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