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National Immunisation Schedule (NIS) - India (UIP) - Complete Guide

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1. What Is the National Immunisation Schedule?

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2. How It Is Formed - The Process

The Body That Forms It - NTAGI

1. Review disease burden data (morbidity, mortality, epidemiology)
2. Assess vaccine safety and efficacy data
3. Evaluate equity considerations (does it reach the most vulnerable?)
4. Assess financial sustainability (Government of India + donor support)
5. Review logistical implications (cold chain, storage, supply chain)
6. Make a formal recommendation to MoHFW
7. MoHFW approves and releases operational guidelines

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3. Historical Evolution / Phases

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4. Current NIS Schedule (2025-2026)

For Infants and Children

For Pregnant Women

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5. Key Vaccines - What They Protect Against

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6. Recent Updates (2024-2026) - Most Important

a) Nationwide HPV Vaccination Campaign (February 28, 2026)

• Launched by Prime Minister Modi from Ajmer, Rajasthan
• Target: 14-year-old girls (adolescent girls, single dose)
• Scale: ~1.15 crore (11.5 million) girls across India
• Free of cost at government health facilities
• India accounts for ~25% of global cervical cancer deaths (~80,000 per year)
• This is India's first large-scale HPV immunisation drive under UIP

b) Indigenous Td Vaccine Launch (February 21, 2026)

• Manufactured at Central Research Institute (CRI), Kasauli
• Replaces the older TT (Tetanus Toxoid) vaccine in the schedule
• ~55 lakh doses to be supplied to UIP by April 2026
• Marks India's self-reliance (Atmanirbhar Bharat) in vaccine production

c) Coverage Milestone

• Full immunisation coverage rose from 62% in 2015 to 98.4% as of January 2026
• Zero-dose children declined from 0.11% (2023) to 0.06% (2024) of total population

d) Mission Indradhanush

• Ongoing campaign to reach left-out and drop-out children and pregnant women
• Has completed multiple rounds (Intensified Mission Indradhanush 2.0, 3.0, 4.0)

e) PCV Nationwide Scale-Up

• PCV (Pneumococcal Conjugate Vaccine) scaled up pan-India - protects against the leading cause of bacterial pneumonia deaths in children

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7. UIP vs IAP Schedule - Key Difference

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8. Memory Tricks - Mnemonic for NIS

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9. Quick Recall Table

BIRTH  →  BCG + OPV0 + HepB
6 wk   →  OPV1 + Penta1 + fIPV1 + RVV1 + PCV1
10 wk  →  OPV2 + Penta2 + RVV2
14 wk  →  OPV3 + Penta3 + fIPV2 + RVV3 + PCV2
9-12m  →  MR1 + JE1 + PCV-B
16-24m →  MR2 + JE2 + DPT-B1 + OPV-B
5-6 yr →  DPT-B2
10 yr  →  Td
16 yr  →  Td
Preg   →  Td1 + Td2 (or Booster)

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• Park's Textbook of Preventive and Social Medicine (23rd Ed.), Section: National Immunisation Schedule, NIS Table 43
• PIB India Press Release (March 2026) - UIP milestones and 2026 launches
• Jacob John T & Kompithra RZ (2025). "India's universal immunization program: A review of successes, challenges, and future directions." Indian Journal of Medical Microbiology [PMID: 40252840]
• ITSU cMYP 2018-22 (NTAGI structure and new vaccine introduction process)

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Mission Indradhanush - All Phases at a Glance

Current Phase: IMI 5.0 (Most Recent)

• Measles-Rubella (MR) vaccination catch-up
• Targeting children up to 5 years
• Introduction of the U-WIN smart card for digital vaccine tracking

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Complete Phase Timeline

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Key Points to Remember

• Total phases so far: 12 rounds (as of 2023, per PIB 2026)
• Current/latest named phase: IMI 5.0 (2023)
• Post-IMI 5.0 (2024-26): Routine UIP + HPV campaign (Feb 2026) + indigenous Td vaccine, but no new "IMI 6.0" has been officially announced as of May 2026
• The programme continues in routine immunisation mode with Mission Indradhanush rounds conducted periodically between the numbered phases

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Quick Memory Trick

• MI 1-4 = 2014-2017 (Regular phases, district expansion)
• IMI 1-5 = 2017-2023 (Intensified, post-COVID catch-up, digital tracking)
• IMI 3.0 onward = U-WIN (digital vaccination records)

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U-WIN - India's Universal Immunisation Digital Platform

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What Is U-WIN?

