EPI VACCINES EPI VACCINES

BCG ( Bacille Calmette-BCG ( Bacille Calmette-Guerin)Guerin)

Protects infants against TBProtects infants against TB In powder form with diluentsIn powder form with diluents Must be discarded after 6 hrs. or at Must be discarded after 6 hrs. or at

the end of the immunization sessionthe end of the immunization session

Type of vaccineType of vaccine Live BacteriaLive Bacteria

Number of dosesNumber of doses 11

ScheduleSchedule At or as soon as possible after birthAt or as soon as possible after birth

BoosterBooster NoneNone

Contraindications Contraindications Symptomatic HIV infectionSymptomatic HIV infection

CommonCommon

Adverse rxnAdverse rxn

Local abcessLocal abcess

Special Special precautionsprecautions

Correct intradermal administration Correct intradermal administration special syringe and needle special syringe and needle

DosageDosage .05 ml.05 ml

Injection Injection sitesite

Outer upper left arm or shoulderOuter upper left arm or shoulder

Injection Injection typetype

intradermalintradermal

StorageStorage Store bet. 2-8 degrees Celsius but not Store bet. 2-8 degrees Celsius but not the diluentsthe diluents

DPT VaccineDPT Vaccine

Type of Type of vaccinevaccine

Diphtheria and tetanus as Diphtheria and tetanus as toxoids. Pertussis as killed toxoids. Pertussis as killed whole-cell bacteriumwhole-cell bacterium

Number of Number of dosesdoses

3 primary doses3 primary doses

scheduleschedule 6,10,14 wks of age6,10,14 wks of age

ContraindicatiContraindicationon

Anaphylactic reaction to Anaphylactic reaction to previous doseprevious dose

Adverse rxnAdverse rxn Mild local or systemic reactionsMild local or systemic reactions

Special Special PrecautionsPrecautions

DPT not usually given over 6 yrs DPT not usually given over 6 yrs of ageof age

DosageDosage 0.5 ml0.5 ml

Injection Injection sitesite

Outer mid thigh in infant/ outer Outer mid thigh in infant/ outer upper arm in older childrenupper arm in older children

Injection Injection typetype

IM IM

Storage Storage Store between 2-8 degrees Celsius Store between 2-8 degrees Celsius should never be frozenshould never be frozen

Side effectsSide effects

FeverFever SorenessSorenessDPT vaccine should never be frozen.DPT vaccine should never be frozen.The shake test will determine if the The shake test will determine if the

vaccine has been damaged by vaccine has been damaged by freezing.freezing.

If the vaccines fails the shake test If the vaccines fails the shake test discard itdiscard it

Oral Polio Vaccine (OPV)Oral Polio Vaccine (OPV)

TypeType Live Oral Polio VaccineLive Oral Polio Vaccine

No. of DosesNo. of Doses 3 doses3 doses

ScheduleSchedule 6, 10, 14 weeks of age6, 10, 14 weeks of age

BoosterBooster Supplementary doses given Supplementary doses given during polio eradication during polio eradication activitiesactivities

ContraindicatioContraindications ns

NoneNone

Adverse Adverse RxnRxn

VAPP very rarely (Approx. 2-4 VAPP very rarely (Approx. 2-4 cases/million children vaccinated)cases/million children vaccinated)

Special Special PrecautionsPrecautions

Children known to have rare Children known to have rare congenital immune deficiency congenital immune deficiency syndrome syndrome

Dosage Dosage 2 drops2 drops

StorageStorage Between -15-25Between -15-25° C° C

MeaslesMeasles

TypesTypes Live attenuated VirusLive attenuated Virus

No. of doses No. of doses 1 dose1 dose

Schedule Schedule 9-11 mos. Of age9-11 mos. Of age

BoosterBooster 22ndnd opportunity (routine or opportunity (routine or campaign) campaign)

ContraindicatiContraindicationon

Severe reaction to previous dose Severe reaction to previous dose

Adverse Rxn.Adverse Rxn. Malaise, fever, rash, rarely Malaise, fever, rash, rarely encephalitis, anaphylaxisencephalitis, anaphylaxis

Special Special PrecautionPrecaution

NoneNone

DosageDosage .5ml.5ml

Injection siteInjection site Outer mid thigh/ upper arm Outer mid thigh/ upper arm depending on the agedepending on the age

Injection TypeInjection Type Subcutaneous Subcutaneous

Storage Storage Between -15-25Between -15-25° C° C

Hepatitis B VaccineHepatitis B Vaccine

TypeType Recombinant DNA or Plasma Recombinant DNA or Plasma DerivedDerived

No. of doses No. of doses 3 doses3 doses

ScheduleSchedule Several optionsSeveral options

Booster Booster nonenone

ContraindicatioContraindicationsns

Anaphylactic rxn to a previous Anaphylactic rxn to a previous dosedose

Adverse Rxn.Adverse Rxn. Local soreness and rednessLocal soreness and redness

DosageDosage .5ml.5ml

Injection siteInjection site Outer mid thigh (infants) Outer mid thigh (infants) outer upper arm ( children outer upper arm ( children and adult) and adult)

