EXPANDED

PROGRAM ON
IMMUNIZATION
(EPI)
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ IMMUNITY
◦ Condition of being protected against a particular disease:
◦ 2 TYPES:
◦
◦ NATURAL/INNATE – Body’s inborn system to protect itself and fight infections
◦ ADAPTIVE – Develops as a result of exposure to disease causing organism so that next time the body
meet it again it can defend itself.
◦
◦ ANTIGEN (Ag) – Substance that causes the body to produce specific antibodies.
◦ ANTIBODY (Ab) – Substance that is produced by the immune system and defends the body against
infections.
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ ACTIVE IMMUNITY
◦ NATURAL ACQUIRED ACTIVE IMMUNITY
◦ Resulting from infection. EX. COVID 19 infection create COVID 19 ANTIBODIES
◦
◦ ARTIFICIALLY ACQUIRED ACTIVE IMMUNITY
◦ Injection of Antigen ( Vaccine attenuated, killed, toxoid, recombinant DNA )
◦ Giving a copy of the microorganism will triger the immune system to produce antibodies against the real microorganism to prevent infection.
◦
◦ PASSIVE IMMUNITY
◦ Naturally acquired passive immunity
◦ Transplacental or via colostrum
◦ Antibodies gained by the mother either thru
◦
◦ ARTIFICIALLY ACQUIRED PASSIVE IMMUNITY
◦ Injection of antibody ( anti serum immunoglobulin )
◦
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ IMMUNIZATION
◦ Beneficial and cost – effective disease prevention measure
◦ Process of inducing immunity against a specific disease through vaccines
◦ PASSIVE ( Administration of antibody containing preparations) or ACTIVE ( stimulation of the
immune system)
◦ Protection is usually long term if not life time
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ HISTORY OF VACCINE DEVELOPMENT
◦ In May 1776, Jenner found a young dairy maid Sarah Nelmes who had fresh cowpox lesions on her
hand.
◦ On May 14, using matter from Sarah’s lesions he inoculated an eight year old boy, James Phipps,
who had never had smallpox.
◦ Phipps became slightly ill over the course of the next 9 days but was well on the 10 th day
◦ On July 1 Jenner inoculated one boy again, this time with smallpox matter. No disease developed;
protection was complete
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ TYPES OF VACCINE:
◦
◦ LIVE ATTENUATED VACCINE
◦ Attenuated ( weaken) form of the “ wild” virus or bacterium.
◦ Long term immunity. Only needs 1-2 doses
◦ Immune response is similar to natural infection
◦
◦ INACTIVATED VACCINE
◦ Giving of microorganism killed through heat and chemical methods
◦ Antibodies can not replicate and that’s why you generally require 3-5 doses including boosters
◦ To remind the body to produce antibodies
◦
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ Established in 1976 by he World Health Organization ( WHO) to ensure that infants/ children and mothers
have access to routinely recommended infant/ childhood vaccines
◦ Six vaccine preventable disease where initially included in the EPI tuberculosis, poliomyelitis, Diptheria,
tetanus, pertussis and measles.
◦ In 2002, WHO estimated that 1.4 million of deaths among child5 years where due to diseases that could
have been prevented by routine vaccinations.

◦ EPI IN THE PHILIPPINES

◦ Began in 1979
◦ PD NO. 996 – providing for compulsory
◦ Basic immunization for infants and children below 8 years old
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ FREE VACCINES: BCG, DPT, OPV AND MEASLES
◦ Done Through;
◦ Routine Immunization for infants/ children/ Women through the reaching every barangay (REB)
strategy.
◦ Supplemental Immunization Activity (SIA)
◦ Strengthening Vaccine – Preventable Diseases surveillance
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ Goals of EPI;

◦ To immunize all infants/ children against the most common vaccine.

