Epi routine immunization schedule for infants

Vaccine BCG Target Anytime at Birth School Entrance Hepa B Anytime at Birth Dosage 0.05ml Interval Once Route Intradermal (ID) Look for Wheal formation Intramuscular (IM) Site Right Deltoid

Tetanus toxoid immunization schedule for pregnant women

Vaccine TT1 Left Deltoid Upper outer Portion of the thigh Upper outer portion of the thigh Mouth (side of the cheek) Outer Part of the upper arm TT2 Schedule As early as possible during pregnancy At least 4 weeks later % of protection Not yet protected 80% Duration of protection none Infant born from mother will be protected from neonatal tetanus. Gives 3 years protection for the mother Infant born from mother will be protected from neonatal tetanus. Gives 5 years protection for the mother Infant born from mother will be protected from neonatal tetanus. Gives 10 years protection for the mother Gives Lifetime protection for the mother. All infants born to that mother will be protected Route and Site IM , (Deltoid) IM , (Deltoid)

0.1ml

0.5ml

DPT

6 wks. Up to 11 mos. 6 wks. Up to 11 mos. 9 months (if epidemic crisis, 6 mos.)

0.5ml

6 wks. Interval from 1st to 2nd dose, then 8 weeks interval from 2nd to 3rd dose 4 weeks x 3 doses

TT3

Intramuscular (IM) Oral (Child must be eat for 30 mins) Subcutaneous (SQ)

At least 6 months later

95%

IM , (Deltoid)

OPV

2 drops

4 weeks x 3 doses

TT4

At least 1 year later

99%

IM , (Deltoid)

Measle s

0.5ml

Once

TT5

At least 1 year later

99%

IM , (Deltoid)

Side Effects of BCG: 1. Kochs Phenomenon acute inflammatory process starting with in 24 hrs. and may last for 2 4 days. Wheal must disappear in about 30 mins 1hr. 2. Abscess formation 1st week soreness and inflammation, 2nd week 11th week healing of abscess and ulceration. If there is no scar developed, Repeat the procedure 3. indolent ulceration a. wrong technique, b. exposure of infant to Pt. c active TB. 4. Glandular Enlargement a. unsterile syringe or needle was used, b. too much vaccine was injected. C. the vaccine might be injected under the skin layer, and not instead in its superficial layer. Management: Physician may order, I and D, or Isoniazid. Side Effects of Hepa B: 1. Mild fever 1 -2 days, - a. Teach mother perform TSB b. advice mother that she may 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 before hot compress 1 3 times after injection then every 6 hours. Side Effects of DPT: 1. Fever within 24 hours 2. local soreness pain and swelling 3. Abscess appears after a week or more due to wrong technique, 4. Convulsions is very rare, but may occur more in children above 3 months of age. 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 mjay give ANTIHISTAMINES (Benadryl) and for 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 mins. prior administration, for him not to vomit once drops were administered.

POINTERS ON IMMUNIZATION: 1. Every child deserves to be given the benefits of immunization protection based on 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 hygiene and other measures for disease prevention. 3. Recommended series of immunization must be completed for adequate protection. 4. Booster doses are important to maintain continuous protection against the diseases. 5. Interruption of schedule does not interfere with final immunity nor does it necessitate contraindication to vaccination. 6. Malnutrition, minor respiratory infections, moderate fever, cough and diarrhea do not constitute contraindications to vaccinations. 7. the absolute contraindications to immunization are : a. DPT2 or DPT3 to a child who has had convulsion or shock with in 3 days the previous dose. b. Live weakened vaccine like BCG must not be given to individual who are immunocompromised due to malignant disease. 8. Measles & OPV vaccines are most sensitive to heat. They must be strictly maintained at -15 20 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 body response. Lengthening the interval leads to higher antibody levels. 12. Practice FEFO first expiry first out rule, and 1 syringe one needle one child policy must strictly implemented. A child is said to be Fully Immunized Child when he/she receives 1 dose of BCG, 3 doses of Hepa B, 3 doses of DPT, 3 doses of OPV, and 1 dose of Measles before his/her 1st Birthday.,.