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Expanded Program for Immunization

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 Expanded Program on Immunization is one of the DOH Programs that has already been institutionalized and adopted by all LGUs in the region. Its objective is to reduce infant mortality and morbidity through decreasing the prevalence of six (6) immunizable diseases (TB, diphtheria, pertussis, tetanus, polio and measles)

Special campaigns have been undertaken to improve further program implementation, notably the National Immunization Days (NID), Knock Out Polio (KOP) and Garantisadong Pambata (GP) since 1993 to 2000. This is being supported by increasing/sustaining the routine immunization and improved surveillance system.

The four major strategies include:




  

Sustaining high routine Full Immunized Child (FIC) coverage of at 90% in all provinces and cities, Sustaining the polio-free country poliofor global certification. Eliminating measles by 2008 Eliminating neonatal tetanus by 2008 .

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.

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.

General Principles in Infants/Children Immunization




measles kills, every infant needs to be vaccinated against measles at the age of 9 months or as soon as possible after 9 months as part of the routine infant vaccination schedule. It is safe to vaccinate a sick child who is suffering from a minor illness (cough, cold, diarrhea, fever or malnutrition) or who has already been vaccinated against measles If the vaccination schedule is interrupted, it is not necessary to restart. Instead, the schedule should be resumed using minimal intervals between doses to catch up as quickly as possible.

Vaccine combinations (few exceptions), antibiotics, lowlow-dose steroids (less than 20mg per day), minor infections with low fever (below 38.5 Celsius), diarrhea, malnutrition, kidney or liver disease, heart or lung disease, non-progressive encephalopathy, nonwell controlled epilepsy or advanced age, are not contraindications to vaccination. Contrary to what the majority of doctors may think, vaccines against hepatitis B and tetanus can be applied in any period of the pregnancy.

There are very few true contraindication and precaution conditions. Only two of these conditions are generally considered to be permanent: severe (anaphylactic) allergic reaction to a vaccine component or following a prior dose of a vaccine, and encephalopathy not due to another identifiable cause occurring within 7 days of pertussis vaccination Only the diluent supplied by the manufacturer should be used to reconstitute a freeze-dried freezevaccine. A sterile needle and sterile syringe must be used for each vial for adding the diluent to the powder in a single vial or ampoule of freeze-dried freezevaccine The only way to be completely safe from exposure to blood-borne diseases from injections, bloodparticularly hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) is to use one sterile needle, one sterile syringe for each.

Care for the Vaccines




To ensure the optimal potency of vaccines, careful attention is needed in handling practices at the country level. These include storage and transport of vaccines from the primary vaccine store down to the end-user at endthe health facility, and further down at the outreach sites. Inappropriate storage, handling and transport of vaccines wont protect patients and may lead to needless vaccine wastage A "first expiry and first out" (FEFO) vaccine system is practiced to assure that all vaccines are utilized before its expiry date. Proper arrangement of vaccines and/or labeling of expiry dates are done to identify those close to expiring. Vaccine temperature is monitored twice a day (early in the morning and in the afternoon) in all health facilities and plotted to monitor break in the cold chain. Each level of health facilities has cold chain equipment for use in the storage vaccines which included cold room, freezer, refrigerator, transport box, vaccine carriers, thermometers, cold chain monitors, ice packs, temperature monitoring chart and safety collector boxes.

Vaccine Minimum Age Interval Percent




ProtectedDuration of Protection TT1 As early as possible During pregnancy TT2 At least 4 weeks later 80% TT2 At least 4 weeks later 80% infants born to the mother will be protected from neonatal tetanus gives 5 years protection for the mother TT4 At least 1 year later 99% protected from neonatal tetanus

 infants born to the mother will be

gives 10 years protection for the mother TT5 At least 1 year later 99% gives lifetime protection for the mother. all infants born to that mother will be protected

Prepared by:

Jeremiah Loyzaga