◦ To sustain the polio – free status of the Philippines
◦ To eliminate measles infection.
◦ To eliminate maternal and neonatal tetanus
◦ To control Diptheria, pertussis, Hepatitis B and German measles.
◦ To prevent extra pulmonary tuberculosis among children.
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
VACCINE FIRST DO NUMBER INTERVAL NEXT ROUTE DISEASE BEING PREVENTED
DOSE SA OF DOSESS DOSE
GE
BCG at birth 0.05 1 none ID Tuberculosis
ml
HEPATITIS B At birth 0.5 3 1-2 mos then 6-18 IM HEPATITIS B
ml mos
DPT 6 WEEKS 0.5 3 4 WEEKS IM DIPTHERIA
ML PERTUSIS
TETANUS
OPV 6 /10/14 2-3 3 4 WEEKS ORAL POLIOMYELITIS
weeks DR
OPS
Hib 6 WEEKS 0.5 3 4 WEEKS IM HEMOPHILUS
OR 2MOS ml INFLUENZA
TYPE B
PCV 6 WEEKS 0.5 3 4 WEEKS IM STREPTOCOCCUS
ml PNEUMONIA
MMR 9 MOS 0.5 2 1 YEAR SC MEASLES
ml MUMPS
RUBELLA
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ BCG – BACILLUS CALMETTE GUERIN
◦ DPT – DIPTHERIA, PERTUSIS, TETANUS
◦ OPV – ORAL POLIO VACCINE
◦ HIB – HAEMOPHILUS INFLUENZA TYPE B
◦ PCV – PNEUMOCOCCAL CONJUGATE VACCINE
◦ MMR – MEASLES, MUMPS, RUBELLA
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ DESCRIPTION OF EPI VACCINES
BACILLUS CALMETE- GUERIN (BCG)- TB antigen injection given on the right deltoid at birth.
( for prevention of TB meningitis, lungs and brain.
HEPATITIS B VACCINE – Intramuscular injection for protection against Hepatitis B Infection.
ORAL POLIO VACCINE (OPV) – given through the mouth in 3 doses ( 6, 10 & 14 wks.)- for
prevention of Polio
ROTAVIRUS VACCINE – for prevention of childhood diarrhea caused by the Rotavirus- given through
the mouth in 2 doses
PENTAVALENT VACCINE – 5-1 VACCINE COMPOSED OF:
1. DIPTHERIA – respiratory disease caused by Corynebacterium Diptheriae.
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
1. DIPTHERIA – respiratory disease caused by Corynebacterium Diptheriae.
2. PERTUSIS – also known as “whooping cough” caused by Bordetella pertussis
3. TETANUS – causes muscles spasm and caused by Clostridium Tetani bacteria
4. Hib – meningitis vaccine of children caused by Haemophilus influenza
5. HEPATITIS B VACCINE
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
MEASLES VACCINE – given at 9 months for prevention of measles
MMR – 3 in 1 VACCINE – for prevention of Mumps, Measles and Rubella ( German Measles)

 MEASLES : Morbillivirus
 MUMPS: Rubulavirus
 RUBELLA: Rubellavirus
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ CONTENT OF EPI VACCINE
BCG – live attenuated bacteria
OPV AND MEASLES - – live attenuated virus
DIPTHERIA AND TT – weakened bacterial toxins
PERTUSIS – killed/ inactivated bacteria
HEPA B – derived from plasma ( plasma deviratives ) DNA recombinants
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ CONTRAINDICATIONS;
◦ 1. Severe illness
◦ 2. Allergy
◦ 3. Immunosuppression
◦ HERB IMMUNITY – immunized individuals provide indirect protection to susceptible members of
a population
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ TARGETS FOR IMMUNIZATION PROGRAM:
◦ A. INFANT – 12 MONTHS OLD
◦ B. SCHOOL ENTRANTS – 6-7 YEARS OLD
◦ PREGNANT MOTHER
 INFANTS ;
 1 BCG
 3 DPT
 3 HEPA B
 1 MEASLES
 3 OPV
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
 SCHOOL ENTRANTS: ( 1booster dose of BCG 6-7 years old
 PREGNANT MOTHERS: 5 Tetanus toxoid
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ COLD CHAIN SYSTEM;
Keeping/ transporting the vaccine in cold temperatures to maintain potency of the vaccine
The system used for storing vaccines in good condition
Also known as vaccine supply chain or immunization supply chain
REFRIGARATOR;
FREEZER ( - 15degrees to – 25 degrees celcius )- OPV & MEASLES
BODY ( 2 Degrees to 8 Degrees celcius) – DPT, HEPA B, BCG 7 TT
2 most sensitive to heat vaccine; OPV AND MEASLES
2 Least sensitive to heat vaccine; BCG & TT
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ RA 10152: Mandatory Basic Immunization services for infants and children repealing PPD 996
◦ Free infants and children up to five ( 5 ) years of age
◦ Haemophilus Influenza Type b ( Hib ) Pneumonia and meningitis
◦ DDT- HEPA B- HIB : Pentavalent vaccine
◦ ROTAVIRUS VACCINE ( ORAL) ; Diarrhea
◦ PNEUMOCOCCAL VACCINE (PCV): Pneumonia
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ PRINCIPLES IN VACCINATION:
◦ 1. No BCG to a child born positive with HIV or AIDS
◦ 2. DPT2 AND DPT3 is not given to a child who has had convulsions or shock within 3 days the
previous dose but you can give DT.
◦ 3. Moderate fever, malnutrition, mild respiratory infection, cough, diarrhea and mild vomiting
aren’t contraindication to vaccination.
◦ 4. Safe to administer all EPI vaccines on the same day at different sites of the body.
◦ 5. No food 30 minutes after giving OPV
◦ 6. Assess the child for allergy to egg before giving measles vaccines.
◦ 7. Measles vaccine should be given as soon as the child is 9 months old regardless of whether other
vaccines will be given on that day
EXPANDED PROGRAM ON
IMMUNIZATION (EPI)
◦ 8. Vaccination schedule should not be restarted from the beginning even if the interval between
doses exceeded.
◦ 9. Repeat BCG vaccination if the child does not develop a scar after the first injection.
◦ 10. Use one syringe, one needle per child during vaccination.
◦ 11. A child with diarrhea who is due for OPV should receive a dose of OPV during the visit but do
not count the dose