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Expanded Program on Immunization

H
Seminar on the Benefits of Immunization
& Disease Prevention
Province of Samar
 Topic Outline:
 Background  Fully Immunized Child
• Immunization •Definition
• Millennium Development Goal •Samar FIC Trend (2007-2015)
• Legal Basis  Herd Immunity
• Program Goals  Contraindications
 Vaccine Preventable Diseases
 False Contraindications
 Vaccines
 Routine Immunization Schedules
 Side Effects
• 0-11mos, 12-15mos, school entrants,  Why vaccines are so special?
pregnant women, senior citizens
 Immunization
Immunization is one of the great public health
achievements of human history.
Each year, vaccines prevent more
than 2.5 million child deaths
globally, an additional 2 million
child deaths could be prevented
each year through immunization
with currently available vaccines.
 In year 2000,
the Philippines,
together with other nations,
have committed to a GLOBAL effort…
 Legal Basis
PD 996 – Policy Statement
“Immunization is a basic right of the children
and therefore, no child shall be deprived of
this right. The state regards the children as
one of the most important assets of the
nation and every effort should be exerted to
promote their welfare and enhance his
opportunity for useful and happy life.”

RA 10152
“Mandatory Infants and Children Health
Immunization Act of 2011”
 Program Goals
DOH AO 39 s.2003
•Maintenance of at least 95% FIC Coverage
•Sustain the Polio-Free Status
•Elimination of Measles
•Elimination of Maternal & Neonatal Tetanus
•Control of Diptheria, Pertusssis, Hepatitis B
infection, Tuberculosis Meningitis and other
disseminated forms of TB.
What are the
Vaccine
Preventable
Diseases?
Tuberculosis
- Caused by
Mycobacterium
Tuberculosis
- Spread through droplet of
infection (coughing,
sneezing)
- Symptoms: fever, cough >
2weeks, loss of appetite
Hepatitis B
- cause of acute and chronic
- hepatitis, cirrhosis, and primary
hepatocellular carcinoma.
- Symptoms are fever, malaise,
myalgia, and arthralgia for 3-10
days, followed by jaundice, light
or gray stools, and hepatomegaly
with tenderness for 1-3 weeks.
- chronic hepatitis, cirrhosis, liver
failure, hepatocellular carcinoma
Diptheria
- Caused by Cornybacterium
diptheriae
 Common presentation
• Low grade fever
• Toxic appearance
• Tonsillopharyngeal patch
 Serious complications
• Upper airway obstruction
• Myocarditis
• Neuritis
 Pertussis
Whooping Cough/”Tusperina”
- Or Whooping cough caused by
Bordetella Pertussis.
- Symptoms begin with mild upper
respiratory tract symptoms and
progress to paroxysm of cough, often
with a characteristic inspiration
whoop.
 Complications
- Secondary bacterial pneumonia,
- Neurologic complications (E.g. seizure
and encephalopathy)
Tetanus
- Is a neurologic toxin-mediated
disease, which manifests as trismus,
lockjaw, and severe muscular
spams.
- Caused by Clostridium Tetani
through wound contamination
- Comlications include laryngospasm,
fracture of the spine or long bones,
hyperactivity of the autonomic
nervous system, nosocomial
infection, and aspiration pneumonia.
Bacterial Meningitis
- HiB wis the leading cause of bacterial
meningitis and invasive bacterial
disease among children <5 years of age.
- Almost all serious HiB disease is age
dependent susceptibility.
- HiB strains that cause invasive disease,
including meningitis, epiglottitis,
pneumonia, arthritis, and cellulitis.
Pneumonia
 Pneumococcal disease is caused by
infection with streptococcus
pneumoniae bacteria.
 This can lead to severe health
problems, including pneumonia,
blood infections, and meningitis.
 Meningitis is an infection of the
covering of the brain.
Poliomyelitis

