EXPANDED PROGRAM ON IMMUNIZATION Flashcards
- Established in 1976
- Legal Basis: Presidential Decree 996 (PD 996)
- To ensure that infants/children and mothers have access to routinely recommended infant/childhood vaccines.
- Six vaccine preventable diseases were initially included in the EPI: TB, poliomyelitis, diphtheria, tetanus, pertussis & measles
EXPANDED PROGRAM ON IMMUNIZATION
- Compulsory Immunization against Hepatitis B
- Provided for compulsory immunization against Hepatitis B for infants & children below 8 years old.
- Provided for hepatitis B immunization within 24 hours after birth of babies of women with hepatitis B
REPUBLIC ACT OF 7846 (RA 7846)
- National Immunization Program
- Mandatory Infants and Children Health Immunization Act of 2011
- Mandates basic immunization covering the vaccine-preventable diseases
Goals of the Program:
1. To immunize all infants/children against the most common vaccine-preventable diseases.
2. To sustain the polio-free status of the Philippines.
3. To eliminate measles infection.
4. To eliminate maternal and neonatal tetanus.
5. To control diphtheria, pertussis, hepatitis B, & German measles.
6. To prevent extrapulmonary TB among children.
REPUBLIC ACT OF 10152
(RA 10152)
Eligible Population
0 – 12 MONTHS (newborn/infants)
Principles
- Epidemiological Situation
- Mass Approach
- Basic Health Service
- “weakened”
- Very effective, provides lifelong protection in 1 or 2 shots.
- Can’t give to weak immune system (like children with HIV infection)
Vaccine: - Bacteria: Tuberculosis (BCG)
- Virus: Oral Polio Vax., measles, Rotavirus, Yellow fever
Ex.: - MMR vaccine (measles, mumps & rubella)
- Anti-Measles Vaccine / Measles Containing Vaccine
- Rotavirus
- Smallpox
- Chickenpox
Attenuated Vaccine - Live but altered (LAV)
- Safer than LAV
- Less effective than LAV
- Not lifetime protection. Needs multiple doses over time
Vaccine: - Bacteria: Whole-cell pertussis (wP)
- Virus: Inactivated Polio Virus (IPV
Ex.: - wP – whole cell Pertussis
- IPV – inactivated polio vaccine
Inactivated Vaccine - Killed
- Safe, can’t cause disease, no possibility of reversion to virulence
- Require several doses, need adjuvant
Vaccine: - Bacteria: Tetanus (TT)
- Diphtheria toxoid
Toxoid Vaccine
- Create response against the molecules in the pathogen’s capsule
Ex.:
- Haemophilus influenzae type b conjugate (Hib)
- Pneumococcal conjugate
- Hepatis B (HepB)
- Acellular pertussis (aP)
Org:
- Meningococcus
- Haemophilus influenzae type b (Hib)
- Pneumococcus
Conjugate subunit Vaccines
Tuberculosis
At birth, 0.05ml, ID, Right deltoid region (arm)
Live, attenuated bacteria
Freeze-dried, reconstituted w/ special diluent
BCG (Bacillus Calmette Guerin)
Diphtheria, Pertussis, Tetanus, Hepatitis B, Pneumonia, Meningitis
6, 10, 14 weeks, 0.5ml, IM, Anterolateral thigh muscle (Vastus Lateralis)
D - weakened vaccine
P - killed bacteria
T - weakened toxins
Diphtheria toxoid, inactivated pertussis bacteria, tetanus toxoid, recombinant DNA surface antigen, and synthetic conjugate of Haemophilus influenzae B bacilli
Liquid, clear
Pentavalent vaccine
DPT -HepB-Hib
(PENTAVALENT)
5-in-1 vaccine
At birth, 0.5ml, IM, Anterolateral thigh muscle (Vastus Lateralis)
Plasma derived
RNA-recombinant, using Hepatitis B surface antigen (HBs Ag)
Cloudy, liquid
Hepatitis B vaccine (Monovalent)
Poliomyelitis
6, 10, 14 weeks, 2 drops, Oral, Mouth
GI mucosal immunity
Live, attenuated virus (trivalent)
Clear, pinkish liquid
Oral polio vaccine
6, 10 weeks, 1.5ml, Oral, Mouth
Live, attenuated virus
Clear, colorless liquid, in a
container with an oral applicator
Rotavirus vaccine
Weakened toxin
Clear, colorless liquid; sometimes
slightly turbid.
