"Don't let what you cannot do interfere determined by the Secretary of
with what you can do." -JOHN WOODEN Health.
EXPANDED PROGRAM FOR The mandatory basic immunization for all
infants and children provided under this
IMMUNiZATION
Act shall cover the following vaccine-
-established in 1976
preventable diseases:
- ensure that infants/children and
a) Tuberculosis;
mothers have access to routinely
recommended infant/childhood vaccines (b) Diphtheria, tetanus and pertussis
Six vaccine preventable diseases were (c) Poliomyelitis:
initially included in the EPI:
(d) Measles
1. Tuberculosis
(e) Mumps
2. Poliomyelitis
3. Diphtheria (f) Rubella or German measles
4. Tetanus
5. Pertussis (g) Hepatitis B;
6. Measles
(h) H. Influenza type B (HIB); and
(Such other types as may be determined
1986
-21.3 % "fully immunized" children less by the Secretary of Health in a
than fourteen months of age based on the department circular
EPI Comprehensive Program review
GLOBAL SITUATION SPECIFIC GOALS
The Burden 1. To Immunize all infants children
-In 2002. WHO estimated that 1.4 million against the most common vaccine
of deaths among children under 5 years preventable diseases.
due to diseases that could have been 2. To sustain the polio free status of
prevented by routine vaccination. This the Philippines.
represents 14% of global total mortality 3. To eliminate measles infection
in children under 5 years of age. 4. To eliminate maternal and neonatal
tetanus
MANDATES: 5. To control diphtheria, pertussis,
hepatitis b and German measles.
6. To prevent extra pulmonary
Republic Act No. 10152 Mandatory
tuberculosis among children.
Infants and Children Health
Immunization Act of 2011
Signed by President Benigno
Aquino III in July26, 2010.
The mandatory includes basic
immunization for children under 5
including other types that will be
STRATEGIES IMMUNIZATION
1. Conduct of Routine Immunization process whereby a person is made
for Infants/Children/Women through immune or resistant to an
the Reaching Every Barangay (REB) infectious disease, typically by the
strategy administration of a vaccine. (WHO)
Vaccines stimulate the body's own
an adaptation of the WHO UNICEF
immune system to protect the
Reaching Every District (RED),
person against subsequent infection
was introduced in 2004 aimed to
or disease. (WHO)
improve the access to routine
immunization and reduce dropouts. Types of Immunizations
5 components of the strategy A Live attenuated
1. Data Analysis for Action Pathogen is treated with chemicals
2. Re Establish Outreach Services or heat to reduce virulence, but not
3. Strengthen links between the kill the organism (e. measles,
community and service mumps, rübella (MMR) and OPV
4. supportive supervision (Sabin) vaccine)
5. Maximizing resources
B. Inactivated
Toxoid- a bacterial exotoxin that
2. Supplemental Immunization Activity has been treated with formalin or
(SIA) heat, which yields a non toxic
tractivated, but still antigenic
Used to reach children who have
agent.. retenus diphtheria
not been vaccinated or have not
inactivated antigenic component
developed sufficient immunity after
of the microorganisms killed viral
previous vaccinations.
organisms or parts of organisms to
3. Strengthening Vaccine-Preventable produce immunity (e.g IPV [Salk],
Diseases Surveillance pertussis, Hemophilus influenza,
recombinant Hepatitis B vaccine)
This is critical for the
eradication/elimination efforts, C. Immunoglobulin: a solution that
especially in identifying true cases contains antibodies from large pools of
of measles and indigenous wild human blood plasma (e.g. Tetanus and
polio virus Hepatitis B immunoglobulin)
Procurement of adequate and
potent vaccines and needles and
syringes to all health facilities
nationwide
COMPONENTS OF EPI
Coverage EPI concerned with the 3 populations infants below 1 year,
school entrants and pregnant women
Surveillance continuous collection and analysis of data cases /deaths of
the 7 EPI diseases
immunization sessions shall be coordinated a monthly basis
activities
Cold chain storage of vaccines from area of manufacturer to the area of
use to important to maintain potency of drugs
Planning and include target setting for fully-immunized.children by year
management
Supervision / timely sharing of information to ensure that objectives are
Monitoring met
Social a dynamic process of engaging people in community action
mobilization for a common goal
Training needed to enhance skills of health workers in the
administration of vaccines and maintaining the potency of
the vaccines.
Health education general health teaching campaign
evaluation Success of the program reviewed
KEYPOINTS OF EPI
1. The attainment of effective antibody level in active immunization takes some time
2. Live uttenuated vaccines likes MMR, OPV evoke more effective and longer lasting
immunologic response that inactivated ones. However, they are contraindicated in
pregnant and immunocompromised patients
3. Booster does are needed to maintain adequate level of immunity
4. A high percentage (90% or more) of susceptible individuals should be immunized
for community protection
5. Interruption of schedule, with a delay between doses, does not necessitate starting
with the series again
6. There is no contraindication to giving multiple vaccines at the same time provided
they are given at different sites using different syringes
7. Opened vaccines should be discarded properly: BCG after 4 hours; discard DPT,
OPV, TT, measles and hepa B vaccines at the end of the working day
8. OPV and measles are most sensitive to heat with storage temperature of -15 degrees
celcius to 25 degrees celcius
RECOMMENDED ROUTINELY ADMINISTERED ACTIVE IMMUNIZATION
TYPE/CO AGE DOSE AGE DOSE POSSIBLE EFFICACY/LE
MPOSITIO REACTIO NGTH OF
N OF N IMMUNITY
VACCINE
BCG (live At 0.05 mL 1st grade 0.1 ml Keloid 50% efficacy,
attenuated birth intraderm entrants intrader scar, 10-15 years
M. bovis) ally over mal over suppurati
right the left ve
deltoid deltoid regional
area area adenitis
DPT Age 3 doses of 1st booster: 1 0.5 mL Fever, Almost 100%,
(diphtheri 6,10 0.5 ml IM year after TIM restlessne 10 years
a and and 14 at the primary dose ss, except
tetanus weeks upper 2nd booster: 4- irrability pertussis
toxoid, of age outer 6 years old local signs component
inactivate or portion of of
d b. thereaf the thigh Booster of DT inflammat
pertussis) ter; at 10 years ion
below interval
6 years
3 doses
with
interva
l of 4
weeks
Hepatitis 2,4 and 3 doses of Probably 5 Same as Local Close to 100%,
B 6 0.5 mL IM years after primary reactions: 5 years or
(recombin months at the primary soreness, longer
ant DNA) of age upper erythema
outer and
portion of swelling
the thigh
OPV 6,10, 2 drops 1st booster: 1 Same as Paralytic More than
(trivalent and 14 per orem year after primary polio but 90%, lifelong
live weeks multiple primary dose extremely
attenuated of age dose rare
virus) or preparatio 2nd booster: 4-
thereaf n at 4 6 years old
ter weeks
interval (3
doses)
Measles 9 1 dose of 2nd dose given 1 dose Fever and 95%, at leats
(live months 0.5 mL SC at 15 months subcutan rash 5-10 12 years
attenuated or later at outer of age eous days after
virus) part of the dose
upper arm
