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 INTERVAL ROUTE SITE

1. BCG Anytime at 0.05ml Once Intradermal (ID) Right
Birth Deltoid
Assess for
Wheal formation
School 0.1ml Left
Entrance Deltoid

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

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

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

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

4. OPV 6 wks. Up 2 drops 4 weeks x 3 Oral Mouth

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

5. Measles 9 months 0.5ml Once Subcutaneous Outer

(SQ) Part of the
(if upper arm
epidemic
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 OF ROUTE AND

PROTECTION PROTECTION SITE

Not yet protected

TT1 As early as possible none
during pregnancy IM , (Deltoid)

Infant born from

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

Gives 3 years
protection for the
mother

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

later mother will be
protected from
neonatal tetanus.

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

Gives 10 years
protection for the
mother
TT5 At least 1 year later 99% Gives Lifetime IM , (Deltoid)
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 1 st
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 INTERVAL ROUTE SITE

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 OF ROUTE AND
PROTECTION PROTECTION SITE

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.