IMMUNIZATION

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Aims and Objectives
1. After reading this document, you should:
2. Understand the differences between active and
passive immunization
3. Understand the immunological principles
behind vaccination
4. Know the general types of vaccine available
5. Understand the general rules to follow before
using vaccines

Chapter 21, Immune System 2

IMMUNIZATION
Is the process by which an individual's immune
system becomes fortified against an agent (known
as the immunogen).
Immunization is done through various techniques,
most commonly vaccination.
Active Immunization
Passive Immunization

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VACCINES
Effective vaccines are:
 Safe
 Protective for sustained period
 Induce neutralizing antibody
In addition they should be:
 Biologically stable
 Cheap to produce
 Easy to administer
Currently available vaccines are either:
 Live (attenuated)
 Killed
 Fractionated
 Recombinant
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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:
 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; and
 Eliminating neonatal tetanus by 2008.

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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.

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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.

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BCG for Infants
Bacillus Calmette-Guerin
 Birth or anytime after
birth
 1 dose
 .05ml Intradermal
 Right deltoid region
 BCG given at earliest
possible age protects the
possibility of TB
meningitis and other TB
infections in which
infants are prone. 8
BCG
Bacillus Calmette-Guerin
 A standard dose is 5 tuberculin units (TU -
0.1 ml) is injected intradermally (between the
layers of dermis) and read 48 to 72 hours
later.
 The reaction is read by measuring the
diameter of induration (palpable raised,
hardened area) across the forearm
(perpendicular to the long axis) in millimeters.
If there is no induration, the result should be
recorded as "0 mm". Erythema (redness)
should not be measured. 9
BCG
Use of two-step testing is recommended for initial
skin testing of adults who will be retested
periodically (e.g., health care workers). This
ensures any future positive tests can be interpreted
as being caused by a new infection, rather than
simply a reaction to an old infection.

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DPT
DTP and DTaP vaccines are a
shot of medicine that help
protect your child from the
diseases diphtheria, tetanus, and
pertussis.
 6 Weeks old
 3 doses; .5ml
 6 weeks DTP 1 – 10
weeks DPT 2 – 14 weeks
DPT 3
 Intramuscular
 Upper outer portion of
the thigh, Vastus
Lateralis (L-R-L) 11
DPT
Are there people who should not get the DTP vaccine or
who should wait until later to get it?
 Tell caregivers if your child he has had one of the
following problems. Caregivers have information on
what to do, such as giving medicine to prevent fever.
 Ever had a moderate or serious reaction after getting
a vaccination.
 Ever had a seizure in the past.
 Has a parent, brother, or sister who has had a
seizure.
 Is now moderately (somewhat) or severely (bad) ill.

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OPV
Risk: as with any medicine, this vaccine has some risks. Most
children do not have serious reactions (problems) from this vaccine.
But, if your child has any problems, they usually start within 3 days
and do not last long.
Mild reactions are common but not serious.
 Fatigue (feeling tired), fever, fussy, less appetite, soreness or
swelling where the shot was given, vomiting,
 Moderate to serious reactions are not very common.
 Crying nonstop for 3 hours or more, fever of 105° f (40.6° C)
or higher, less alert, limp, pale, and seizure.
Severe reactions are very rare.
 Breathing problems and shock, severe brain reaction which
is having a very long seizure and going into a coma.
Caregivers are still studying to find out whether the pertussis
part of the vaccine can cause long-term brain damage after a
severe brain reaction. 13
OPV
The Oral polio vaccine (OPV) is a live-attenuated
vaccine, produced by the passage of the virus
through non-human cells at a sub-
physiological temperature, which produces
spontaneous mutations in the viral genome
6 weeks
3 doses; 2-3 drops
4 weeks intervals
Oral
The extent of protection against polio is increased
the earlier the OPV is given.
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Hepatitis B virus
Hepatitis B virus, abbreviated HBV, is a species
of the genus Orthohepadnavirus, which is likewise
a part of the Hepadnaviridae family of viruses.[1]
This virus causes the disease hepatitis B.
At birth
3 doses; .5mL
4 weeks interval
IM
Upper outer portion of the thigh, Vastus Lateralis
(R-L-R)

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Measles
Measles vaccine is a highly effective vaccine used
against measles.
9 months
1 dose; .5mL
Subcutaneous
Upper outer portion of the arms, right deltoid

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General Principles in Infants/Children Immunization

Chapter 21, Immune System 17