Expanded Program for Immunization Chd Report

8/6/2019 Expanded Program for Immunization Chd Report

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Expanded Program forExpanded Program for

ImmunizationImmunization


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TheThe Expanded Program onExpanded Program onImmunization (EPI) in theImmunization (EPI) in the PhilippinesPhilippinesbegan in July 1979. And, in 1986, made abegan in July 1979. And, in 1986, made aresponse to the Universal Childresponse to the Universal Child

Immunization goal.Immunization goal. TheThe Expanded Program onExpanded Program on

ImmunizationImmunization is one of the DOHis one of the DOHPrograms that has already beenPrograms that has already beeninstitutionalized and adopted by all LGUs ininstitutionalized and adopted by all LGUs inthe region. Its objective is to reduce infantthe region. Its objective is to reduce infant

mortality and morbidity through decreasingmortality and morbidity through decreasingthe prevalence of six (6) immunizablethe prevalence of six (6) immunizablediseases (TB, diphtheria, pertussis,diseases (TB, diphtheria, pertussis,tetanus, polio and measles)tetanus, polio and measles)


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The four major strategiesThe four major strategies

include:include:

Sustaining high routine FullSustaining high routine FullImmunized Child (FIC) coverageImmunized Child (FIC) coverageof at 90% in all provinces andof at 90% in all provinces and

cities,cities, Sustaining the polioSustaining the polio--free countryfree country

for global certification.for global certification.

Eliminating measles by 2008Eliminating measles by 2008 Eliminating neonatal tetanus byEliminating neonatal tetanus by

20082008..


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Routine Immunization ScheduleRoutine Immunization Schedule

for Infantsfor Infants

The standard routine immunizationThe standard routine immunizationschedule for infants in theschedule for infants in thePhilippines is adopted to providePhilippines is adopted to providemaximum immunity against themaximum immunity against the

seven vaccine preventable diseasesseven vaccine preventable diseasesin the country before the child's firstin the country before the child's firstbirthday. The fully immunized childbirthday. The fully immunized childmust have completed BCG 1, DPT 1,must have completed BCG 1, DPT 1,DPT 2, DPT 3, OPV 1, OPV 2, OPVDPT 2, DPT 3, OPV 1, OPV 2, OPV3, HB 1, HB 2, HB 3 and measles3, HB 1, HB 2, HB 3 and measlesvaccines before the child is 12vaccines before the child is 12months of age.months of age.


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General Principles inGeneral Principles in

Infants/Children ImmunizationInfants/Children Immunization measles kills, every infant needs to be vaccinated againstmeasles kills, every infant needs to be vaccinated against

measles at the age of 9 months or as soon as possible after 9measles at the age of 9 months or as soon as possible after 9months as part of the routine infant vaccination schedule. It ismonths as part of the routine infant vaccination schedule. It issafe to vaccinate a sick child who is suffering from a minor illnesssafe to vaccinate a sick child who is suffering from a minor illness(cough, cold, diarrhea, fever or malnutrition) or who has already(cough, cold, diarrhea, fever or malnutrition) or who has alreadybeen vaccinated against measlesbeen vaccinated against measles

If the vaccination schedule is interrupted, it is not necessary toIf the vaccination schedule is interrupted, it is not necessary torestart. Instead, the schedule should be resumed using minimalrestart. Instead, the schedule should be resumed using minimalintervals between doses to catch up as quickly as possible.intervals between doses to catch up as quickly as possible.

Vaccine combinations (few exceptions), antibiotics,Vaccine combinations (few exceptions), antibiotics,lowlow--dose steroids (less than 20mg per day), minordose steroids (less than 20mg per day), minorinfections with low fever (below 38.5 Celsius),infections with low fever (below 38.5 Celsius),diarrhea, malnutrition, kidney or liver disease, heartdiarrhea, malnutrition, kidney or liver disease, heart

or lung disease, nonor lung disease, non--progressive encephalopathy,progressive encephalopathy,well controlled epilepsy or advanced age, are notwell controlled epilepsy or advanced age, are notcontraindications to vaccination. Contrary to whatcontraindications to vaccination. Contrary to whatthe majority of doctors may think, vaccines againstthe majority of doctors may think, vaccines againsthepatitis B and tetanus can be applied in any periodhepatitis B and tetanus can be applied in any periodof the pregnancy.of the pregnancy.


