NATIONAL IMMUNIZATION PROGRAM

(NIP)

Mary Ann E. Lopez MAN RN LPT

 NATIONAL IMMUNIZATION PROGRAM

• EPI was established in 1976 to ensure that

infants/children and mothers have access to
routinely recommended infant/childhood vaccines

• Reducing the morbidity and mortality among

children against the most common vaccine-
preventable diseases
 National Immunization Program

• Supporting Legislation:

– R.A. 10152, also known as

Mandatory Infants and Children
Health Immunization Act of 2011

– R.A. 7846 provided for compulsory

immunization against hepatitis B
for infants and children below 8
years old
 Specific Goals of NIP/ EPI

1. To immunize all infants/children against the most

common vaccine-preventable diseases.
2. To sustain the polio-free status of the Philippines.
3. To eliminate measles infection. Presidential
Proclamation No. 4, s. 1998 launched the Philippine
Measles Elimination Campaign (Office of the
President, 1998).
 Specific Goals of EPI

4. To eliminate maternal and neonatal tetanus. Presidential

Proclamation No. 1066, s. 1997 declared a national neonatal
tetanus elimination campaign starting 1997 (Office of the
President, 1997).

5. To control diphtheria, pertussis, hepatitis B and German

measles.

6. To prevent extra pulmonary tuberculosis among children.

 Six vaccine preventable diseases

❑ Tuberculosis
❑ Poliomyelitis
❑ Diptheria
 Six vaccine preventable diseases

❑ Tetanus
❑ Pertussis
❑ Measles
 Immunization Schedule

Antigen Age Dose Route Site

Right
deltoid
BCG vaccine At birth 0.05 ml. Intradermal
region
(arm)
Hepatitis B Anterolateral
At birth 0.5 ml. Intramuscular
thigh muscle
vaccine
DPT-HepB-Hib 6 weeks, 10
Anterolateral
(Pentavalent weeks, 14 0.74 ml. Intramuscular thigh muscle
vaccine) weeks
 Immunization Schedule

Antigen Age Dose Route Site

Anti- measles vaccine Outer part of
9-11 months 0.5 ml. Subcutaneous
(AMV1) upper arm
Measles-mumps-
Outer part of
rubella vaccine 12-15 months 0.5 ml. Subcutaneous
upper arm
(AMV2)
Rotavirus vaccine 6 weeks, 10 weeks 1.5 ml. Oral Mouth
 Target Setting and Vaccine Requirement

• Vaccine requirement is calculated based on target

population size.

• The nurse uses the following formulas to estimate target

population size:
– Estimated number of infants = total population x 2.7%
– Estimated number of 12-59 month-old children = total
population x 10.8%
– Estimated number of pregnant women = total
population x 3.5%.
 Maintaining the Potency of EPI Vaccines

To be potent, vaccines must be properly stored, handled

and transported

1. Maintain the Cold Chain

– The cold chain is a system for ensuring the potency of
a vaccine from the time of manufacture to the time it
is given to an eligible client
– In RHU, PHN is the Cold Chain Officer
2. Observe the first expiry-first out (FEFO) policy
 Maintaining the Potency of EPI Vaccines

4. Comply with recommended duration of storage and

transport

5. Take note if the vaccine container has a vaccine vial monitor

(VVM) and act accordingly.
– The VVM is a round disc of heat-sensitive material
placed on a vaccine vial to register cumulative heat
exposure
 Maintaining the Potency of EPI Vaccines

4. Abide by the open-vial policy of the DOH

5. Reconstitute freeze-dried vaccines ONLY with the diluents
supplied with them
6. Discard reconstituted freeze-dried vaccines six hours after
reconstitution or at the end of the immunization session,
whichever comes sooner
7. Protect BCG vaccine from sunlight
 Side Effects and Adverse Reactions of Immunization

Vaccines Side Effects Management

Koch’s phenomenon: an acute inflammatory
reaction within 2 to 4 days after vaccination;
usually indicates previous exposure to No management is needed.
tuberculosis.
BCG

Refer to the physician for

Deep abscess at vaccination site
incision and drainage.

