EXPANDED PROGRAM

ACTIVE IMMUNITY
IMMUNIZATION (previous term)

protection that is produced by the person’s own

New coined term: NATIONAL
immune system.
IMMUNIZATION PROGRAM (NIP)
Lasts for many years, often during a lifetime.
Active immunization is the induction of
IMMUNIZATION (WHO) immunity after exposure to an antigen.
Antibodies are created by the recipient and
Process whereby a person is made immune or may be stored permanently.
resistant to an infectious disease, typically by Active NATURAL Active ARTIFICIAL
the administration of a vaccine.
Exposure Antigens
A proven tool for controlling and eliminating Carrier Attenuated – BCG,
life-threatening infectious diseases and is Sick of the disease OPV,AMV
Rotavirus
estimated to avert between 2 and 3 million
Killed-Pertussis, HBV
deaths each year.
Weakened toxins –
TT, DT
One of the most cost-effective health
investments, with proven strategies that make Introduced through
it accessible to even the most hard-to-reach injection
and vulnerable populations.

Vaccines PASSIVE IMMUNITY

stimulate the body’s own immune system to
protect the person against subsequent infection protection by products produced by an animal
or disease. or human and transferred to another human,
usually by injection.
IMMUNITY Passive immunization often provides effective
protection, but this protection wanes
condition of being secure against any particular (disappears) with time, usually within a few
disease weeks or months.
the ability of the human body to tolerate the
presence of material indigenous to the body, It is the transfer of active humoral immunity in
and to eliminate foreign material. the form of readymade antibodies, from one
individual to another.
This discriminatory ability provides protection
from infectious disease, since most microbes Passive Passive ARTIFICIAL
are identified as foreign by the immune system.
NATURAL
Immunity to a microbe is usually indicated by VERTICAL Gamma globulins (6 mos.
the presence of antibody to that organism. TRANSMISSION – 1 yr)
: Antitoxin/antiserum/
2 basic mechanisms for acquiring immunity: Breastmilk (IgA)
 Placenta (IgG) serum 1. Live-attenuated vaccines {LAV}
Immunoglobulin – actual Live but weakened
Antibody medication for rabies Ex. BCG
produced by
certain diseases 2. Inactivated vaccines {killed antigen}
(mumps, Ex. Pertussis
measles) will be
passed onto the
baby. 3. Subunit {purified antigen}
a. Protein-based
If you did not b. Polysaccharide
acquire that c. Conjugate
disease, there
will be no
4. Toxoid {inactivated toxins}
antibodies
produced. Ex. TT , DT
TYPES EXAMPLES
Live-attenuated Bacteria: TB
Not giving any (BCG)
antigen Available since the
Limited (up to 1950s, LAV are derived Virus: OPV
days or 5 months from disease-causing : Measles
only) pathogens (virus or :
bacteria) that have been Rotavirus
VACCINE weakened under : Yellow
laboratory conditions. fever
They will grow in a
helps the body’s immune system to recognize and
vaccinated individual,
fight pathogens like viruses or bacteria, which then
but because they are
keeps us safe from the diseases they cause.
weak, they will cause no
or very mild disease.
protect against more than 25 debilitating or life-
threatening diseases, including measles, polio,
Inactivated Bacteria:
tetanus, diphtheria, meningitis, influenza,
made from Whole-cell
tetanus, typhoid and cervical cancer.
microorganisms Pertussis
(viruses, bacteria, other) (wP)
How vaccines are classify?
that have been killed
through physical or Virus: IPV
There are many types of vaccines, categorized
chemical processes.
by the antigen used in their preparation.
These killed organisms
cannot cause disease.
Their formulations affect how they are used,
how they are stored, and how they are
Sub-unit (purified antigen) Bacteria:
administered.
Acellular
: Protein-based pertussis (aP)
present an antigen to
TYPES:
the immune system Virus: HepB
 without viral particles, Pneumococcal, bloodstream and is
using a specific, isolate Meningococcal largely responsible for
protein of the , Salmonella the symptoms of the
pathogen. A weakness typhi disease.
of this technique is that
isolated proteins, if Bacteria: The protein-based toxin is
denatured, may bind to Haemophilus rendered harmless
different antibodies imfluenza Type (toxoid) and used as the
than the protein of the B antigen in the vaccine to
pathogen. (HiB) elicit immunity.
:
Pneumococcal
: Polysaccharide (PCV-7, PCV- EPI: RATIONALE
Some bacteria when 10, PCV-13)
infecting humans are EPI was established in 1976 to ensure that
often protected by a infants/children and mothers have access to
polysaccharide (sugar) routinely recommended infant/childhood vaccines.
capsule that helps the
organism evade the Six vaccine preventable diseases were initially
human defense included in the EPI:
systems especially in 1. TB
infants and young 2. Poliomyelitis
children. 3. Diphtheria
4. Tetanus
5. Pertussis
: Conjugate 6. Measles (Rubeola)
create a response
against the molecules
The immunization coverage of children
in the pathogen’s
has improved. The 2009 National Demographic
capsule. In comparison
and Health Survey showed that 3 out of 4
to plain polysaccharide
births were protected against neonatal tetanus,
vaccines, they benefit
that is, women whose last birth was protected
from a technology that
against neonatal tetanus was 76%. The
binds the
differentials in protection against neonatal
polysaccharide to a
tetanus among subgroups of women vary.
carrier protein that can
induce a long-term
Across regions, TT coverage ranged from 39%
protective response
in ARMM to 88% in Central Visayas and
even in infants.
Cagayan Valley. By level of education, TT
coverage was lowest for women with high
Toxoid Bacteria: TT
school education at 80% (NSO, 2009).
based on the toxin : DT
produced by certain
bacteria. The toxin
invades the EPI: SUPPORTING LEGISLATIONS
 d. To eliminate maternal and neonatal tetanus.
P.D. No. 966 of 1976 e. To control diphtheria, pertussis, hepatitis B,
providing compulsory basic immunization for and German measles (Rubella)
infants and children below 8 years old f. To prevent extrapulmonary TB among
children.
R.A. 7846 of 1994
Provided for compulsory immunization against
hepatitis B for infants and children below 8 years
old.
EPI: DISEASES
Provided for hepatitis B immunization within 24
hours after birth of babies of women with hepatitis 1. Tuberculosis (TB)
B. 2. Diphtheria
3. Poliomyelitis (polio)
4. Measles
5. Pertussis
Presidential Proclamation No. 6 of 1996 6. Tetanus
Implementing a United Nations Goal on Universal 7. Hepatitis B
Immunity by 1990; and designating Wednesdays as 8. Yellow fever
Immunization Day

