EPI-report.docx

7/30/2019 EPI-report.docx

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Expanded Program on Immunization

Children who lack immunization are more susceptible to common childhood diseases.

The EPI is one of the DOH programs that have been institutionalized and adopted by all

LGUs in the country.

OBJECTIVE:

To reduce morbidity and mortality against 7 childhood immunizable diseases.

(Tuberculosis/Primary Complex, Diphtheria, Pertussis, Tetanus, Poliomyelitis, Measles, and

Hepatitis B)

Immunization is a process by which vaccines are introduce to the body, beforeinfection sets in.

Specific Goals:

1. To immunize all infants/children against the most common vaccine-preventablediseases.

2. To sustain the polio-free status of the Philippines.3. To eliminate measles infection.4. To eliminate maternal and neonatal tetanus.5. To control diphtheria, pertussis, hepatitis b and German measles.6. To prevent extra pulmonary tuberculosis among children.

PRINCIPLES:

1. The program is based on epidemiological situation; schedules are drawn on thebasis of the occurrences and characteristics features of the said diseases.

2.

The whole community rather than just an individual is to be protected, thus, massapproach is applied.

3. Immunization is a basic health service and as such, it is integrated into the healthservices provided for by Rural Health Unit.


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ELEMENTS:

1. Target Setting2. Cold chain logistic management3. Information, education and communication4. Assessment and evaluation of the programs overall performance5. Surveillance studies and research

EPI ROUTINE IMMUNIZATION SCHEDULE FOR INFANTS

VACCINE TARGET DOSAGE INTERVAL ROUTE SITE

1. BCG Anytime

at Birth

School

Entrance

0.05ml

0.1ml

Once Intradermal (ID)

Assess for

Wheal

formation

Right

Deltoid

Left

Deltoid

2. Hepa B Anytime

at Birth

0.5ml 6 wks.

Interval

from 1st

dose to 2nd

dose, then

8 weeks

interval

From 2nd to3rd dose

Intramuscular

(IM)

Upper

outer

Portion of

the thigh

3. DPT 6 wks. Up

to 11 mos.

0.5ml 4 weeks x

3 doses

Intramuscular

(IM)

Upper

outer

portion of

the thigh

4. OPV 6 wks. Upto 11 mos.

2 drops 4 weeks x3 doses

Oral(Child must be

NPO for 30

mins.)

Mouth(side of

the

cheek)


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5. Measles 9 months 0.5ml Once Subcutaneous

(SQ)

Outer

Part of the

upper arm

Side Effects of BCG:

1. Kochs Phenomenon acute inflammatory process starting with in 24 hrs. andmay last for 24 days. Wheal must disappear in about 30 minutes1hr.

2. Abscess formation1st weeksoreness and inflammation, 2nd week11th weekhealing of abscess and ulceration. Abscess maybe invariable due to

subcutaneous or deep injection and may be managed with Incision andDrainage.

3. Indolent ulceration an ulcer which, persists after 12 weeks from date ofvaccination or an ulcer that is more than 10mm deep. This may be treated with

INH powder.

4. Glandular Enlargement the glands draining the injection site may becomeenlarged. If suppuration occurs, treat as a deep abscess.

Management: Physician may order, I and D, or Isoniazid.

Side Effects of Hepatitis B:

1. Mild fever 1 -2 days, - a. Teach mother perform TSB b. advice mother that shemay give Paracetamol every 4 hours if fever not relapse. Fever more than 4 days,

refer to the Physician.

2. Mild Pain, swell and redness.a. Teach mother to do cold compress first beforehot compress 13 times after injection then every 6 hours.

Side Effects of DPT:

1. Fever within 24 hours2. local soreness pain and swelling3. Abscess appears after a week or more due to wrong technique,


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4. Convulsions are very rare, but may occur more in children above 3 months ofage. This is due to the Pertussis virus component of the vaccine. There are now

available D and T only vaccines that may avoid convulsions of DPT.

Side Effects of Measles Vaccine:

1. Fever and Rashes for rashes mother may give ANTIHISTAMINES (Benadryl) andfor itchiness (Calamine Lotion).

Side effects for OPV:

NONE: But be aware of possible risk for aspiration once wrong site is used. Make sure

also that the baby was NPO 30 minutes prior administration, for him not to vomit once

drops were administered.

TETANUS TOXIOD IMMUNIZATION SCHEDULE FOR PREGNANT WOMEN

VACCINE SCHEDULE % OF

PROTECTION

DURATION OF

PROTECTION

ROUTE AND

SITE

TT1 As early as

possible

during

pregnancy

Not yet

protected

noneIM , (Deltoid)

TT2 At least 4

weeks later

80%

Infant born

from mother

will be

protected

from neonatal

tetanus.

Gives 3 years

protection for

the mother

IM , (Deltoid)

TT3 At least 6

months later

95% Infant born

from mother

will be

protected

from neonatal

tetanus.

IM , (Deltoid)


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Gives 5 years

protection for

the mother

TT4 At least 1 yearlater 99%

Infant born

from motherwill be

protected

from neonatal

tetanus.

Gives 10 years

protection for

the mother

IM , (Deltoid)

TT5 At least 1 year

later

99% Gives Lifetime

protection for

the mother. All

infants born to

that mother

will be

protected

IM , (Deltoid)

POINTERS ON IMMUNIZATION:

1. Every child deserves to be given the benefits of immunization protection basedon PD 996 immunization law. September 16, 1976 Basic compulsory

immunization of children below 8 years old is implemented.

2. No vaccine gives 100% protection. They go hand in hand with good hygieneand other measures for disease prevention.

3. Recommended series of immunization must be completed for adequateprotection.

4. Booster doses are important to maintain continuous protection against thediseases.

5. Interruption of schedule does not interfere with final immunity nor does itnecessitate contraindication to vaccination.

6. Malnutrition, minor respiratory infections, moderate fever, cough and diarrheado not constitute contraindications to vaccinations.

7. the absolute contraindications to immunization are :


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a. DPT2 or DPT3 to a child who has had convulsion or shock within 3 days theprevious dose.

b. Live weakened vaccine like BCG must not be given to individual who areimmunocompromised due to malignant disease.

8. Measles and OPV vaccines are most sensitive to heat. They must be strictlymaintained at -1520 C.

9. Vaccines are safe and effective with mild side effects after vaccination.10. No extra doses must be given to child/mother who missed a dose.

11.Giving doses of a vaccine at less than 4 weeks interval may lessen the anti-bodyresponse. Lengthening the interval leads to higher antibody levels.

12.Practice FEFO first expiry first out rule, and 1 syringe one needle one child policymust strictly implemented.

A child is said to be Fully Immunized Child when he/she receives 1 dose of BCG, 3

doses of Hepatitis B, 3 doses of DPT, 3 doses of OPV, and 1 dose of Measles before

his/her 1stBirthday.,.

Reference:

Handout #13- Child Health Programs (Prepared by: Mr. Dean Michael D. Songco, RN,

MAN)

Documents

EPI-report.docx