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There are very few true contraindication andThere are very few true contraindication andprecaution conditions. Only two of theseprecaution conditions. Only two of theseconditions are generally considered to beconditions are generally considered to bepermanent: severe (anaphylactic) allergic reactionpermanent: severe (anaphylactic) allergic reactionto a vaccine component or following a prior doseto a vaccine component or following a prior dose

of a vaccine, and encephalopathy not due toof a vaccine, and encephalopathy not due toanother identifiable cause occurring within 7 daysanother identifiable cause occurring within 7 daysof pertussis vaccinationof pertussis vaccination

Only the diluent supplied by the manufacturerOnly the diluent supplied by the manufacturershould be used to reconstitute a freezeshould be used to reconstitute a freeze--drieddriedvaccine. A sterile needle and sterile syringe mustvaccine. A sterile needle and sterile syringe mustbe used for each vial for adding the diluent to thebe used for each vial for adding the diluent to the

powder in a single vial or ampoule of freezepowder in a single vial or ampoule of freeze--drieddriedvaccinevaccine

The only way to be completely safe from exposureThe only way to be completely safe from exposureto bloodto blood--borne diseases from injections,borne diseases from injections,particularly hepatitis B virus (HBV), hepatitis Cparticularly hepatitis B virus (HBV), hepatitis Cvirus (HCV), and human immunodeficiency virusvirus (HCV), and human immunodeficiency virus(HIV) is to use one sterile needle, one sterile(HIV) is to use one sterile needle, one sterile

syringe for each.syringe for each.


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Care for the VaccinesCare for the Vaccines

To ensure the optimal potency of vaccines, carefulTo ensure the optimal potency of vaccines, carefulattention is needed in handling practices at the countryattention is needed in handling practices at the countrylevel. These include storage and transport of vaccineslevel. These include storage and transport of vaccinesfrom the primary vaccine store down to the endfrom the primary vaccine store down to the end--user atuser atthe health facility, and further down at the outreach sites.the health facility, and further down at the outreach sites.Inappropriate storage, handling and transport of vaccinesInappropriate storage, handling and transport of vaccines

wont protect patients and may lead to needless vaccinewont protect patients and may lead to needless vaccinewastagewastage

A "first expiry and first out" (FEFO) vaccine system isA "first expiry and first out" (FEFO) vaccine system ispracticed to assure that all vaccines are utilized before itspracticed to assure that all vaccines are utilized before itsexpiry date. Proper arrangement of vaccines and/orexpiry date. Proper arrangement of vaccines and/orlabeling of expiry dates are done to identify those close tolabeling of expiry dates are done to identify those close toexpiring. Vaccine temperature is monitored twice a dayexpiring. Vaccine temperature is monitored twice a day(early in the morning and in the afternoon) in all health(early in the morning and in the afternoon) in all healthfacilities and plotted to monitor break in the cold chain.facilities and plotted to monitor break in the cold chain.Each level of health facilities has cold chain equipment forEach level of health facilities has cold chain equipment foruse in the storage vaccines which included cold room,use in the storage vaccines which included cold room,freezer, refrigerator, transport box, vaccine carriers,freezer, refrigerator, transport box, vaccine carriers,thermometers, cold chain monitors, ice packs,thermometers, cold chain monitors, ice packs,temperature monitoring chart and safety collector boxes.temperature monitoring chart and safety collector boxes.


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Vaccine Minimum Age IntervalVaccine Minimum Age Interval

PercentPercent

ProtectedDuration ofProtectionProtectedDuration ofProtection

TT1 As early as possibleTT1 As early as possible

During pregnancyDuring pregnancy

TT2 At least 4 weeks later 80%TT2 At least 4 weeks later 80%

TT2 At least 4 weeks later 80% infantsTT2 At least 4 weeks later 80% infantsborn to the mother will be protected fromborn to the mother will be protected fromneonatal tetanusneonatal tetanus

gives 5 years protection for the mother TT4gives 5 years protection for the mother TT4

At least 1 year later 99%At least 1 year later 99% infants born to the mother will beinfants born to the mother will be

protected from neonatal tetanusprotected from neonatal tetanus


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gives 10 years protection for thegives 10 years protection for the

mother TT5 At least 1 year latermother TT5 At least 1 year later

99%99%

gives lifetime protection for thegives lifetime protection for the

mother.mother.

all infants born to that mother

will be protected


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Prepared by:Prepared by:

Jeremiah LoyzagaJeremiah Loyzaga

Documents

Expanded Program for Immunization Chd Report