R.A. 10152 (Mandatory Infants and Children TUBERCULOSIS (TB)

Health Immunization Act of 2011)
mandates basic immunization covering the vaccine-
preventable diseases
Added to the six immunizable diseases
previously mentioned are hepatitis B, mumps,
rubella, diseases caused by Haemophilus
influenzae type B (Hib), and other diseases as
determined by the Secretary of Health in a
department circular. It gives the directive to
government hospitals and health centers to
provide for free mandatory basic immunization
to infants and children up to 5 years of age.
EPI: SPECIFIC GOALS OF THE
PROGRAM
a. To immunize all infants/children against the
most common vaccine-preventable diseases.
b. To sustain the polio-free status of the
Philippines.
c. To eliminate measles infection.
Killed more than 3 million people in 1995.
It usually attacks the lungs, but other parts of
the body, including the bones, joints and brain
can also be affected.
There is a difference between
tuberculosis infection and disease.
People with the infection only do not feel
ill and have no symptoms. The infection
may last for a lifetime and the infected
person may never develop the disease.
Persons with the infection but not the
disease cannot spread the infection to
others.
People of all ages can contract
tuberculosis. It spreads rapidly,
particularly where people are living in
crowded conditions, have poor access
to care, and are malnourished.
Case Definition
  A child with history of contact with a
suspect or confirmed case of pulmonary
tuberculosis
 Any child who does not return to normal
health after measles or whooping cough
 Loss of weight, cough, and wheeze which
does not respond to antibiotic therapy for
acute respiratory disease
 Abdominal swelling with a hard painless
mass and free fluid
 Painful firm or soft swelling in a group of
superficial lymph nodes
 Any bone or joint lesion or slow onset
 Signs suggesting meningitis or disease in the
central nervous system
Agent
Mycobacterium Tuberculosis
Reservoir
Man
Diseased cattle (BOVINE TB)
Mode of Transmission
Droplet infection: when a person with the
disease coughs or sneezes, the germs enter
the air = a person inhaling air that contains TB
germs may become infected.
TB can spread rapidly where people are living
in crowded conditions, have difficulty in
obtaining medical care, and are poorly
nourished.
In some areas it is possible to become infected
from cattle with the disease, for instance by
consuming unpasteurized milk.
Transmissible
A Period tubercle bacilli is
person who excretes
communicable
The degree of communicability depends upon:
 The number of bacilli in the air
 Virulence of bacilli
 Environmental conditions like overcrowding
Incubation Period
4-12 weeks but the infection may persist for
months or years before the disease develops.
A person with the disease can infect others for
several weeks after he or she begins
treatment.
The risk of developing TB is highest in children
aged under 3 years and in very old people,
although anyone may be affected.
Persons with TB infection who have weakened
immune systems, for instance people with
HIV/AIDS, are more likely to develop the
disease than are those with normal immune
systems.
Concern about TB has been heightened
recently because some strains of the causative
organism have developed resistance to drugs.
Signs and Symptoms
Symptoms:
general weakness, weight loss, fever and night
sweats.
Pulmonary TB: persistent cough, the coughing
up of blood, and chest pain.
However, in young children the only sign of
pulmonary tuberculosis may be stunted growth
or failure to thrive.
Other signs and symptoms depend on the part
of the body that is affected.
TB of the bones and joints there may be
swelling, pain and crippling effects in the hips,
knees or spine.
Best available for children is immunization with
BCG vaccine. In persons who have been thus
immunized it is impossible to determine
whether a positive tuberculin skin test reaction
is caused by the immunization or by infection
with the TB bacterium. However, such
individuals can be further examined to
determine whether they are infected.
Occurrence

Complications  Worldwide
 Mortality and morbidity higher in
developing countries

TB weakens the body generally, increasing the

likelihood that the affected person will contract
other diseases or that existing diseases will
become more severe.

Risk Factor for Infxn

Low access to care

Immunodeficiency

Malnutrition

Alcoholism

Diabetes

Treatment

Must complete a course of curative therapy,

which usually includes taking two or more anti-
tuberculosis drugs for at least six months.

Unfortunately, some people fail to take the

medications as prescribed or to complete their
course of therapy, or they may be given
ineffective treatments ----> may lead to multi-
drug-resistant TB, which can be spread to
other people

Prevention