Expended Program for Immunization

(EPI)
Expended program for Immunization (EPI)
Principles of EPI include:
1. Epidemiological situation
2. Mass approach
3. Basic Health Service
The 7 immunizable diseases are:
1. Tuberculosis
2. Diptheria
3. Pertussis
4. Measles
5. Poliomyelitis
6. Tetanus
7. Hepatitis B
Administration of vaccines:
Vaccine Content
Form &
Dosage
# of Doses Route
BCG
Live
attenuated
bacteria
Freeze dried
infant- 0.05ml
Preschool-
0.1ml
1 ID
DPT
DT- weakened
toxin
P-killed
bacteria
liquid-0.5ml 3 IM
OPV
weakened
virus
liquid-2drops 3 Oral
Hepa B
Plasma
derivative
Liquid-0.5ml 3 IM
Measles
Weakened
virus
Freeze dried-
0.5ml
1 Subcutaneous

Schedule of Vaccines:
Vaccine
Age at
1
st
dose
Interval between dose Protection
BCG
At birth

DPT
6 weeks 4 weeks DPT
OPV
6weeks 4weeks Poliomyelitis
Hepa B
@ birth
@birth,6
th
week,14
th
week
HepaB
Measles
9m0s.-
11m0s.
measles

6 months earliest dose of measles given in case of outbreak
9months-11months- regular schedule of measles vaccine
15 months- latest dose of measles given
4-5 years old- catch up dose
Fully Immunized Child (FIC)- less than 12 months old child with complete immunizations of
DPT, OPV, BCG, Anti Hepatitis, Anti measles.

Vaccine
Minimum age
interval
% protected
Duration of
Protection
TT1
As early as
possible
0% 0
TT2 4 weeks later 80% 3 years
TT3 6 months later 95% 5 years
TT4
1year later/during
next pregnany
99% 10 years
TT5
1 year later/third
pregnancy
99% Lifetime

There is no contraindication to immunization except when the child is
immunosuppressed or is very, very ill (but not slight fever or cold). Or if the
child experienced convulsions after a DPT or measles vaccine, report such to the
doctor immediately.
Malnutrition is not a contraindication for immunizing children rather, it is an
indication for immunization since common childhood diseases are often severe to
malnourished children.
Cold Chain under EPI:
Cold Chain is a system used to maintain potency of a vaccine from that of manufacture to
the time it is given to child or pregnant woman.
The allowable timeframes for the storage of vaccines at different levels are:
o 6months- Regional Level
o 3months- Provincial Level/District Level
o 1month-main health centers-with ref.
o Not more than 5days- Health centers using transport boxes.
Most sensitive to heat: Freezer (-15 to -25 degrees C)
o OPV
o Measles
Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celcius)
o BCG
o DPT
o Hepa B
o TT
Use those that will expire first, mark X/ exposure, 3
rd
- discard,
Transport-use cold bags, let it stand in room temperature for a while before storing DPT.
Half life packs: 4hours-BCG, DPT, Polio, 8 hours-measles, TT, Hepa B.

FEFO (first expiry and first out) vaccine is practiced to assure that all vaccines are
utilized before the expiry date.
Proper arrangement of vaccines and/or labeling of vaccines expiry date are done to identify
those near to expire vaccines.