- Is an acute disease
characterized by asymmetric
flaccid paralysis, with areflexia
of the involved limb.
- Leading cause of permanent
disability in the pre-vaccine era
Measles / “Tipdas”
- Highly contagious disease
characterized by upper respiratory
tract symptoms along with high
grade fever, maculopapular rash,
and kopliks spots.
- Complications:
- Pneumonia and acute encephalitis
are more common among children <
5 years of age.
Mumps / “Bayu-ok”
- An Acute viral illness.
- Common manifestation is parotitis.
- Complications:
- Meningitis
- Orchitis – which may cause testicular
atrophy and rarely sterility
- Myocarditis
- Pancreatitis
- deafness
Rubella / “Makayha”
- Mild exanthematous fever.
- Infection during early
pregnancy may cause
congenital rubella syndrome
and a complex of infant
anomalies (e.g. deafness,
cataracts, heart defects, and
mental retardation).
 VACCINES
“with the exception of safe water, no other
modality, not even antibiotics, has had such a
major effect on reduction of mortality (deaths)
and morbidity (illness & disability) and on
population growth”
-WHO, UNICEF
Routine Immunization Schedule
 NATIONAL IMMUNIZATION PROGRAM

• BCG
• OPV • MR
• DPT+HepB+Hib • Flu
• Td
• PCV13 • Pneumo
• Rotavaccine • HPV
• AMV
• MMR
• IPV
• Dengue
• JE
• DTaP
 Routine Immunization Schedule

School Entrants
•Grade 1 – MR & Td
•Grade 7 – MR & Td
Pregnant Women
•TT1/TD1 (first contact)
•TT2/TD2 (1 month)
•TT3/TD3 (6months)
•TT4/TD4 (1 year after)
•TT5/TD5 (1 year after)
 Routine Immunization Schedule

Senior Citizens
•Pneumonia
60 yrs old &
65 yrs old
•Flu
6O and above
- a child before reaches 1 year old received :
1 dose of BCG and HEPATITIS B
2 doses of MMR
3 doses of PENTAHIB, OPV
 % Fully Immunized Child
Province of Samar (2007-2015)
Why do we need to immunize
most of our children??
 What are the
Contraindications
for
Immunization?
 Nabakunahan sanglit Waray ka May Nabakunahan pero natapunan hin my
Protektado Bakunahi Masakit sakit

Komunidad 1 : An Kadam an Waray kabakunahi

Damo an natapunan hin sakit
Daku an posibilidad na mg kasakit. Bisan an nabakunahan pwede mgkasakit tungod nga habubo an immunization
coverage
 Nabakunahan sanglit Protektado Waray bakuna May Masakit

Komunidad 2 : damo an nabakunahan

Mahinay makatapon an sakit.
An waray na bakunahan pwede nga deri matapunan tungod nga naprotektahan hira han madamo
nga nabakunahan (HERD IMMUNITY).
What are only Absolute Contraindications (2) :
1. DPT vaccine should NOT be given to children
over 5 years of age or children who suffered a
severe reaction to a previous dose of this
vaccine

2. BCG vaccine should NOT be given to children

who have signs and symptoms of AIDS or other
immune deficiency diseases or those who are
immunosuppressed due to malignant dse,
therapy with immunosuppresives agents and
irradiation
 What are the
False Contraindication
for
Immunization?
FALSE CONTRAINDICATIONS FOR IMMUNIZATION ?

1. Children suffering from malnutrition should be

immunized

2. Low-grade fever, mild ARI and other minor

illnesses should not be considered as
contraindications to immunizations

3. Diarrhea should not be considered as

contraindication to OPV
 What are the
Expected
Side Effects of
Immunization and their
Management?
Local Reaction
Generally are the least severe and the most frequent.
Ex: pain, swelling, and redness at the injection site.
The reaction are common with inactivated vaccines, and are
usually mild and self limited.
Treatment: Cold cloth at injection site, Paracetamol.
Systemic Reaction
Are more generalized events including fever, malaise, myalgia, headache, & loss of appetite. Common
with live attenuated vaccines because live attenuated vaccines because live attenuated vaccines
must replicate in order to produce immunity. Symptoms are similar to a mild form of the natural
disease.
Treatment: Give extra fluids, wear cool clothing, TSB, Paracetamol.
Allergic Reaction
Are severe and may be life threatening. Fortunately, they are very rare.
This may be caused by the vaccine antigen or vaccine components,
e.g. cell culture materials, stabilizers, preservatives or antibiotics.
The risk of an allergic reaction can be minimized by a good history screening.
Treatment: Antihistamine, Epinephrine
 Summary:
Why are vaccines so special?
1.Vaccines promote health
2.Vaccines have an expansive reach
3.Vaccines have a rapid impact
4.Vaccines saves lives & cost
Thank you very much for
listening!

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Any Questions?