EXPANDED PROGRAM ON IMMUNIZATION Flashcards
The four major strategies of EPI includes:
-Sustaining high routine FIC coverage of at least 90% in all provinces and cities
-Sustaining the polio free country for global certification
- Eliminating measles by 2008
- Eliminating neonatal tetanus by
2008.
The development of National Plan of Action for Polio Eradication has been
done when?
1990 which help a lot in the implementation of the eradication of polio.
our country has been certified polio free?
2000, in kyoto Japan
the process by which vaccines are introduced into the body
before infection sets in.
Immunization
general principles which apply in vaccinating children:
-it is safe and 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, regardless of whether vaccines will be given that day.
9 months: 85% protection.
1 y.o. & ↑: 95% protection.
-The vaccination schedule should not be restarted from the beginning, even if the interval between doses exceeds the recommended interval by months or years.
-Moderate fever; Malnutrition; Mild Respiratory Infection, Cough, Diarrhea and Vomiting: Not contraindicated for vaccination. unless so sick, that he needs to be hospitalized.
-It is safe and effective with mild side effects after vaccination. local reaction, fever, & systemic symptoms : Normal immune response.
-giving doses of vaccine <4 weeks interval may lessen antibody response. lengthening leads to higher antibody levels.
-No extra doses given to children/mother who missed a dose of DPT/HB/OPV/TT. Vaccination must be continued as if no time had elapsed between doses.
-Principle: Don’t reconstitute freeze-dried vaccines other than the diluent supplied with them.
-Repeat BCG
vaccination if the child does not develop a scar after the 1st injection.
- Use one syringe one needle per child during vaccination.
Not Contraindicated to Vaccination:
Malnutrition; Mild Respiratory Infection, Cough, Diarrhea and Vomiting.
The absolute contraindications to immunization are :
DPT 2 or DPT3: who has convulsion or shock within 3 days the previous dose.
Vaccines with Whole cell pertussis component: with evolving neurological disease (uncontrolled epilepsy of progressive encephalopathy)
Live Vaccines (BCG): Immunosuppresed due to malignant diseases (Child with clinical AIDS),
therapy with immunosuppressive agents, or irradiation (exposed to rad).
The EPI Target Diseases:
***Vaccination among infants and newborns (0-12 months) against the seven vaccine preventable diseases.
Tuberculosis
Diphtheria
Pertussis
Tetanus
Poliomyelitis
Measles
Hepatitis
the day which is designated as immunization day and is adopted in all parts of the country?
WEDNESDAY
BHS: Monthly
Far flung area: Quarterly
Some local areas: Everyday to cover all targets
What do u call a child receives:
-one dose of BCG,
-3 doses of OPV,
-3 doses of DPT,
-3 doses of HB
-one dose of measles
before a child’s first birthday
11 vaccination: before 1st birthday
Fully Immunized Child
BCG
Age at 1st dose:
Birth or anytime after birth
No. of doses:
1
Reason:
BCG given at earliest possible
to protects from
-TB,
-Menengitis
-other TB infectious
in which infants are prone.
DPT & OPV
Age at 1st dose:
6 weeks
No. of doses:
3
Minimum Interval Best Doses:
4 weeks
Reason:
DPT: early start reduces chance of severe pertussis
OPV: protection against polio is ↑; earliest: keeps Philippines polio free.
HEPATITIS B
Age at 1st dose:
At birth
No. of doses:
3
Minimum Interval Best Doses:
6 weeks
-From 1st dose to 2nd dose
8 weeks
-from 2nd dose to 3rd dose
Reason:
-prevent from being infected & carrier.
-prevent liver cirrhosis & liver cancer
-9000 die from HB; 10% Filipino has chronic HB infection
-eliminate HB before 2012 (Western Regional Goal)
MEASLES
Age at 1st dose:
9 Months
No. of doses:
1
Reason:
-85% of measles can be prevented
-Prevent deaths (2% die),
-Malnutrition, pneumonia, diarrhea (at least 20%) get these complications from measles
-Eliminate measles by 2008
What illness does the baby is being protected from TT injection?
neonatal tetanus
The baby will gain protection to the “2ND DOSE”
TT 1
Minimum Age/ Interval:
As early as possible during pregnancy
TT2
Minimum Age/ Interval:
At least 4 weeks later
Percent Protected:
80%
Duration of protection:
Infants: protected from neontal tetanus
Mother: 3 years protection
TT3
Minimum Age/ Interval:
At least 6 months later
Percent Protected:
95%
Duration of protection:
Infants: protected from neontal tetanus
Mother: 5 years protection
TT4
Minimum Age/ Interval:
1 year later
Percent Protected:
99%
Duration of protection:
Infants: protected from neontal tetanus
Mother: 10 years protection
TT5
Minimum Age/ Interval:
1 Year
Percent Protected:
99%
Duration of protection:
Infants: all infants born to that mother will be protected
Mother: lifetime protection
Reason why vaccines need to be stored at correct temperature?
