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Expanded Program on Immunization

Expanded Program on Immunization

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Published by: kakilala on Sep 05, 2010
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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, 2. Sustaining the polio-free country for global certification 3. Eliminating measles by 2008, 4. 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.


Minimu Numb Minimum m Age er Interval Dose at 1st of Between Dose Doses Doses




10% of Filipinos have Hepatitis B infection. An early start of Hepatitis B vaccine reduces the chance of being infected and becoming a carrier. it is not necessary to restart. . fever or malnutrition) or who has already been vaccinated against measles. diarrhea. the schedule should be resumed using minimal intervals between doses to catch up as quickly as possible. About 9. It is safe to vaccinate a sick child who is suffering from a minor illness (cough.Bacillus CalmetteGuérin Birth or anytime after birth 1 0. Prevents liver Upper cirrhosis and liver outer cancer which are Intramuscula portion more likely to develop r of the if infected with thigh Hepatitis B early in life. If the vaccination schedule is interrupted.5 mL -- BCG given at earliest Right possible age protects deltoid the possibility of TB Intradermal region of meningitis and other the arm TB infections in which infants are prone. Measles Vaccine (not MMR) 9 months 1 0. General Principles in Infants/Children Immunization • • Because measles kills. Keeps the Philippines polio-free. cold. Instead. thigh The extent of protection against polio is increased the Oral Mouth earlier the OPV is given. Upper At least 85% of outer measles can be Subcutaneou portion prevented by s of the immunization at this arms age.000 die of complications of Hepatits B.5 mL 4 weeks Oral Polio Vaccine 6 weeks 3 2-3 4 weeks drops Hepatitis B Vaccine At birth 3 0.5 mL 6 weeks interval from 1st dose to 2nd dose. Upper An early start with outer Intramuscula DPT reduces the portion r chance of severe of the pertussis[. 8 weeks interval from 2nd dose to third dose.. 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.05 mL -- DiptheriaPertussisTetanus Vaccine 6 weeks 3 0.

kidney or liver disease. minor infections with low fever (below 38. hepatitis C virus (HCV). There are very few true contraindication and precaution conditions. but also prevent neonatal tetanus in their newborn infants. low-dose steroids (less than 20mg per day). are not contraindications to vaccination. 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. and encephalopathy not due to another identifiable cause occurring within 7 days of pertussis vaccination. Only the diluent supplied by the manufacturer should be used to reconstitute a freeze-dried vaccine. and human immunodeficiency virus (HIV) is to use one sterile needle. antibiotics.• • • • Vaccine combinations (few exceptions). one sterile syringe for each child. malnutrition. heart or lung disease. Contrary to what the majority of doctors may think. 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. The only way to be completely safe from exposure to blood-borne diseases from injections. diarrhea. well controlled epilepsy or advanced age. Tetanus Toxoid Immunization Schedule for Women When given to women of childbearing age. Vaccin e TT1 TT2 Minimum Age/Interval As early as possible during pregnancy At least 4 weeks later Percent Protect ed -80% • Duration of Protection -infants born to the mother will be . vaccines that contain tetanus toxoid (TT or Td) not only protect women against tetanus. nonprogressive encephalopathy. particularly hepatitis B virus (HBV).5º Celsius). vaccines against hepatitis B and tetanus can be applied in any period of the pregnancy.

Care for the Vaccines To ensure the optimal potency of vaccines. a classification for countries close to maternal and neonatal tetanus elimination. Proper arrangement of vaccines and/or labeling of expiry dates are done to identify those close to expiring. handling and transport of vaccines won’t protect patients and may lead to needless vaccine wastage. freezer.protected from neonatal tetanus • TT3 At least 6 months later • 95% • • gives 3 years protection for the mother infants born to the mother will be protected from neonatal tetanus gives 5 years protection for the mother infants born to the mother will be protected from neonatal tetanus gives 10 years protection for the mother gives lifetime protection for the mother all infants born to that mother will be protected TT4 At least 1 year later 99% • • TT5 At least 1 year later 99% • In June 2000. transport box. Each level of health facilities has cold chain equipment for use in the storage vaccines which included cold room. temperature monitoring chart and safety collector boxes. thermometers. ice packs. the 57 countries that have not yet achieved elimination of neonatal tetanus were ranked and the Philippines was listed together with 22 other countries in Class A. and further down at the outreach sites. A "first expiry and first out" (FEFO) vaccine system is practiced to assure that all vaccines are utilized before its expiry date. refrigerator. careful attention is needed in handling practices at the country level. Inappropriate storage. . Vaccine temperature is monitored twice a day (early in the morning and in the afternoon) in all health facilities and plotted to monitor break in the cold chain. vaccine carriers. cold chain monitors. These include storage and transport of vaccines from the primary vaccine store down to the end-user at the health facility.

