose -2	Diphtheria, Pertussis, Tetanus	5-6 years	0.5ml	Intramuscular	Right upper arm
Tetanus Toxoid	Tetanus	10 years and 16 years	0.5ml	Intramuscular	Right upper arm
HPV(Human Papilloma virus)	Cancer of cervix	10 years to 26 years at the interval of 0,2 and 6 months	0.5ml	Intramuscular	Deltoid
*For Pregnant Mothers*
Tetanus Toxoid -1	Tetanus (lockjaw)	Early in pregnancy	0.5ml	Intramuscular	Upper arm
Tetanus Toxoid -2	Tetanus	4 weeks after TT-1	0.5ml	Intramuscular	Upper arm

Vaccines to be administered after consultation with Physician and Parents.

Japanese

Encephalitis

Japanese Encephalitis Virus

16-24 months

0.5ml

Subcutaneous

Left upper arm

Influenza Inactivated Vaccine (IIV)

Flu illness

6-7 months

Every 1 year Booster

6-35 months - 0.25 ml repeat after 1month

>3yrs- 0.5ml

Intramuscular

Antero-lateral side of mid thigh

Meningococcal Conjugate

Meningitis

At 11-12 year age

Booster Dose at 16 years

0.5ml

Intramuscular

Deltoid