[12] MIDTERMS | NATIONAL IMMUNIZATION PROGRAM (NIP) Flashcards
An organizational component of DOH charged with preventing disease, disability, and death from vaccine-preventable diseases in children and adults.
National Immunization Program
How long does it take for the body to produce antibodies after vaccine administration?
28 DAYS
Launch of EPI
1976
EPI
Orginal objectives, decrease morbidity and mortality among infants and children caused by ____
Orginal objectives, decrease morbidity and mortality among infants and children caused by 6 immunizable diseases
EPI PRINCIPLES
- The program is based on ____ situation; schedules are drawn on the basis of the ____ and ____ of epidemiological features of the disease
- The whole community rather than just the individual is to be protected, thus ____ approach is utilized
- ____ is a basic health service and integrated into the health services being provided by the RHU
- The program is based on epidemiological situation; schedules are drawn on the basis of the occurence and characteristics of epidemiological features of the disease
- The whole community rather than just the individual is to be protected, thus mass approach is utilized
- Immunization is a basic health service and integrated into the health services being provided by the RHU
STRATEGIES
- Conduct routine immunization for infants/children/women through the ____ strategy
- ____ (SIA)
- Conduct routine immunization for infants/children/women through the Reaching Every Barangay (REB) strategy
- Supplemental Immunization Activity (SIA)
STRATEGIES
- Strengthening Vaccine-Preventable ____
- Procurement of adequate and potent ____ to all health facilities nationwide
- Strengthening Vaccine-Preventable Diseases Surveillance
- Procurement of adequate and potent vaccines and needles and syringes to all health facilities nationwide
TARGET SETTING
- Essential for effective planning and implementation
- Includes infants, children ____ y/o, and women
- Essential for effective planning and implementation
- Includes infants, children < 5 y/o, and women
Mandatory Infants and Children Health Immunization Act of 2011
Republic Health Act No. 10152
R.A. 10152
Basic immunization for children under ____ including other types that will be determined by the Secretary of Health
Basic immunization for children under 5 including other types that will be determined by the Secretary of Health
GUIDELINES OF COLD CHAIN MANAGEMENT
- All vaccines refrigerators or freezeers shall be ____
- Vaccines are stored according to the ____ for each antigen
- Regular temp. monitoring
- ____ for emergency measures
- All vaccines refrigerators or freezeers shall be used exclusively for EPI vaccines
- Vaccines are stored according to the temp. requirement for each antigen
- Regular temp. monitoring
- Contingency plan for emergency measures
COLD CHAIN LOGISTUC MANAGEMENT
Provided to each midwife for temporary storage and transport of the vaccines to their catchment areas
VACCINE CARRIERS
COLD CHAIN MANAGEMENT
COMBINATION REFRIGERATOR / FREEZER UNIT
- No vaccines on ____. Fill the space with frozen packs and water bottles
- No vaccine in ____ or on the ____ of the refrigerator. Fill the space with cold packs or water jugs
- No vaccine near cold ____
- No vaccine on the ____ shelf
COMBINATION REFRIGERATOR / FREEZER UNIT
- No vaccines on doors. Fill the space with frozen packs and water bottles
- No vaccine in drawers or on the floor of the refrigerator. Fill the space with cold packs or water jugs
- No vaccine near cold air vents
- No vaccine on the top shelf
COLD CHAIN MANAGEMENT
FOR ALL UNITS
- Keep vaccines ____ inches away from walls and other boxes
- Post ____ stickers on electrical outlets. Plug in only 1 unit per outlet
- Place the thermometer probe in the ____ of the unit. Post a temperature log on the door
FOR ALL UNITS
- Keep vaccines 2-3 inches away from walls and other boxes
- Post Do Not Unplug stickers on electrical outlets. Plug in only 1 unit per outlet
- Place the thermometer probe in the center of the unit. Post a temperature log on the door
VACCINES MOST SENSITIVE TO HEAT (3)
ORAL POLIO, MEASLES, MMR (-15C TO -25C)
VACCINES LEAST SENSITIVE TO HEAT (6)
PENTAVALENT, BCG, TETANUS TOXOID, PCV-10, IPV, ROTAVIRUS, HPV (+2C TO +8C)
OPEN VIAL POLICY
- Multi-dose liquid vaccines (OPV, DPT, TT, and Hepa B) may be used in the next immunization sessions for up to a max of ____ weeks provided that all the proper conditions are met
- Multi-dose liquid vaccines (OPV, DPT, TT, and Hepa B) may be used in the next immunization sessions for up to a max of 4 weeks provided that all the proper conditions are met