• Nationally launched: October 2024 by the Prime Minister
• Built on the eVIN + CoWIN framework - i.e., the same technological architecture that powered India's COVID-19 vaccination drive
• Available in 12 Indian languages including English
• As of 2024: became the largest digital immunisation repository in the world

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The Digital Health Trilogy Behind It

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How U-WIN Works - Step by Step

For Beneficiaries (Parents/Guardians)

1. Register on the U-WIN app or portal using a mobile number
2. One mobile number can register up to 10 people covering:
   • Pregnant women
   • Infants (0-1 year)
   • Children (1-7 years)
   • Adolescents (7-19 years)
3. Each beneficiary gets a unique health identifier - linked to their ABHA (Ayushman Bharat Health Account) or Child ABHA
4. Receive appointment reminders via SMS for upcoming due vaccines
5. After vaccination, a digital vaccination certificate is generated (like CoWIN certificate)
6. Access vaccination history anytime from the app

For Healthcare Workers (ANMs, Vaccinators)

1. Log in to U-WIN on their device (phone/tablet)
2. System auto-generates the list of beneficiaries due for vaccination on that session day
3. Worker marks each dose administered - child's record updated in real time
4. Helps with community mobilisation (knowing who to chase up)
5. Flags children who are overdue or have missed doses ("drop-outs")
6. Works even in remote areas like Andaman & Nicobar islands

For Programme Supervisors / Government

1. Real-time national dashboard showing coverage district by district
2. Identifies zero-dose children (never vaccinated) and partial immunisation cases
3. Tracks session performance - did the session happen? How many doses were given?
4. Integrates with eVIN so vaccine availability at the facility is matched against demand
5. Generates automatic reports for HMIS (Health Management Information System)

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Key Features Summary

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Why U-WIN Matters

• Before U-WIN: Vaccine records were on paper cards (the yellow immunisation card), easily lost, no national database, no way to track missed children at scale
• After U-WIN: Every dose is logged centrally, missed children are flagged automatically, and parents get reminders - closing the gap between scheduled and actual immunisation

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Vaccine Cold Chain - Complete Guide

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What Is the Cold Chain?

Right vaccine → Right quantity → Right place → Right time → Right condition (no temperature breaks) → Right cost

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India's Cold Chain Infrastructure (2026 Update)

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Cold Chain Equipment - Classified

A. Storage Equipment

Electrical

Solar

Non-electrical

• Cold boxes
• Vaccine carriers

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B. Transportation Equipment

Key rule: At sub-centre and village level, vaccines are NOT stored - they are supplied on the day of use only. Risk of cold chain failure is greatest at this level.

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Temperature Sensitivity of Vaccines

Freeze-sensitive vaccines (must NOT go below 0°C)

• Pentavalent (DPT+HepB+Hib)
• Hepatitis B
• IPV (fIPV)
• PCV
• Rotavirus
• HPV
• Td / TT / DT
• Influenza, Cholera

Heat-sensitive vaccines (Groups A-F, most to least sensitive)

Light-sensitive vaccines

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ILR - The Most Important Cold Chain Link

• Operates on vapour compression (like a regular fridge)
• Has an ice-lined inner wall that maintains vaccine temperature for up to 8 hours during power cuts
• Basket-type design - vaccines stored in baskets, NOT against the walls
• Temperature must be checked and recorded twice daily (morning + end of session)

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Open Vial Policy (OVP) - 2015

