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Angeles University Foundation

Angeles City

“Expanded Program on
Immunization”

Presented By:
Jefferson Baladhay Dungca
BSN IV - 4
Group 13

Submitted To:
Mr. Dennis S. Cortez, R.N. MN
Clinical Instructor, CHN Marcos Village

OBJECTIVES:
“To Reduce morbidity and Mortality against 7 childhood Immunizable
diseases.” (Tuberculosis, Diptheria, Pertusis, Tetanus, Poliomyelitis,
Measles, and Hepatitis B.)

Established here at Philippines by Pres. Marcos on the month of July,


1976

PRINCIPLES:

1. The program is based on epidemiological situation; schedules are


drawn on the basis of the occurrences and characteristics
features of the said diseases.
2. The whole community rather than just an individual is to be
protected, thus, mass approach is applied.
3. Immunization is a basic health service and as such, it is
integrated into the health services provided for by Rural Health
Unit.

Immunization – is a process by which vaccines are introduce to the


Body, before infectious sets in.

ELEMENTS :

1. Target Setting – (0 – 12 mos.)


2. Cold chain Management (for vaccine life span and utilization)
3. Information, education and communication

3 Reasons:

a. For parents, to be motivated to submit their child to


immunization
b. To provide health teachings on benefits and importance of
immunization
c. To inform the public about its availability and schedule
(RHU q Weds. BHS q once a month, and remote area q
Quarterly)

4. Assessment and evaluation of the programs over all performance


5. Surveillance, studies and research.

EPI ROUTINE IMMUNIZATION SCHEDULE FOR INFANTS


VACCINE TARGET DOSAGE INTERVA ROUTE SITE
L

1. BCG Anytime 0.05ml Once Intradermal Right


at Birth (ID) Deltoid

School 0.1ml Assess for


Wheal formation
Left
Entrance Deltoid

2. Hepa B Anytime 0.5ml 6 wks. Intramuscular Upper


at Birth Interval (IM) outer
from 1st
dose to 2nd
Portion
dose, then of the
8 weeks thigh
interval
From 2nd to
3rd dose

3. DPT 6 wks. 0.5ml 4 weeks Intramuscular Upper


Up to 11 x 3 doses (IM) outer
mos. portion
of the
thigh

4. OPV 6 wks. 2 drops 4 weeks Oral Mouth


Up to 11 x 3 doses (Child must be (side of the
mos. PO for 30 mins.) cheek)

5. 9 0.5ml Once Subcutaneou Outer


Measles months s Part of
(SQ) the
(if upper
epidemic arm
crisis, 6
mos.)

Side Effects of BCG:


1. Koch’s Phenomenon – acute inflammatory process starting with
in 24 hrs. and may last for 2 – 4 days. Wheal must disappear in
about 30 mins – 1hr.
2. Abscess formation – 1st week – soreness and inflammation, 2nd
week – 11th week healing of abscess and ulceration. If there is no
scar developed, Repeat the procedure
3. indolent ulceration – a. wrong technique, b. exposure of infant to
Pt. c active TB.
4. Glandular Enlargement – a. unsterile syringe or needle was used,
b. too much vaccine was injected. C. the vaccine might be
injected under the skin layer, and not instead in its superficial
layer.
Management: Physician may order, I and D, or Isoniazid.

Side Effects of Hepa B:

1. Mild fever 1 -2 days, - a. Teach mother perform TSB b. advice


mother that she may give Paracetamol every 4 hours if fever not
relapse. Fever more than 4 days, refer to the Physician.

2. Mild Pain, swell and redness. – a. Teach mother to do cold compress


first before hot compress 1 – 3 times after injection then every 6 hours.

Side Effects of DPT:

1. Fever within 24 hours


2. local soreness pain and swelling
3. Abscess appears after a week or more due to wrong technique,
4. Convulsions is very rare, but may occur more in children above 3
months of age. This is due to the Pertussis virus component of
the vaccine. – there are now available D and T only vaccines that
may avoid convulsions of DPT.

Side Effects of Measles Vaccine:


1. Fever and Rashes – for rashes mother mjay give
ANTIHISTAMINES (Benadryl) and for itchiness (Calamine Lotion).

Side effects for OPV:

NONE: But be aware of possible risk for aspiration once wrong site is
used. Make sure also that the baby was NPO 30 mins. prior
administration, for him not to vomit once drops were administered.

TETANUS TOXIOD IMMUNIZATION SCHEDULE FOR PREGNANT WOMEN

VACCINE SCHEDULE % OF DURATION ROUTE AND


PROTECTIO OF SITE
N PROTECTIO
N

Not yet
TT1 As early as none
protected IM , (Deltoid)
possible during
pregnancy

Infant born from


At least 4 weeks 80% mother will be
TT2
later protected from IM , (Deltoid)
neonatal
tetanus.

Gives 3 years
protection for
the mother

TT3 At least 6 95% Infant born from IM , (Deltoid)


months later mother will be
protected from
neonatal
tetanus.

Gives 5 years
protection for
the mother
Infant born from
TT4 At least 1 year mother will be
99% IM , (Deltoid)
later protected from
neonatal
tetanus.