Tetanus toxoid
9-11 months, 0.5ml, SUBCU, Outer part of the upper arm
Live, attenuated virus
Freeze-dried, reconstituted with a special diluent
Anti-measles vaccine
(AMV1)
12-15 months, 0.5ml, SUBCU, Outer part of the upper arm
Live, attenuated viruses
Freeze-dried, reconstituted with a special diluent
Measles-mumps-rubella vaccine (AMV2)
Least sensitive to heat
Most sensitive to cold
Pentavalent
Hep B
Diphtheria Tetanus Toxoid
2°C to 8°C
Body of Fridge
8 hours if room temp
Most sensitive to heat
OPV
- 15°C to -25°C
Freezer
Nationwide Immunization Day
WEDNESDAY
Barangay Health Station
MONTHLY
Far Flung Area
QUARTERLY
Some areas, to cover all targets
EVERY DAY
If more than one injection has
to be given on the same limb
Injection sites should be 2.5-5cm apart (1in)
FIC
- Given BCG, three doses of OPV, three doses of DPT and hepatitis B vaccine or three doses of Pentavalent vaccine, and one dose of anti-measles vaccine before reaching one year of age
Fully Immunized Child
CIC
- Completed their immunization schedule at the age of 12-23 months
Completely Immunized Child
CPAB
- two doses of TT during this pregnancy, provided that the second dose was given at least a month prior to delivery; or at least three doses of TT anytime prior to pregnancy with this child
Child Protected At Birth
Vaccines confer immunity only when they are potent
To retain the potency vaccines must be properly stored, handled, and transported
System for ensuring the potency of a vaccine from the time of manufacture to the time it is given to an eligible client.
Cold Chain Officer
Cold Chain
Maintain Potency
Proper Vaccine Storage
First Expiry, First Out (FEFO) Principle
Vaccine Vial Monitor
Shake Test
Max.:
48 hours at Vaccine carriers
5 days at Transport box
4 weeks (28 days) - mulit-dose vaccines, if all conditions are met
1 month in the Fridge
Fridge 12 inches from the wall
Body of Refrigerator Temp
2°C to 8°C
AMV, MMR, Rota,
HBV, 5-in-1, RV, TT (damaged by freezing)
Diluents
Freezer Temp
-15°C to -25°C
OPV
Temperature monitoring
Twice a day (2x)
Upon opening
Before closing
Protect
BCG from sunlight
Rota virus from light
Poliomyelitis
14 weeks, 0.5ml, IM, Vastus Lateralis
Serum immunity (blood)
Clear, liquid
Inactivated Polio Vaccine (IPV)
Pneumonia Meningitis
6, 10, 14 weeks, (For 2-5 yo. give 1 dose), 0.5ml, IM, Vastus Lateralis
Clear, liquid
Pneumococcal Conjugate Vaccine
Mumps, Measles, German Measles
9 months and 12-15 months, 0,5ml, SUBCU, Outer Arm
Live-attenuated virus
Freeze-dried with special diluent
Measles, Mumps, Rubella (MMR)
DT Dose 1
As early as possible
0%
0
Vaccines that have special diluent and should be discarded 6 hours after reconstitution or after clinic hours
BCG, AMV, MMR
DT Dose 2
4 weeks after
80%
3 years
DT Dose 3
6 months after DT2
95%
5 years
DT Dose 4
1 year after DT3
99%
10 years
DT Dose 5
1 year after DT4
99%
Lifetime