• Cold chain has been maintained (vaccine stored at +2°C to +8°C throughout)
• VVM (Vaccine Vial Monitor) has not passed the discard point
• Vial expiry date has not passed
• Vaccine septum has not been submerged in water
• No visible contamination or floating particles

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Vaccine Vial Monitor (VVM)

• The inner square is lighter than the outer circle = safe to use
• Inner square same colour or darker = discard, do not use
• Helps field workers make real-time discard decisions without a thermometer

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eVIN - Digital Cold Chain Monitoring (Latest Update)

• IoT temperature sensors on every storage unit
• Real-time alerts if temperature goes out of range
• Tracks vaccine stock levels at each cold chain point
• Central dashboard for supply chain managers
• Proved critical during COVID-19 rollout
• Now being exported as a model to other countries (Lao PDR, Zambia)

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Handling During Immunisation Session

• Check vials at start of session; discard if VVM has passed
• Keep freeze-sensitive vaccines (Pentavalent, IPV, PCV, Hep B) away from direct contact with frozen ice packs - place a layer of foam/card between them
• OPV can be placed directly against ice packs (freeze-stable)
• Reconstituted vaccines (BCG, MR): discard after 4 hours or at end of session, whichever is earlier
• Multi-dose opened vials with preservatives: OVP applies (up to 28 days) if conditions met

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New Updates (2025-2026)

1. eVIN expanded nationwide - all States/UTs now covered with real-time temperature + stock monitoring
2. U-WIN integration with eVIN - demand-side and supply-side now digitally linked for the first time
3. Model Immunisation Centres launched in UP, Bihar, Chandigarh, and Ladakh - upgraded cold chain + digital infrastructure as pilot hubs
4. HPV vaccine cold chain set up pan-India for the February 2026 campaign (HPV is freeze-sensitive, Group E)
5. A-VIN (Animal Vaccine Intelligence Network) - same eVIN framework now piloted in two states for animal vaccines, showing scalability of the model

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• Park's Textbook of Preventive and Social Medicine - "The Cold Chain," Cold Chain Equipment, Temperature Requirements sections (pp. 122-126)
• PIB India - Celebrating the Power of Vaccines, 2026
• UNDP India - A Decade of Digital Health, 2025

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Freeze-Sensitive & Light-Sensitive Vaccines - Mnemonics + ILR Arrangement

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1. FREEZE-SENSITIVE Vaccines

Mnemonic: "Don't Let The Poor Infants Freeze"

DPT · Rotavirus · IPV · Pentavalent · TT/Td · HepB + PCV + HPV

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2. LIGHT-SENSITIVE Vaccines

Mnemonic: "BCG Measles Rub the Rubella MMR"

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3. ILR (Ice-Lined Refrigerator) - Standard Arrangement

Official WHO/GOI Rule:

┌─────────────────────────────────────────┐
│        FREEZER COMPARTMENT (top)        │  ← ICE PACKS only
├─────────────────────────────────────────┤
│   TOP BASKET → FREEZE-SENSITIVE         │  ← HepB, Penta, DPT,
│                                         │     TT/Td, IPV, PCV, HPV
├─────────────────────────────────────────┤
│   BOTTOM BASKET → HEAT-SENSITIVE        │  ← OPV, BCG, MR,
│                (freeze-stable)          │     Measles, Rotavirus, JE
└─────────────────────────────────────────┘

Why this seems backwards (but makes perfect sense):

• The coldest zone in a top-opening ILR is the bottom - closest to the ice-lined walls
• Freeze-sensitive vaccines placed at top = farther from the ice = protected from freezing
• Heat-sensitive freeze-stable vaccines placed at bottom = benefit from coldest zone = more protection from heat
• Diluents go next to their corresponding freeze-dried vaccines (or on the bottom shelf if space is short)

Memory trick:

"FREEZE-sensitive = goes on TOP (away from ice)" "HEAT-sensitive = goes to BOTTOM (nearest ice)"

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4. Additional ILR Rules (Dos and Don'ts)

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5. Quick Recap Table

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