the epi routine schedule of immunization in the phillippines
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Every Wednesday is designated as
immunization day and is adopted in all parts of
the country. In barangay health station
immunization is done monthly while in far
flung areas it is done quarterly. However, some
areas adopted local practices to provide
everyday vaccination in their areas to cover all
targets.
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The standard routine immunization
schedule for infants is adopted to provide
maximum immunity against the seven
vaccine preventable diseases before a
childs birthday. A child is said to be Fully
Immunized Child When a Child receivesone Dose of BCG, 3 doses of OPV, 3 doses
of DPT, 3 doses of HB and one dose of
measles before a childs first birthday.
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VACCINE MINIMUM AGE
at 1st DOSE
NUMBER
OF DOSES
MINIMUM
INTERVAL
BETWEEN
DOSES
REASON
BCG Birth or anytimeafter birth
1 BCG is given at earliestpossible age to protects the
possibility of TB meningitis
and other TB infectious in
which infants are prone.
DPT 6 weeks 3 4 weeks An early start with DPTreduces the chance of severe
pertussis
OPV 6 weeks 3 4 weeks The extent of protection
against polio is increased the
earlier the OPV is given
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VACCINE MINIMUM AGE
at 1st DOSE
NUMBER
OF DOSES
MINIMUM
INTERVAL
BETWEEN DOSES
REASON
Hep B At birth 3 6 weeks interval
from 1st dose to
2nd dose, and 8weeks interval
from 2nd dose to
third dose
An early start of Hep B reduces the
chance of being infected and
becoming a carrier. Prevent a livercirrhosis and liver cancer.
Measles 9 months At least 85% of measles can be
prevented by immunization at thisage. Prevents deaths , malnutrition,
pneumonia, diarrhea
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Tetanus toxoid vaccination for women is
important to prevent tetanus in both motherand the baby. When two doses of TT injection
given at one month interval between each dose
during pregnancy or even before pregnancyperiod the baby is protected against neonatal
tetanus. Completing the five doses following the
schedule provide lifetime immunity.
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VACCINE MINIMUM
AGE/INTERVAL
PERCENT
PROTECTED
DURATION OF PROTECTION
TT1 As early as
possible duringpregnancy
TT2 At least 4 weeks
later
80% - Infants born to the motherwill be
protected from neonatal tetanus
- Gives 3 years protection for the
mother
TT3 At least 6
months later
95% - Infants born to the mother will be
protected from neonatal tetanus
- Gives 5 years protection for the
mother
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VACCINE MINIMUM
AGE/INTERVAL
PERCENT
PROTECTED
DURATION OF PROTECTION
TT4 At least one year
later
99% - Infants born to the
mother will be protected
from neonatal tetanus
- Gives 10 years
protection for the
motherTT5 At least one year
later
99% - Gives life time protection
for the mother
- All infants born to that
mother will be protected
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Vaccines are substances very sensitive at
various temperatures. To avoid spoilage andmaintain its potency, vaccines need to be stored
at correct temperature.
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Type/Form of Vaccines STORAGE TEMPERATUREMost sensitive to
heat
Oral Polio -15OC (at the freezer)
Measles -15oC (at the freezer)
Least sensitive to
heat
DPT/Hep B
D Toxoid which is a
weakened toxin
P Killed Bacteria
T Toxoid which is a
weakened toxin
+2oC to +8oC (in the body of
the refrigerator)
Hep B
BCG (freeze dried)
Tetanus Toxoid
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When handling, transporting and storing vaccines,special care must be given to provide quality potent
vaccines among the targets.
A first expiry and first out (FEFO) vaccine is
practiced to assure that all vaccines are utilized before its
expiry date. Proper arrangement of vaccines and or
labelling of vaccines expiry date are done to identify thosenear to expire vaccines.
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Temperature monitoring of vaccines is done in alllevels of health facilities to monitor vaccine temperature.
This is done twice a day early in the morning and in the
afternoon before going home. Temperature is plotted
everyday in a temperature monitoring chart to monitor
break in the cold chain.
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Each level of health facilities has cold chainequipment for use in the storage of vaccines. These are:
cold room, freezer, refrigerator, transport box, vaccine
carrier. Other cold chain logistics supplies includes:
thermometers, cold chain monitor, ice packs, temperaturemonitoring charts, safety collector box. These are essentials
in proper management of vaccines and other EPI logistics.
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VACCINE DOSE ROUTE OFADMINISTRATION
SITE OFADMINISTRATION
BCG Infants 0.05 ml Intradermal Right Deltoid of the Arm
DPT 0.5 ml Intramuscular Upper outer Portion of
the thigh
OPV 2 drops or
depending on
manufacturers
instructions
Oral Mouth
Measles 0.5 ml Subcutaneous Outer part of the upper
arm
Hep B 0.5 ml Intramuscular Upper outer portion of
the thigh
Tetanus Toxoid 0.5 ml Intramuscular Deltoid Region of the
upper arm
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As a nurse you need to:
Actively master list infants eligible for vaccinationin the community
Immunize infants following the recommended
immunization schedule, route of administration,correct dosage and following the proper cold chain
storage of vaccines.
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As a nurse you need to:
Observe aseptic technique on immunization anduse syringe and one needle per child. These reduces
blood borne diseases and promote safety injection
practices.
Dispose used syringe and needles properly by using
collector box and disposed it in the septic vault to
prevent health hazard
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As a nurse you need to:
Inform, educate and communicate with theparents
To create awareness/motivate to submit their childrenfor vaccination
To provide health teachings on the importance andbenefits of immunization, importance of the follow updose to avoid defaulters and normal course of vaccine
To inform immunization schedule as adopted by local
units
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As a nurse you need to:
Conduct health visits in the community to assessother health needs of the community and be able to
provide package of health services to targets
Identify cases of EPI target diseases per standardcase definition
Manage vaccine properly by following the
recommended storage of vaccines
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As a nurse you need to:
Record the children given with vaccination in thetarget client list
Submit report and record of children vaccinated,
cases and deaths on diseases, vaccine received andutilized and any other EPI related reports.
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As a nurse you need to:
Identify and actively search cases and deaths ofEPI target diseases following standard case
definition.
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REFERENCE:
Public Health Nursing in thePhilippines
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