tetanus. safety and costeffectiveness of Tritanrix-HB/Hib. with no reduced immunogenicity observed for any of the components of the combined vaccine. The World Health Organization (WHO) Expanded Program on Immunization (EPI) has been extended to include recommendations for hepatitis B and Haemophilus influenzae type b (Hib) vaccinations. This paper reviews the efficacy. whole cell pertussis. to reduce the logistic costs of vaccine delivery. Pharmacoeconomic analyses have shown combined DTP-HB/Hib vaccines to be cost-effective compared to separate vaccines. pertussis. Methods: The immunogenicity and reactogenicity results of five published clinical trials involving Tritanrix-HB/Hib in a variety of immunization schedules and countries were reviewed. hepatitis B and conjugated Hib vaccine. The WHO has recommended that combined vaccines be used where possible.Original article: Facilitating the WHO expanded program of immunization: the clinical profile of a combined diphtheria. the only commercially available combined diphtheria. It has similar reactogenicity to DTPw vaccines alone. an assessment of its suitability for use in national immunization programs was made. hepatitis B and Haemophilus influenzae type b vaccine Abstract Background: Vaccines are important weapons in the fight against infectious diseases. tetanus. Based on these data and cost-effectiveness studies. Results: Tritanrix-HB/Hib has shown excellent immunogenicity in clinical trials using a variety of schedules. .

5 mg RE or placebo with TOPV at 6.com/science?_ob=ArticleURL&_udi=B7CPT-4BM4R4D57&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_ver sion=1&_urlVersion=0&_userid=10&md5=e0c3d79f92db80a64975ee0eeb3eaf64) JOURNALS Research Communication: Integration of Vitamin A Supplementation with the Expanded Program on Immunization Does Not Affect Seroconversion to Oral Poliovirus Vaccine in Infants1 To whom correspondence should be addressed.org/cgi/content/abstract/129/12/2203 ) . This should facilitate widespread coverage of hepatitis B and Hib vaccinations and their rapid incorporation into the EPI. on antibody responses to trivalent oral poliovirus vaccine (TOPV) is unknown. 15 mg retinol equivalent (RE). This study demonstrates that oral vitamin A does not affect antibody responses to poliovirus vaccine when integrated with the Expanded Program on Immunization. Infants (n = 467) received oral vitamin A. Seroconversion rates to poliovirus types 1. Rixensart. double-blind. G1axoSmithKline Biologicals. Address correspondence to H. Rue de l'Institut. L. Childhood immunization programs may provide infrastructure for delivering vitamin A supplements to infants in developing countries. Bock.Conclusions: Replacement of DTPw vaccination by Tritanrix-HB/Hib can be done without modifying the existing national immunization programs. placebo-controlled clinical trial was conducted to determine the effect of giving vitamin A simultaneously with TOPV on antibody responses to poliovirus. Article Outline • References Corresponding author. 2 and 3 were measured by a microvirus neutralization assay at enrollment and at 9 mo of age. (Source : http://jn. A randomized. 89. Antibody responses to poliovirus types 1.sciencedirect. 7.nutrition. 2 and 3 among treatment groups. The effect of giving vitamin A. (Source : http://www. 2 and 3 ranged from 98 to 100% in the three treatment groups. 10 and 14 wk of age. Belgium. an immune enhancer.1330 . . and there were no differences in mean antibody titers to poliovirus types 1.

Carlos-Eliezer C FS2 – NCM201 – Group 5 .Expanded Program on Immunization Borromeo.

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