Session 6

Immunization

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 Learning Objectives
By the end of this session, the students will be able
to:

(1) review the principles of immunology;

(2) check the child’s immunization status;
(3) recommend the proper immunization to
all sick children; and
(4) demonstrate the proper technique of
immunization
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 Immunization

Disease prevention means immunizing infants and young children

against preventable viral and bacterial diseases.

Goal of immunization: to confer long lasting immunity against

infectious diseases .
- immediate goal is prevention of disease in individuals or groups
- ultimate goal is eradication of disease .

Physicians, therefore, must maintain timely immunization, (both active

and passive) as high priority in the care of infants and children; and
must complete the course of immunizations.

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 Check the child’s Immunization Status

Age Vaccine
At Birth BCG, HBVI
6 weeks DPT1, OPV1
10 weeks DPT2, OPV2, HBV2
14 weeks DPT3, OPV3,HBV3
9 months Measles

Decide if child needs an immunization today or

if the mother should be told to come back with the
child at a later date for immunization.
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 Follow DOH Recommended
Immunization Schedule
Vaccine/ Route Minimum Age Number Minimum Interval
At First Dose of Doses Between doses*

BCG /ID Birth 1

HBV /IM Birth 3 4 weeks
DPT/ IM 6 weeks 3 4 weeks
OPV/PO 6 weeks 3 4 weeks
Measles/ SC 9 months 1

*This provides maximal immunity to the 7 EPI diseases before the child’s 1st birthday.

(1) Give the recommended vaccine when the child is at the appropriate age for each
dose.
(2) All children should receive all the recommended immunizations before their 1st
birthday.
(3) If the child do not come for an immunization at the recommended age. Give
necessary immunization any time after the child reaches that age.
(4) No need to repeat the whole schedule
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 Contraindications to Immunization

 Minorillness is not a contraindication to

immunization, should not delay
immunization

 It
is very important to immunize sick and
malnourished children against tuberculosis,
Hepatitis B, Measles, Polio, Diphtheria,
Pertussis & Tetanus
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 Situations Contraindicated to
Immunization
BCG – DO not give BCG to a child known to have AIDS

DPT – DO not give DPT2/DPT3 to a child who had convulsive

seizures, shock or any other adverse reaction after the most
recent dose. Instead, give DT

DPT – Do not give to a child with recurrent convulsions or another

active neurological disease of the central nervous system

OPV – If the child has diarrhea, give a dose of OPV, but do not count
the dose, ask the mother to return in 4 weeks for the missing
dose of OPV

 Ifthe child is going to be referred, do not

immunize the child before referral
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 Exercise: Decide if contraindicated or not

If the child Immunize this child No Immunization Today

today if scheduled Has no
pneumonia:

 Has cough or cold

 Has diarrhea
 Has AIDS
 Has no immunization
at all
 Has fever
 Has current anti-
Microbial therapy
 Has local skin Infection
 Has convulsion after
DPT1 & needs DPT2 & OPV2
today
 Has chronic Heart Problem
8  Has Malnutrition
 Exercise: Decide if contraindicated or
not

If the Child: Immunize this child No Immunization

today if scheduled Today

 Has recent exposure to

Infectious Disease
 Is exclusively breastfed
 Has older brother with
convulsion last year
 Has mild to moderate local
reaction (soreness,
redness, swelling)
 Is in the convalescent phase of
Illness
 Has personal or family history
of penicillin allergies/other allergies
 Has Tetanus
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 Exercise: Decide if contraindicated or not

If the child Immunize this child No Immunization

Today if scheduled Today
 Is an atypical / special host
– Congenital disorders
of immune function
( no live virus nor live
bacteria vaccines)
– Corticosteroid /Immuno-
suppressive therapy
– Has immuneglobulin or blood
or packed rbc/ platelet/ FFP/
Cryoprecipitate transfusion
– Has household contacts of
Persons with immunologic
Deficiency ( no OPV )
- Has postexposure to:
Hepatitis B
Measles
Diphtheria
10 Pertussis
Tetanus
 Assess other problems

 Assess any other problems mentioned by the

mother or observed during the physical
examination.
 Refer to any guidelines on treatment of the
problems.
 Refer to the hospital if:

- The infant has a serious problem

- You do not know how to help the infant
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