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IMMUNIZATION
(EPI)
LEGAL BASIS FOR IMMUNIZATION
Administrative Order No. 39 s. 2003 ( April 21, 2003)
Policies on the Nationwide Implementation of the Expanded Program on
Immunization.
Immunization is a basic right of the child and therefore no child shall be deprived of
this right.
The State regards children as one of the most important assets of the nation and
therefore every effort should be exerted to promote their welfare and full
development of their potentials for a useful and quality life.
Republic Act No. 101521 (June 8, 2011) Mandatory Infants and Children Health
Immunization Act of 2011
An act providing for mandatory basic immunization services for infants and children,
repealing for the purpose Presidential Decree No. 996 as amended.
The mandatory basic immunization for all infants and children shall cover the
following vaccine-preventable diseases: TB, diphtheria, tetanus, pertussis, polio,
measles, mumps, rubella, heap B and Influenza (HIB)
Tetanus
Pertussis Hepatitis B
Case Definition
Measles
Suspect:
1. Fever of at least three days duration with
2. Maculopapular rash and
3. Any of the following: cough, coriza (runny nose),
conjunctivitis
Confirmed: A suspect case positive for measles IgM
antibody thru blood examination or suspect case with
epidemiologic linkage to an IgM antibody positive case
Red Blotchy Rash
Measles Identification
Infectious agent : Measles virus
Incubation period : 7-18 days, average 10 days
Reservoir / Host : Humans
Diagnosis : Clinically and epidemiologic
linkage
MEASLES VACCINE
Type of vaccine Live attenuated virus
Dosage 0.5 ml
Diphtheria:
An illness of the upper
DIPHTHERIA
longer
Reservoir / Host : Humans
Diagnosis : Clinically-confirmed
DIPHTHERIA
Bull Neck
Identification
An acute disease induced by an exotoxin of the
tetanus bacillus
A serious health problem where maternity care
services are limited and immunization against
tetanus is inadequate
After delivery
dressing the umbilical stump with
substances/instruments contaminated
with tetanus spores
Opisthotonus
Trismus
Clinical Picture
Case Definition
Whooping Cough (Pertussiss)
24
Polio
ORAL POLIO VACCINE (OPV)
Type of vaccine
Live oral polio vaccine (OPV)
Number of Doses
Three doses
Schedule
6, 10, 14 weeks of age
Contraindications
None
Adverse reaction
Very rare
Special precautions
Rare congenital immune deficiency
syndromes
Dosage
2 drops
Storage
-15 to -25C
BCG VACCINE
Type of vaccine Live bacteria
Number of Doses One dose
Schedule At or as soon as possible after birth
Contraindications Symptomatic HIV infection
Adverse reaction Local abscess, regional lymphadenitis
Special precautions Correct intradermal administration
Dosage 0.05 ml
Injection site Outer upper right arm
Injection type Intradermal
Storage +2 to +8C
Immunization Schedule for Infants:
Recommended by WHO - Expanded Program on Immunization
Age Vaccines
Birth = BCG, HepB
6 weeks = Penta 1, OPV 1, PCV1
10 weeks = Penta 2, OPV 2, PCV2
14 weeks = Penta 3, OPV 3, PCV3
9 months = Measles
12-15 mos = MMR
Dosage, Route and Site of Administration
VACCINE DOSE ROUTE SITE
BCG 0.05 Intradermal Deltoid region of the
R arm
OPV 2 drops Oral Mouth
Hep B 0.5 ml Intramuscular Upper outer portion
of the thigh
PCV 13 0.5 ml Deep IM Upper outer portion
of the thigh
Adverse Event:
Infection - (e.g., Local suppuration at
injection site abscess,
cellulitis, systemic
infection, sepsis, toxic
shock
Programme Errors
2. Vaccine Prepared Incorrectly
- Vaccine reconstituted with incorrect
diluent
- Drugs substituted for vaccine or diluent
Adverse Event:
Local reaction or abscess
Programme Errors
3. Immunization injected into wrong site
- subcutaneous instead of intradermal for
BCG
- Too superficial for toxoid vaccine (DPT,
TT, Hepa B)
- Buttocks
Adverse Event:
Local reaction or injection site abscess
Programme Errors
4. Vaccine transported / stored incorrectly
Adverse Event:
- Increased local reaction
5. Contraindications ignored
Adverse Event:
- Avoidable vaccine reaction
Case Definitions and Treatment for AEFI