OPEN VIAL POLICY
FOR MULTI-DOSE LIQUID VACCINES
- Expiry date has not passed
- The vaccine has not been contaminated
- The vials have been stored under appropriate cold chain conditions
- The vaccine vial septum has not been ____
- The ____ on the vial, if attached, has not reached the discard point
FOR MULTI-DOSE LIQUID VACCINES
- Expiry date has not passed
- The vaccine has not been contaminated
- The vials have been stored under appropriate cold chain conditions
- The vaccine vial septum has not been submerged in water
- The vaccine vial monitor on the vial, if attached, has not reached the discard point
looks like a square inside a circle
VACCINE VIAL MONITOR (VVM)
VACCINE VIAL MONITOR (VVM)
- As the vaccine vial is exposed to more heat, the ____ becomes darker
- Use only vials with inner square that are ____ in color than the outside circle
- Inner squares that have begun to ____ should be used before vials with lighter inner square
- VVMs do not measure exposure to ____ for freeze-sensitive vaccines
- A VVM not at the discard point does not exclude the possibility that the vaccine was frozen. Before use, make sure that the freeze-sensitive vaccine with good VVM has not been frozen
- As the vaccine vial is exposed to more heat, the square becomes darker
- Use only vials with inner square that are lighter in color than the outside circle
- Inner squares that have begun to darken but still lighter than outer circle should be used before vials with lighter inner square
- VVMs do not measure exposure to freezing temperatures for freeze-sensitive vaccines
- A VVM not at the discard point does not exclude the possibility that the vaccine was frozen. Before use, make sure that the freeze-sensitive vaccine with good VVM has not been frozen
- Freeze-dried vaccines (AMV and BCG) should be discarde ____ hours after reconstitution or at the end of the immunization session
- Freeze-dried vaccines (AMV and BCG) should be discarde 6 hours after reconstitution or at the end of the immunization session
LEGAL BASIS
Compulsory Basic Immunization for Infants and Children below 8 y/o
PRESIDENTIAL DECREE NO. 996
LEGAL BASIS
Implementing a UN goal on Universal Child Immunization by 1990
PRESIDENTIAL PROCLAMATION NO. 6
LEGAL BASIS
Reaffirming the commitment of the Philippines to the Universal Child and Mother Immunization goal of the WHA
PRESIDENTIAL PROCLAMATION NO. 46
LEGAL BASIS
Compulsory Immunization against Hepa B for Infants and Children below 8 y/o
REPUBLIC ACT 7846
LEGAL BASIS
Providing for Mandatory Basic Immunization Services for Infants and Children up to 5 y/o
REPUBLIC ACT 10152
LEGAL BASIS
Policies on the Nationwide Implementation of EPI
DOH ADMINISTRATIVE ORDER NO. 39 S. 2003
LEGAL BASIS
Implementing Guidelines on Hepa B Immunization for Infants
DOH ADMINISTRATIVE ORDER NO. 2006-0015
LEGAL BASIS
Administration of Rotavirus Vaccine for Infants
DOH MEMORANDUM NO. 2012-0153
LEGAL BASIS
Administration of Pneumococcal Conjugate Vaccine-13 (PCV 13)
DOH MEMORANDUM NO. 2014-0155
LEGAL BASIS
Administration of Inactivated Poliomyelitis Vaccine
DOH MEMORANDUM NO. 2015-164
LEGAL BASIS
Guidelines in the Implementation of School-Based Immunization
DOH MEMORANDUM NO. 2015-0146
LEGAL BASIS
Guidelines in the Implementation of School-Based Immunization
DOH MEMORANDUM NO. 2015-0238
Designated as Immunization Day
WEDNESDAY
GENERAL PRINCIPLES OF IMMUNIZATION
- Safe & immunologically effective to administer all EPI vaccines on the ____ at ____.
- Measles vaccine should be given as soon as the child is ____ months old.
- Vaccination schedule should not be ____.
- Safe & immunologically effective to administer all EPI vaccines on the same day at different sites of the body.
- Measles vaccine should be given as soon as the child is 9 months old.
- Vaccination schedule should not be restarted from the beginning.
GENERAL PRINCIPLES OF IMMUNIZATION
- Vaccine should be given with the recommended ____ weeks interval
- Strictly follow principle of never, ever reconstituting the freeze dried vaccine in anything other than the ____ supplied with them.
- Vaccine should be given with the recommended 4 weeks interval
- Strictly follow principle of never, ever reconstituting the freeze dried vaccine in anything other than the diluent supplied with them.
GENERAL PRINCIPLES OF IMMUNIZATION
- False contraindications to immunization:
____ grade fever
m____
mild ____ infections
d____
other minor illnesses - Repeat BCG vaccination if the child does not develop a ____ after the first injection.
