EXPANDED PROGRAM ON

IMMUNIZATION (PHILIPPINES)
The Expanded Program on Immunization (EPI)
in the Philippines began in July 1979. And, in 1986,
made a response to the Universal Child
Immunization goal. The four major strategies
include:
[1]
Sustaining high routine Full Immunized Child (FIC)
coverage of at least 90% in all provinces and cities,
Sustaining the polio-free country for global
certification
Eliminating measles by 2008,
Eliminating neonatal tetanus by 2008.
Routine Schedule of Immunization
Every Wednesday is designated as immunization day and
is adopted in all parts of the country. Immunization is done
monthly in barangay health stations, quarterly in remote
areas of the country.
Routine Immunization Schedule for Infants
The standard routine immunization schedule for infants in
the Philippines is adopted to provide maximum immunity
against the seven vaccine preventable diseases in the
country before the child's first birthday. The fully
immunized child must have completed BCG 1, DPT 1, DPT
2, DPT 3, OPV 1, OPV 2, OPV 3, HB 1, HB 2, HB 3 and
measles vaccines before the child is 12 months of age
[2]
.
Vaccine
Minimum Age
at 1st Dose
Number
of Doses
Dose
Minimum
Interval
Between
Doses
Route Site Reason
Bacillus
Calmette-Gurin
Birth or
anytime after
birth
1 0.05 mL -- Intradermal
Right deltoid
region of the
arm
BCG given at
earliest
possible age
protects the
possibility of
TB meningitis
and other TB
infections in
which infants
are prone
[3]
Diphtheria-
Pertussis-
Tetanus Vaccine
6 weeks 3 0.5 mL 4 weeks Intramuscular
Upper outer
portion of the
thigh
An early start
with DPT
reduces the
chance of
severe
pertussis
[4]
.
Oral Polio
Vaccine
6 weeks 3
2-3
drops
4 weeks Oral Mouth
The extent of protection against polio is
increased the earlier the OPV is given.
Keeps the Philippines polio-free
[5]
.
Hepatitis B
Vaccine
At birth 3 0.5 mL
6 weeks
interval
from
1st dose to
2nd dose,
8 weeks
interval
from
2nd dose to
third dose.
Intramuscu
lar
Upper
outer
portion of
the thigh
An early start of Hepatitis B vaccine reduces
the chance of being infected and becoming a
carrier
[6]
.
Prevents liver cirrhosis and liver cancer which
are more likely to develop if infected with
Hepatitis B early in life
[7][8]
.
About 9,000 die of complications of Hepatits
B. 10% of Filipinos have Hepatitis B
infection
[9]
Measles
Vaccine
(not MMR)
9
months
1 0.5 mL --
Subcutane
ous
Upper
outer
portion of
the arms
At least 85% of measles can be prevented by
immunization at this age
[10]
.
General Principles in Infants/Children Immunization
Because measles kills, every infant needs to be vaccinated against measles at the
age of 9 months or as soon as possible after 9 months as part of the routine infant
vaccination schedule. It is safe to vaccinate a sick child who is suffering from a
minor illness (cough, cold, diarrhea, fever or malnutrition) or who has already been
vaccinated against measles
[11]
.
If the vaccination schedule is interrupted, it is not necessary to restart. Instead, the
schedule should be resumed using minimal intervals between doses to catch up as
quickly as possible.
[12]
.
Vaccine combinations (few exceptions), antibiotics, low-dose steroids (less than
20 mg per day), minor infections with low fever (below 38.5 Celsius), diarrhea,
malnutrition, kidney or liver disease, heart or lung disease, non-progressive
encephalopathy, well controlled epilepsy or advanced age, are not contraindications
to vaccination. Contrary to what the majority of doctors may think, vaccines against
hepatitis B and tetanus can be applied in any period of the pregnancy
[13]
.
There are very few true contraindication and precaution conditions. Only
two of these conditions are generally considered to be permanent: severe
(anaphylactic) allergic reaction to a vaccine component or following a prior
dose of a vaccine, and encephalopathy not due to another identifiable
cause occurring within 7 days of pertussis vaccination
[14]
. Only the diluent
supplied by the manufacturer should be used to reconstitute a freeze-dried
vaccine. A sterile needle and sterile syringe must be used for each vial for
adding the diluent to the powder in a single vial or ampoule of freeze-dried
vaccine
[15]
. The only way to be completely safe from exposure to blood-
borne diseases from injections, particularly hepatitis B virus (HBV), hepatitis
C virus (HCV), and human immunodeficiency virus (HIV) is to use one
sterile needle, one sterile syringe for each child
[16]