Gives 10 years
protection for
the mother

TT5 At least 1 year 99% Gives Lifetime IM , (Deltoid)


later protection for
the mother. All
infants born to
that mother will
be protected

POINTERS ON IMMUNIZATION:

1. Every child deserves to be given the benefits of immunization


protection based on PD 996 immunization law. September 16,
1976 – Basic compulsory immunization of children below 8 years
old is implemented.
2. No vaccine gives 100% protection. They go hand in hand with
good hygiene and other measures for disease prevention.
3. Recommended series of immunization must be completed for
adequate protection.
4. Booster doses are important to maintain continuous protection
against the diseases.
5. Interruption of schedule does not interfere with final immunity
nor does it necessitate contraindication to vaccination.
6. Malnutrition, minor respiratory infections, moderate fever, cough
and diarrhea do not constitute contraindications to vaccinations.
7. the absolute contraindications to immunization are :
a. DPT2 or DPT3 to a child who has had convulsion or shock
with in 3 days the previous dose.
b. Live weakened vaccine like BCG must not be given to
individual who are immunocompromised due to malignant
disease.
8. Measles and OPV vaccines are most sensitive to heat. They must
be strictly maintained at -15 – 20 C.
9. Vaccines are safe and effective with mild side effects after
vaccination.
10. No extra doses must be given to child/mother who missed a
dose.

11. Giving doses of a vaccine at less than 4 weeks interval may


lessen the anti body response. Lengthening the interval leads to
higher antibody levels.
12. Practice FEFO first expiry first out rule, and 1 syringe one
needle one child policy must strictly implemented.

“ A child is said to be Fully Immunized Child when he/she receives 1


dose of BCG, 3 doses of Hepa B, 3 doses of DPT, 3 doses of OPV, and 1
dose of Measles before his/her 1st Birthday.,.”

Jef7

OBJECTIVES:
PRINCIPLES:

The program is based on epidemiological situation; schedules are


drawn on the basis of the occurrences and characteristics features
of the said diseases.

The whole community rather than just an individual is to be


protected, thus, mass approach is applied.

Immunization is a basic health service and as such, it is integrated


into the health services provided for by Rural Health Unit.

Immunization –

ELEMENTS :

Target Setting – (0 – 12 mos.)

Cold chain Management (for vaccine life span and utilization)

information, education and communication

3 Reasons:

a. For parents, to be motivated to submit their child to


immunization
b. To provide health teachings on benefits and importance of
immunization
c. To inform the public about its availability and schedule
(RHU q Weds. BHS q once a month, and remote area q
Quarterly)

Assessment and evaluation of the programs over all performance


Surveillance, studies and research.

EPI ROUTINE IMMUNIZATION SCHEDULE FOR INFANTS

VACCINE TARGET DOSAGE INTERVA ROUTE SITE


L

1. BCG

2. Hepa B

3. DPT

4. OPV

5.
Measles

Side Effects of BCG:

Koch’s Phenomenon –
Abscess formation –

indolent ulceration –

Glandular Enlargement –

Management: Physician may order, I and D, or Isoniazid.

Side Effects of Hepa B:

1. Mild fever 1 -2 days, -

2. Mild Pain, swell and redness.

Side Effects of DPT:

5. Fever within 24 hours


6. local soreness pain and swelling
7. Abscess appears after a week or more due to wrong technique,
8. Convulsions is very rare, but may occur more in children above 3
months of age. This is due to the Pertussis virus component of
the vaccine. – there are now available D and T only vaccines that
may avoid convulsions of DPT.

Side Effects of Measles Vaccine:

2. Fever and Rashes –

Side effects for OPV:

NONE: But be aware of possible risk for aspiration once wrong site is
used. Make sure also that the baby was NPO 30 mins. prior
administration, for him not to vomit once drops were administered.
TETANUS TOXIOD IMMUNIZATION SCHEDULE FOR PREGNANT WOMEN

VACCINE SCHEDULE % OF DURATION ROUTE AND


PROTECTIO OF SITE
N PROTECTIO
N

TT1

TT2

TT3

TT4

TT5

POINTERS ON IMMUNIZATION:

Every child deserves to be given the benefits of immunization


protection based on immunization law.

No vaccine gives 100% protection. They go hand in hand with good


hygiene and other measures for disease prevention.
Recommended series of immunization must be completed for
adequate protection.

Booster doses are important to maintain continuous protection


against the diseases.

Interruption of schedule does not interfere with final immunity nor


does it necessitate contraindication to vaccination.

Malnutrition, minor respiratory infections, moderate fever, cough


and diarrhea do not constitute contraindications to vaccinations.

the absolute contraindications to immunization are :

Measles and OPV vaccines are most sensitive to heat. They must be
strictly maintained at -15 – 20 C.

Vaccines are safe and effective with mild side effects after
vaccination.

Giving doses of a vaccine at less than 4 weeks interval may lessen


the anti body response. Lengthening the interval leads to higher
antibody levels.

Practice FEFO first expiry first out rule, and 1 syringe one needle
one child policy must strictly implemented.