- False contraindications to immunization:
low grade fever
malnutrition
mild respiratory infections
diarrhea
other minor illnesses - Repeat BCG vaccination if the child does not develop a scar after the first injection.
GENERAL PRINCIPLES OF IMMUNIZATION
- Generally, one should immunize unless the child is so sick that he needs to be hospitalized.
Absolute contraindications to immunization :
* Severe ____ reaction to previous dose of vaccine
- With known ____ to vaccine component
- A child with a sign and symptoms of severe ____
- Fever of ____ C and above
- Generally, one should immunize unless the child is so sick that he needs to be hospitalized.
Absolute contraindications to immunization :
* Severe hypersensitivity reaction to previous dose of vaccine
- With known allergy to vaccine component
- A child with a sign and symptoms of severe dehydration
- Fever of 38.5 C and above
GENERAL PRINCIPLES OF IMMUNIZATION
Absolute contraindications to immunization:
a. DPT vaccine:
* over ____ years of age
* suffered a severe reaction to previous dose (convulsion or shock w/in 3 days of the most recent dose)
* recurrent ____
* active ____ disease
Absolute contraindications to immunization:
a. DPT vaccine:
* over 5 years of age
* suffered a severe reaction to previous dose (convulsion or shock w/in 3 days of the most recent dose )
* recurrent convulsions
* active neurological disease
GENERAL PRINCIPLES OF IMMUNIZATION
Absolute contraindications to immunization:
b. BCG vaccine:
* with ____ or other immune deficiency diseases
* i____
* therapy with immunosuppressive agents or ____
* after ____ y/o
Absolute contraindications to immunization:
b. BCG vaccine:
* with AIDS or other immune deficiency diseases
* immunosuppressed
* therapy with immunosuppressive agents or irradiation
* after 1 y/o
GENERAL PRINCIPLES OF IMMUNIZATION
Absolute contraindications to immunization :
c. IPV:
* severe allergic reaction (anaphylaxis) to a previous dose or to any component of the vaccine.
- Infants w/ moderate or severe illness temp. ≥ ____°C should not be vaccinated until they have improved.
Absolute contraindications to immunization :
c. IPV:
* severe allergic reaction (anaphylaxis) to a previous dose or to any component of the vaccine.
- Infants w/ moderate or severe illness temp. ≥ 39°C should not be vaccinated until they have improved.
GENERAL PRINCIPLES OF IMMUNIZATION
Absolute contraindications to immunization :
d. PCV 13:
* severe allergic reactions to a prior dose or to any component of the vaccine, including ____
- Infants with moderate or severe illness (temp. ____ °C) should not be vaccinated until they improved.
Absolute contraindications to immunization :
d. PCV 13:
* severe allergic reactions to a prior dose or to any component of the vaccine, including diphtheria toxoid
- Infants with moderate or severe illness (temp. 39 °C) should not be vaccinated until they improved.
GENERAL PRINCIPLES OF IMMUNIZATION
Absolute contraindications to immunization :
e. Rotavirus vaccine:
* Hypersensitivity to any of their components
- History of ____ or intestinal malformations, predisposition to ____.
- Vaccination should be postponed in case of ongoing acute ____ or serious febrile illness.
Absolute contraindications to immunization :
e. Rotavirus vaccine:
* Hypersensitivity to any of their components
- History of intussusceptions or intestinal malformations, predisposition to intussusceptions.
- Vaccination should be postponed in case of ongoing acute gastroenteritis or serious febrile illness.
GENERAL PRINCIPLES OF IMMUNIZATION
- Low birth wt. or prematurity are NOT contraindications to hepatitis B vaccination
(wt. less than ____ gm.: birth dose, & 3 additional
doses) - Safe & effective with mild side effects after vaccination
- Doses of a vaccine less than the recommended ____ weeks interval may lessen the antibody response.
- Low birth wt. or prematurity are NOT contraindications to hepatitis B vaccination
(wt. less than 2000 gm.: birth dose, & 3 additional
doses) - Safe & effective with mild side effects after vaccination
- Doses of a vaccine less than the recommended 4 weeks interval may lessen the antibody response.
GENERAL PRINCIPLES OF IMMUNIZATION
- ____ must be given to children/mother who missed a dose of DPT/OPV/TT/ Hepatitis B.
- Use ____ syringe one needle per child during vaccination.
- No extra doses must be given to children/mother who missed a dose of DPT/OPV/TT/ Hepatitis B.
- Use one syringe one needle per child during vaccination.