-To avoid spoilage
-Maintain its potency
Most Sensitive to Heat
“MOst sensitive to heat”
Measles (Freeze dried)
Oral Polio (Live attenuated)
Storage Temperature:
-15°C to -25°C (at the
freezer)
Least sensitive to heat
“D-H-B-T”
-DPT/Hep B
“D” Toxoid; weakened toxin
“P” Killed bacteria
“T” Toxoid; weakened toxin
-Hep B
-BCG (freeze dried)
-Tetanus Toxoid
-practiced to assure that all vaccines are utilized before its expiry date.
- Proper arrangement of vaccines and/or labelling
of vaccines expiry date are done to identify those near to expire vaccines.
“first expiry and first out” (FEFO)
-Temperature monitoring of vaccines is done in all levels of health facilities to
monitor vaccine temperature.
-This is done twice a day early in the morning and in the afternoon before going home.
-Temperature is plotted every day in a temperature monitoring chart to monitor break in the cold chain.
Temperature Monitoring
Cold chain equipment for use in the storage of vaccines:
-Cold room
-Freezer
-Refrigerator
-Transport box
-Vaccine carrier
Other cold chain logistics supplies includes:
-Thermometers
-Cold chain monitor
-Ice packs
-Temperature monitoring chart
-Safety collector box
Administration of vaccines:
BCG
DOSE:
Infants 0.05 ml
Route of Administration:
ID
Site of Administration
Right deltoid
Administration of vaccines:
DPT
DOSE:
0.5ml
Route of Administration:
IM
Site of Administration:
Upper outer portion of
the thigh/ Vastus Lasteralis
Administration of vaccines:
OPV
DOSE:
2 Drops or depending on manufacturer’s
Route of Administration:
ORAL
Site of Administration:
Mouth
Administration of vaccines:
MEASLES
DOSE:
0.5 ml
Route of Administration:
Subcutaneous
Site of Administration:
Outer part of the upper arm/
Administration of vaccines:
HEPATITIS B
DOSE:
0.5 ml
Route of Administration:
IM
Site of Administration:
Upper outer portion of
the thigh/ Vastus Lateralis
Administration of vaccines:
TETANUS TOXOID
DOSE:
0.5 ml
Route of Administration:
IM
Site of Administration:
Deltoid
Reconstituting the freeze dried BCG Vaccine:
a. Always keep the diluent cold by sustaining with BCG vaccine ampules in refrigerator or vaccine carrier.
b. Using a 5 ml syringe, aspirate 2 ml. of saline sollution from the opened ampule of diluent
c. Inject the 2 ml saline into the ampule of freeze dried BCG.
d. Thoroughly mix the diluent and vaccine by drawing the mixture back into the syringe and expel it slowly into the ampule several times.
e. Return the reconstituted vaccine on the slit of the foam provided in the vaccine carrier
INTRADERMAL PRINCIPLE
Giving Oral Polio Vaccine
A. Read the manufacturer’s instructions to determine number of drops to be given. Use the dropper provided.
b. Let the mother hold the child lying firmly on his back.
c. If necessary open the child’s mouth by squeezing the cheeks gently between your fingers to make his lips point upwards
d. Put drops of vaccine straight from the dropper, onto the child’s tongue. But do not let the dropper touch the child’s tongue.
e. Make sure that the child swallows the vaccine. If he spits it out, give another
dose.
Hepatitis B and DPT
Giving Hepatitis B/DPT
a. Ask mother to hold the child across her knees so that his thigh is facing upwards. Ask her to hold child’s legs.
b. Clean the skin with a cotton ball, moistened with water and let skin dry.
c. Place your thumb and index finger on each side of the injection site and grasp the muscles slightly. The best injection site is the outer part of the child’s mid-thigh
d. Quickly push the needle into the space between your fingers, going deep in the muscle.
E. Withdraw to look for bloodflow, if injected into a vein.
f. Inject the vaccine.
Reconstituting the Freeze Dried
Measles Vaccine
a. Using a 10 ml syringe aspirate 5 ml of special diluent, from the ampule.
b. Empty the diluent from the syringe into the vial with the vaccine.
c. Thoroughly mix the diluent and vaccine by drawing the mixture back into the syringe and expelling it slowly into the vial several times. Do not shake the vial.
d. Protect reconstituted measles vaccine from sunlight. Wrap vial in foil.
e. Place the reconstituted vaccine in the slit of the foam provided in the vaccine carrier.
IM PRINCIPLES
Note when giving EPI vaccines:
Note: Shake the vial before every injection.
