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May 28-29, 2012
An Act providing for MANDATORY BASIC IMMUNIZATION SERVICES FOR INFANTS AND CHILDREN, repealing for the purpose
Presidential Decree No. 996, as amended.
RA 10152Section 3. Coverage. – The mandatory basic immunization shall be
given for free at any government hospital or health center to infants and children up to five (5) years of age.
The Hib problemGlobally, one of every 25 children under 5
years of age is estimated to die from Hib disease.
In most pre-vaccine studies Hib caused approximately 20% of severe pneumonia and was the leading cause of bacterial meningitis
Estimated 2.7 million childhood pneumonia cases per year in PHL
Hib possibly 10% to 30% of cases in PHL
Bacterial Meningitis SurveillancePhilippinesSentinel surveillance of bacterial
meningitis:41% of cases were aged 1 year or less57% of cases were under 5 years71% of cases were under 15 years
Conclusion: meningitis is disproportionately a disease of infants
One third of these cases can be prevented by Hib immunization now
Reduction in other age groups expected from Hib vaccine interruption of Hib transmission
Hib pneumonia and meningitis burden is often underestimated
Surveillance detects only a very small portion of the true burden of Hib: lab infrastructure not sufficient; prior use of antibiotics lumbar punctures not always done; children with Hib never reach a healthcare facility.
Hib studies show burden of Hib disease many times higher than what was previously thought.
A Bangladesh study showed that the Hib vaccine prevented:over 1/3 of hospitalized pneumonias and over 80% of hospitalized probable bacterial
meningitis cases
What is Heamophilus Influenza Type BHib is one of the six related types of H.
Influenzae bacteriumHib’s victim are mainly children younger
than five(5) years oldHib bacteria are commonly present in the
nose and throatThe bacteria are transmitted from person to
person in droplets through sneezing and coughing
Signs and SymptomsPneumonia and meningitis are the most
important diseases caused by Hib bacteria.In developing countries, pneumonia is more
common than meningitis in children with Hib disease.
Hib disease should be suspected in the case of any child with signs and symptoms of meningitis or pneumonia.
Complications of Hib
Children who survive Hib meningitis may develop
1. permanent disability, including brain damage, hearing loss
2. mental retardation
3. 5% to 10% cases of Hib meningitis are at risk of dying
What is the treatment and Prevention for Hib?
Hib disease can be treated with antibiotics.
Hib disease can be prevented with vaccine given in early infancy
Hib VaccineAre liquid or lyophilized (freeze-dried )Monovalent, quadrivalent, Pentavalent - One injection against 5 diseases Diptheria Pertussis Tetanus Hepatitis B Hib
Stored at + 2 C and +8 CExtremely freeze-sensitive;Penta must NEVER be FROZENImmunization Safety: Auto-disabled syringes No Pre-filling
Hib Vaccine/Pentavalent Vaccine- Given as a 0.5 ml, intramuscular injection in infant’s outer mid thigh
- Co-administration - Pentavalent may be administered with
OPV
Recording and Reporting
SCHEDULE SA PAGBAKUNA
EDAD MGA BAKUNA NA DAPAT MATANGGAP
BIRTHBCG Hep B
6 weeks
Hep B OPV1 DPT1
(OPTION 1)
RV
(OPTION 2)
RV
(penta)
Hib
10 weeks OPV2 DPT2 RV RV Hib
14 weeks Hep B OPV3 DPT3 RV Hib
9 months MEASLES
12-15 months
MMR
SCHEDULE SA PAGBAKUNA
EDAD MGA BAKUNA NA DAPAT MATANGGAP
BIRTHBCG Hep B
6 weeks
PENTA OPV1
(OPTION 1)
RV
(OPTION 2)
RV
10 weeks
PENTA
OPV2 RV RV
14 weeks PENTA OPV3 RV
9 months MEASLES
12-15 months
MMR
Contraindications and Precautions to Vaccination
Contraindicated for persons known to have experienced a severe allergic reaction (anaphylaxis) following a prior dose of that vaccine.
Vaccination should be delayed for children with moderate or severe acute illnesses.
Minor illnesses (e.g., mild upper respiratory infection) are not contraindications to vaccination.
Adverse Reactions from Hib VaccineAdverse reaction following Hib conjugate
vaccines are not common. Swelling, redness, or pain have been
reported in 5%–30% of recipients and usually resolve within 12–24 hours.
Systemic reactions such as fever and irritability are infrequent.
Serious adverse reactions are rare
New Pentavalent Vaccine 5 in oneOne vial = 5 antigens DPT-HepB-Hib
Now DPT, HepB & Hib are all together
But birth dose HepB still needed
One vial contains ten dosesJust like DPT
Same schedule as DPT - 3 doses (6,
10 and 14 weeks of age)
Example of a health staff brochure
Simple messages for the public New 5 in one vaccineMore protection for babies:
protects from 5 diseasesLess jabs
one jab contains 5 vaccinesSame times
3 doses: 6 weeks, 10 weeks, 14 weeks of ageDon’t let your baby miss any dose!
Simple message for health workersNew 5 in one vaccineNew Pentavalent vaccine has 5 vaccines in one vial One vial contains DTP-HepB-Hib This means More protection because DPT, HepB and Hib are
all given togetherBut Less injections because HepB is included in the 5 in one
vaccineYou will still need to give the birth dose of HepB, then you
will give 3 doses of pentavalent at 6, 10 and 14 weeks; Same schedule as DPT.
All other vaccines (BCG, OPV, measles) stay the sameOne vial of pentavalent vaccine (‘Penta’) contains ten doses,
storage is the same as DPT: 2 to 8C and must never be frozen Immunization cards will be changed to help you record new
Penta dosesPlease make sure every infant gets all its doses of all
vaccines on time
Disease burden highest among 4 mos. And 18 months.
Hib disease primarily pneumonia and meningitis in young children, is a significant public health concern
PENTAVALENT:
-We give to 6 weeks old up to below 5 yrs.
-Over 5 years old, risk of Hib disease is low
-“P” component in DPT can cause adverse reaction in
> 5 yrs. Old, teenagers and adults
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