TETANUS TOXOID IMMUNIZATION
TT1
Time: Anytime during pregnancy
TETANUS TOXOID IMMUNIZATION
TT2
Time: 1 month after dose 1
Duration of Protecion: 3 years
TETANUS TOXOID IMMUNIZATION
TT3
Time: 6 months after dose 2
Duration of Protecion: 5 years
TETANUS TOXOID IMMUNIZATION
TT4
Time: 1 year after dose 3
Duration of Protecion: 10 years
TETANUS TOXOID IMMUNIZATION
TT5
Time: 1 year after dose 4
Duration of Protecion: lifetime
TETANUS DIPTHERIA IMMUNIZATION SCHEDULE
Number of Doses
- Pregnant women who had received ____ childhood DPT/Pentavalent doses should receive ____ doses of Td
- Pregnant women w/ no previous DPT/Pentavalent immunization or unreliable immunization information should receive ____ Td
- Dosage: ____ ml
- Site: upper outer part of the arm
- Method of Administration: IM
Number of Doses
- Pregnant women who had received 3 childhood DPT/Pentavalent doses should receive 3 doses of Td
- Pregnant women w/ no previous DPT/Pentavalent immunization or unreliable immunization information should receive 5 Td
- Dosage: 0.5 ml
- Site: upper outer part of the arm
- Method of Administration: IM
SCHOOL-BASED IMMUNIZATION
1.MCV (Measles-containing vaccine), Td (Tetanus-diphtheria), and MR (Measles-Rubella) vaccines
- All school children enrolled in Grade ____ shall be vaccinated w/ the appropriate vaccines as specified
- Screened for their measles vaccination history at the time of school entry and vaccinate if evidences show either zero or only ____ dose to ensure that these students received at least ____ MCV by school entry.
- Administered w/ 1 dose of ____ vaccines.
- Students enrolled in grade 7 regardless of age shall be vaccinated w/ ____ dose each of measles-rubella (MR) and Td vaccines on the same immunization session.
1.MCV (Measles-containing vaccine), Td (Tetanus-diphtheria), and MR (Measles-Rubella) vaccines
- All school children enrolled in Grade 1 & 7 shall be vaccinated w/ the appropriate vaccines as specified
- Screened for their measles vaccination history at the time of school entry and vaccinate if evidences show either zero or only 1 dose to ensure that these students received at least 2 MCV by school entry.
- Administered w/ 1 dose of Tetanus-diphtheria (Td) vaccines.
- Students enrolled in grade 7 regardless of age shall be vaccinated w/ 1 dose each of measles-rubella (MR) and Td vaccines on the same immunization session.
SCHOOL-BASED IMMUNIZATION
2.Human Pappilomavirus (HPV) Vaccine
- A component strategy in the prevention of cervical cancer.
- All ____ years old female school children enrolled in Grade 4 shall be vaccinated w/ two doses of quadrivalent HPV vaccine following the DOH recommended immunization schedule.
- Dosage: HPV ____ ml, IM, ____ deltoid arm
- All students who received the first dose of HPV shall be given the second dose after ____ months
2.Human Pappilomavirus (HPV) Vaccine
- A component strategy in the prevention of cervical cancer.
- All 9 to 13 years old female school children enrolled in Grade 4 shall be vaccinated w/ two doses of quadrivalent HPV vaccine following the DOH recommended immunization schedule.
- Dosage: HPV 0.5 ml, IM, left deltoid arm
- All students who received the first dose of HPV shall be given the second dose after 6 months
HEALTH TEACHINGS
BCG
* Deep ____ at vaccination - refer to the physician for incision and drainage.
- Do not ____ the area of injection.
- A scar will form ____ weeks after injection
BCG
* Deep abscess at vaccination - refer to the physician for incision and drainage.
- Do not massage the area of injection.
- A scar will form 12 weeks after injection
HEALTH TEACHINGS
MMR
* If the child has fever give ____ or any appropriate antipyretic every four hours after immunization.
Rotavirus
* Reassure parents and instruct them to give ____ to the child
MMR
* If the child has fever give paracetamol or any appropriate antipyretic every four hours after immunization.
Rotavirus
* Reassure parents and instruct them to give antipyretic to the child
HEALTH TEACHINGS
Measles Vaccine
* If the child has fever give paracetamol or any appropriate antipyretic every four hours after immunization
- Alternating ____ for 24 hours for pain and soreness
Tetanus Toxoid
* No medication for ____
* For pain ____ compress 24 hours
Measles Vaccine
* If the child has fever give paracetamol or any appropriate antipyretic every four hours after immunization
- Alternating cold and warm compress for 24 hours for pain and soreness
Tetanus Toxoid
* No medication for pregnant
* For pain cold compress 24 hours