Hepatitis
Local soreness at the injection site. No treatment is necessary.
B vaccine
 Side Effects and Adverse Reactions of Immunization

Vaccines Side Effects Management

Reassure mother that soreness
will disappear after 3 to 4
Local soreness at the injection site. days.

DPT- Abscess after a week or more usually

HepB-Hib indicates that the injection was not deep
Incision and drainage may be
(Pentaval enough or the needle was not sterile.
necessary.
ent
vaccine)
Convulsions: although very rare, may occur
inchildren older than 3 months; caused by Proper management of
pertussis vaccine. convulsions; pertussis vaccine
should not be given anymore.
 Side Effects and Adverse Reactions of Immunization

Vaccines Side Effects Management

OPV None
Anti- Reassure the mother and
Fever 5 to 7 days after vaccination in some
measles instruct her to give antipyretic
children. Sometimes, there is a mild rash.
vaccine to the child.
Reassure the mother and
Local soreness, fever, irritability, and
MMR instruct her to give antipyretic
malaise in some children.
to the child.
Reassure the mother and
Rotavirus Some children develop mild vomiting and
instruct her to give antipyretic
vaccine diarrhea, fever and irritability.
and Oresol to the child.
Apply cold compress at the
Tetanus
Local soreness at the injection site. site. No other treatment is
toxoid
needed.
 COLD CHAIN REQUIREMENTS

• OPV stored in freezer at the temperature of

(-15°C to -25°C)
• All other vaccines, including measles vaccine,
MMR have to stored in the refrigerator at a
temperature of(+2°C to +8°C)
• Keep diluents cold by storing them in the
refrigerator in the lower or door shelves
•
 CONTRAINDICATIONS TO IMMUNIZATION

• In general, there are no contraindications to immunization of a

sick child if the child is well enough to go home

• Absolute contraindications – DO NOT GIVE:

– Pentavalent vaccine/DPT to
• children over 5 years of age
• a child with recurrent convulsions or another active
neurological disease of the central nervous system

• Pentavalent vaccine 2 or 3/DPT 2 or DPT 3 to a child who

has had convulsions or shock within 3 days of the most
recent dose
 CONTRAINDICATIONS TO IMMUNIZATION

• Absolute contraindications – DO NOT GIVE:

– Rotavirus vaccine when the child has a history of
hypersensitivity to a previous dose of the vaccine,
intussusceptions or intestinal malformation, or acute
gastroenteritis (DOH, 2012b)

– BCG to a child who has signs and symptoms of AIDS or

other immune deficiency conditions or who are
immunosuppressed (DOH, 2003a).
 EPI Recording and Reporting

Accomplished using the Field Health Service Information System

(FHSIS)
1. Fully immunized children (FIC)
a) BCG
b) 3 doses of OPV
c) 3 doses of DPT
d) hepatitis B vaccine or 3 doses of Pentavalent vaccine
e) one dose of anti-measles vaccine before reaching one year
of age
 EPI Recording and Reporting

2. Completely immunized children

• completed their immunization schedule at the age of 12 to
23 months
3. Child protected at birth (CPAB)
• is a term used to describe a child whose mother has
received
a) 2 doses of tetanus toxoid during this pregnancy, provided
that the second dose was given at least a month prior to
delivery, OR
b) at least 3 doses of tetanus toxoid anytime prior to pregnancy
with this child
IMPORTANT CONSIDERATIONS RELATED TO
THE ADMINISTRATION OF VACCINES

Use only one strerile syringe and needle

per client

There is no need to restart a vaccination

series regardless of the time and has
elapsed between doses
IMPORTANT CONSIDERATIONS RELATED TO
THE ADMINISTRATION OF VACCINES
All EPI antigens are safe and effective
when administered simultaneously, that
is, during the same immunization
session but different sites.

Only monovalent hepatitis B vaccine

must be used for the birth dose.
5Children who have not received
AMV1 as scheduled andSlide Title
children
whose parents or caregivers do not
know whether they have received
AMV1 shall be given AMV1 as soon as
possible, then AMV2 one monthe
after AMV1.

All children entering day care centers/

preschool and Grade 1 shall be
screened for measles immunization.
THANK YOU
KEEP SAFE