IMMUNIZATION – process by which a person becomes protected against a disease through

vaccination.

VACCINATION – the act of introducing a vaccine into the body to produce immunity to a
specific disease.

VACCINE – a product that stimulates a person’s immune system to produce immunity to a

specific disease, protecting the person from that disease.
EXPANDED POGAM ON IMMUNIZATION (EPI) – established in 1976 to ensure that
infants/children and mothers have access to routinely recommended vaccines.

Legal Basis:
P.D. 996
➢ “Providing for Compulsory Basic Immunization fo Infants & Children below 8 years old”

R.A. 10152
➢ “Mandatory Infant & Children Immunization Act of 2011”
➢ The mandate includes basic immunization for children under 5 including other types that
will be determined by the secretary of Health.
➢ Signed by Benigno Aquino III
GOALS OF EPI:

➢ To reduce the morbidity & mortality among children against the most common
vaccine-preventable diseases

➢ Specific Goal:
1. To immunize all infants/children against the most common vaccine-
preventable diseases.To sustain the polio-free status of the Philippines.
2. To eliminate the measles infection.
3. To eliminate maternal & neonatal tetanus.
4. To control diphtheria, pertussis, heap b, & German Measles.
5. To prevent extra-pulmonary tuberculosis among children.
VACCINE PREVENTABLE DISEASES:

➢ Tuberculosis
➢ Poliomyelitis
➢ Diphteria
➢ Tetanus
➢ Pertussis
➢ Measles

RECENTLY ADDED:

➢ Hepatitis B
➢ Mumps
➢ Rubella
➢ Pneumonia
➢ Meningitis/Encephalitis
❑ Tuberculosis (TB) is an infectious disease that most often affects the lungs. TB is caused by a type of
bacteria. It spreads through the air when infected people cough, sneeze or spit.

❑Causative Agent: Mycobacterium

Tuberculosis

❑MOT: Airborne

❑Clinical Manifestations:
➢ Weight loss
➢ Cough for 2 weeks/more
➢ Fever
➢ Hemoptysis
➢ Night sweats (Pathognomonic Sign)
❑ Polio, or poliomyelitis, is a disabling and life-threatening disease caused by the poliovirus. The virus spreads
from person to person and can infect a person's spinal cord, causing paralysis (can't move parts of the body)

❑ MOT: Early – Droplet Spray

➢ Late – Fecal – Oral

❑ Clinical Manifestations:
➢ Hoyhe’s sign – head drop
➢ Tripod position
➢ Paralysis
❑ Diphtheria is a serious infection caused by strains of bacteria called Corynebacterium diphtheriae that make
toxin. It can lead to difficulty breathing, heart rhythm problems, and even death. Centers for Disease
Control and Prevention (CDC) recommends vaccines for infants, children, teens, and adults to prevent
diphtheria.

❑ MOT: Direct contact via OPEN WOUND & droplet

❑ Clinical Manifestations:
➢ Painful muscular spasms
➢ Opisthotomos posture
➢ Risus sardonicus (Pathognomonic sign)
➢ Spasmodic Coughing (15-20 coughs) followed by
vomiting Tetanus
❑ Hepatitis B is an infection of the liver caused by the hepatitis B virus. The infection can be acute (short and
severe) or chronic (long term). Hepatitis B can cause a chronic infection and puts people at high risk of death
from cirrhosis and liver cancer.

❑ Causative Agent: Hepa B virus

❑ MOT: Direct, Indirect, Vertical

❑ Clinical Manifestations:
➢ Fever
➢ Abdominal pain
➢ Anorexia
➢ Jaundice
❑ An acute and highly contagious viral disease characterized by fever, runny nose, cough, red eyes, and a
spreading skin rash. Measles, also known as rubeola, is a potentially disastrous disease.

❑ MOT: Airborne

❑ Clinical Manifestations:
➢ Fever
➢ Cough, coryza (rhinitis/sipon), conjunctivitis
➢ Cephalocaudal rash
➢ Koplik’s spot (Pathognomonic sign

❑ Rubella is a contagious disease caused by a virus. Most

people who get rubella usually have a mild illness, with
symptoms that can include a low-grade fever, sore throat,
and a rash that starts on the face and spreads to the rest of the
body.

❑ MOT: Droplet/ Direct

 PRINCIPLES OF
EPI:
1. It is safe and immunologically effective to administer all EPI vaccines on the same
day at different sites of the body
2. Measles vaccines should be given as soon as the child is 9 months old regardless of
whether other vaccines will be given on that day.
3. The vaccination schedule should not be restarted from the beginning even if the
intervals between doses exceed the recommended interval by months or years.
4. Moderate fever, malnutrition, mild respiratory infection, cough, diarrhoea, &
vomiting are not contraindications to vaccination.
The absolute contraindications to immunization are:

a. DPT 2 (or DPT – containing vaccines) is contraindicated to a child who has had convulsions or shock within 3
days the previous dose.
b. Vaccines containing whole-cell pertussis component should not be given to children with evolving
neurological disease (uncontrolled epilepsy)
c. Live vaccines like BCG should never be given to individuals who are immunosuppressed due to a malignant
disease, therapy with immunosuppressive agents, or irradiation.
d. It is not safe to give IPV to the following: Children allergic to streptomycin, neomycin, Polymyxin B, or a
previous IPV dose. Children with known bleeding disorders as bleeding may occur after injection.
e. It is safe & expected to have mild side effects after vaccination. Local reaction, fever, & mild systemic
symptoms can result as part of the normal immune response.
f. Giving doses of a vaccine at less than the recommended interval may lessen the antibody response.
g. No extra doses must be given to a child/mother who missed a dose of DPT/HB/OPV/TT. The vaccination must
be continued as if no time had elapsed between doses.
h. Freeze dried vaccines MUST ONLY be reconstituted by the diluent supplied by the manufacturer.
i. Use one syringe, one needle one child principle during vaccinations.
 EPI VACCINES
VACCINE DISEASE MINIMUM AGE NO. OF DOSAGE ROUTE SITE
PREVENTED AT DOSES
FIRST DOSE
Within 24 hours after
BCG (Bacillus Calmette-Guerin) Tuberculosis birth 1 0.05 mL Intradermal Right deltoid region of the upper
arm
Hepatitis B Vaccine Hepa B Within 24 hrs after 1 0.5 mL Intramuscular Upper outer portion of thigh/
birth anterolateral
aspect of the thigh (Vastus Lateralis)

Pentavalent Vaccine
1. Diptheria
Components: 2. Pertussis Upper outer portion of the thigh
1. Diptheria 3. Tetanus 6 weeks (4 weeks 3 0.5 mL Intramuscular or anterolateral aspect of the thigh
2. Whole-cell pertussis vaccine 4. Hepatitis interval)
(Vastus Lateralis)
3. Tetanus vaccine 5. Pneumonia
4. Hepatitis B vaccine 6. Meningitis
5. HiB conjugate vaccine

Oral Polio Vaccine (OPV) 2 drops (or

Poliomyelitis 6 weeks (4 weeks 3 depending on Oral Mouth
-“sabin” vaccine interval) manufacturer’s rec.)
- composed of live, attenuated viruses

Inactivated Polio Vaccine (IPV)

-“salk” vaccines Poliomyelitis 14 weeks & 2 0.5 mL Intramuscular Upper outer left thigh or Upper left
- composed of killed viruses 9 months deltoid
-strenghtens the protection given by OPV

1. Pneumonia 6 weeks (4 weeks

Pneumococcal Conjugate Vaccine 2. Meningitis interval) 3 0.5 Ml Intramuscular Upper outer left thigh or Vastus
(PCV) Lateralis

1. Measles 9 months
 SEQUENCE OF COMPLETELY IMMUNIZED CHILD
❑ADMINISTRATION:
Step 1: OPV
(CIC)
❑ A child who has received all
❑ Step 2: PCV (Left) recommended basic vaccines after
❑ Step 3: Penta (Right) his/her first birthday.
❑ Step 4: IPV (Left)
TETANUS TOXOID IMMUNIZATION FOR WOMEN
FULLY IMMUNIZED CHILD (FIC)
❑ Prevents tetanus in both mother & baby
❑ A child who has received all ❑ Completing five doses of the prescribed schedule will give
recommended basic vaccines before lifetime immunity.
his/her birthday.
❑ BCG at birth
❑ Polio doses at 6 – 10 – 14 weeks of age. TETANUS TOXOID (TT)
❑ Pentavalent doses at 6-10 14 weeks of
❑ Dosage: 0.5 mL
age. ❑ Route: Intramuscular
❑ PCV doses at 6 – 10 – 14 weeks of age.
❑ Site: Delt
❑ Measles dose at 9 months of age.
Two doses of TT injection given a one-month
interval between each dose during pregnancy or
even before pregnancy period protects the baby
from neonatal tetanus
VACCINE MINIMUM AGE/ PERCENT OF DURATION OF
INTERVAL POTECTION PROTECTION
As early as possible
TT1 during pregnancy None None

➢ Infant born will be protected from neonatal tetanus

➢ 3 years protection to the mother
TT2 4 weeks after TT1 80%

> Infant born will be protected from neonatal tetanus

> 5 years protection to the mother
TT3 6 months after TT2 95%

➢ Infant born will be protected from neonatal tetanus

➢ 10 years protection to the mother.
TT4 One year after TT3 99%

➢ Lifetime protection to mother.

➢ All neonate born to the mother will be protected
TT5 One year after TT4 99%
STORAGE OF VACCINES
CHARACTERISTICS TYPE/FORM OF STORAGE TEMPRERATURE
VACCINE
Most sensitive to heat OPV -15°C to -25°C (Stored at
Measles freezer)

BCG (freeze dried) DPT (If still

existing) Pentavalent
Least sensitive to heat Hep. B Tetanus Toxoid -2°C to +8°C (in the body of the
IPV refrigerator)
NURSING MANAGEMENT
❑ Clean the skin with cotton ball moistened with alcohol and let the skin dry before
injecting vaccines.
❑ If fever occurs to child, explain to mother that this is normal and needs no
aggressive treatment. Advise her to give TSB or antipyretic drops, as ordered.
❑ Swelling of the injection site is a very common side effect. Advise mother to apply
cold compress over
 THANK
YOU