Injection TypeInjection Type IntramuscularIntramuscular

Storage Storage Store between 2-8Store between 2-8° C. Never ° C. Never FreezeFreeze

Type Type Toxoid as DT, TT or TDToxoid as DT, TT or TD

No. of dosesNo. of doses At least 2 primary dosesAt least 2 primary doses

ScheduleSchedule See next tableSee next table

BoosterBooster TT/TD every 10 yrs or during TT/TD every 10 yrs or during pregnancy. DT 18 mos-6 yrs. pregnancy. DT 18 mos-6 yrs.

ContraindicatioContraindicationsns

Anaphylactic rxnAnaphylactic rxn

Tetanus ToxoidTetanus Toxoid

Adverse Rxn Adverse Rxn Mild local or systemic reactions Mild local or systemic reactions

DosageDosage .5 ml .5 ml

Injection siteInjection site Outer upper armOuter upper arm

Injection type Injection type IntramascularIntramascular

Storage Storage Store between 2-8Store between 2-8° C. Never ° C. Never FreezeFreeze

TT immunization TT immunization scheduleschedule

Dose of Dose of TTTT

When to giveWhen to give Expected Expected duration of duration of protectionprotection

11 At first contact or At first contact or as early as as early as possible in possible in pregnancypregnancy

nonenone

22 At least 4 wks At least 4 wks after TT1after TT1

1-3 yrs1-3 yrs

33 At least 6 mos. after At least 6 mos. after TT2 or during TT2 or during subsequent pregnancysubsequent pregnancy

At least 5 yrsAt least 5 yrs

44 At least 1 yr after TT3 At least 1 yr after TT3 or during subsequent or during subsequent pregnancypregnancy

At least 10 yrsAt least 10 yrs

55 At least 1 yr after TT4 At least 1 yr after TT4 or during subsequent or during subsequent pregnancypregnancy

For all child For all child bearing years and bearing years and possibly longerpossibly longer

Immunization schedule for Immunization schedule for childrenchildren

AgeAge EPI visitEPI visit Antigens given Antigens given With Birth With Birth DoseDose

Birth Birth 00 BCGBCG Hep B -birthHep B -birth

6 wks6 wks 11 OPV1, DPT1OPV1, DPT1 Hep B2Hep B2

10 wks10 wks 22 OPV2, DPT2OPV2, DPT2

14 wks14 wks 33 OPV3, DPT3OPV3, DPT3 Hep B3Hep B3

9-12 9-12 mos.mos.

44 MeaslesMeasles

IndicationsIndications

Allergy or asthmaAllergy or asthma Any minor illness such as respiratory Any minor illness such as respiratory

tract infections or diarrhea with tract infections or diarrhea with temperature below 38.5temperature below 38.5°C °C

Family history of adverse events Family history of adverse events following immunization following immunization

Family history of convulsion, seizures Family history of convulsion, seizures or fitsor fits

Treatment with antibioticsTreatment with antibiotics

Known or suspected HIV infection with no Known or suspected HIV infection with no signs and symptoms of AIDS signs and symptoms of AIDS

Child being breastfed Child being breastfed Chronic illnesses such as chronic diseases Chronic illnesses such as chronic diseases

of the heart, lungs, kidney or liverof the heart, lungs, kidney or liver Stable neurological conditions such as CP Stable neurological conditions such as CP

or Down’s syndrome or Down’s syndrome Premature or low birth weightPremature or low birth weight

MalnutritionMalnutrition History of jaundice at birthHistory of jaundice at birth

ContraindicationsContraindications

Anaphylaxis or severe Anaphylaxis or severe hypersensitivity reactionhypersensitivity reaction

Do not give BCG or yellow fever Do not give BCG or yellow fever vaccine to an infant that exhibits vaccine to an infant that exhibits the signs and symptoms of AIDSthe signs and symptoms of AIDS

Giving vaccines at the same Giving vaccines at the same timetime

If you are giving more than 1 If you are giving more than 1 vaccine vaccine DO NOT use the same DO NOT use the same syringe, DO NOT use the same syringe, DO NOT use the same arm or leg for more than 1 arm or leg for more than 1 injectioninjection

DO Not give more than 1 dose of DO Not give more than 1 dose of the same vaccine in 1 sessionthe same vaccine in 1 session

Give doses of the same vaccine at Give doses of the same vaccine at the correct intervals.the correct intervals.

Note:Note:

If a child has diarrhea when you If a child has diarrhea when you give OPV administer an extra dose give OPV administer an extra dose