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Expanded Program of Immunization
Expanded Program of Immunization
(Tuberculosis, Diptheria, Pertusis, Tetanus, Poliomyelitis, Measles, and epatitis !. "stablished here at Philippines by Pres. Marcos on the month o# $uly, %&7' PRINCIPLES( %. The program is based on epidemiological situation) schedules are dra*n on the basis o# the occurrences and characteristics #eatures o# the said diseases. +. The *hole community rather than ,ust an indi-idual is to be protected, thus, mass approach is applied. .. Immunization is a basic health ser-ice and as such, it is integrated into the health ser-ices pro-ided #or by /ural ealth 0nit. Immunization 1 is a process by *hich -accines are introduce to the !ody, be#ore in#ectious sets in. ELEMENTS ( %. Target 2etting 1 (3 1 %+ mos.4 +. 5old chain Management (#or -accine li#e span and utilization4 .. In#ormation, education and communication 3 Reasons: a. 6or parents, to be moti-ated to submit their child to immunization b. To pro-ide health teachings on bene#its and importance o# immunization c. To in#orm the public about its a-ailability and schedule (/ 0 7 8eds. ! 2 7 once a month, and remote area 7 9uarterly4 :. ;ssessment and e-aluation o# the programs o-er all per#ormance <. 2ur-eillance studies and research. EPI ROUTINE IMMUNIZATION SC E!ULE "OR IN"ANTS #ACCINE %. %C$ TAR$ET ;nytime at !irth 2chool "ntrance +. e&a % ;nytime at !irth !OSA$E 3.3<ml 3.%ml INTER#A L =nce ROUTE Intradermal (ID4 ;ssess #or 8heal #ormation ' *?s. Inter-al #rom %st dose to +nd dose, then @ *ee?s inter-al 6rom +nd to .rd dose Intramuscular (IM4 SITE /ight Deltoid >e#t Deltoid 0pper outer Portion o# the thigh
3.<ml
.. !PT
3.<ml
: *ee?s A . doses
Intramuscular (IM4
:. OP#
+ drops
: *ee?s A . doses
<. Meas'es
3.<ml
=nce
2ubcutaneous (294
Si(e E))ects o) %C$: %. BochCs Phenomenon 1 acute in#lammatory process starting *ith in +: hrs. and may last #or + 1 : days. 8heal must disappear in about .3 mins 1 %hr. +. ;bscess #ormation 1 %st *ee? 1 soreness and in#lammation, +nd *ee? 1 %%th *ee? healing o# abscess and ulceration. I# there is no scar de-eloped, Re&eat t*e &+oce(u+e .. indolent ulceration 1 a. *rong techni7ue, b. eAposure o# in#ant to Pt. c acti-e T!. :. Dlandular "nlargement 1 a. unsterile syringe or needle *as used, b. too much -accine *as in,ected. 5. the -accine might be in,ected under the s?in layer, and not instead in its super#icial layer. Mana,ement: Physician may order, I and D, or Isoniazid. Si(e E))ects o) e&a %:
%. Mild #e-er % E+ days, E a. Teach mother per#orm T2! b. ad-ice mother that she may gi-e Paracetamol e-ery : hours i# #e-er not relapse. 6e-er more than : days, re#er to the Physician. +. Mild Pain, s*ell and redness. 1 a. Teach mother to do cold compress #irst be#ore hot compress % 1 . times a#ter in,ection then e-ery ' hours. Si(e E))ects o) !PT: %. +. .. :. 6e-er *ithin +: hours local soreness pain and s*elling ;bscess appears a#ter a *ee? or more due to *rong techni7ue, 5on-ulsions is -ery rare, but may occur more in children abo-e . months o# age. This is due to the Pertussis -irus component o# the -accine. 1 there are no* a-ailable D and T only -accines that may a-oid con-ulsions o# DPT.
Si(e E))ects o) Meas'es #accine: %. 6e-er and /ashes 1 #or rashes mother m,ay gi-e ;FTI I2T;MIF"2 (!enadryl4 and #or itchiness (5alamine >otion4.
Si(e e))ects )o+ OP#: F=F"( !ut be a*are o# possible ris? #or aspiration once *rong site is used. Ma?e sure also that the baby *as FP= .3 mins. prior administration, #or him not to -omit once drops *ere administered. POINTERS ON IMMUNIZATION: %. "-ery child deser-es to be gi-en the bene#its o# immunization protection based on PD &&' immunization la*. 2eptember %', %&7' 1 !asic compulsory immunization o# children belo* @ years old is implemented. +. Fo -accine gi-es %33G protection. They go hand in hand *ith good hygiene and other measures #or disease pre-ention. .. /ecommended series o# immunization must be completed #or ade7uate protection. :. !ooster doses are important to maintain continuous protection against the diseases. <. Interruption o# schedule does not inter#ere *ith #inal immunity nor does it necessitate contraindication to -accination. '. Malnutrition, minor respiratory in#ections, moderate #e-er, cough and diarrhea do not constitute contraindications to -accinations. 7. the absolute contraindications to immunization are ( a. DPT+ or DPT. to a child *ho has had con-ulsion or shoc? *ith in . days the pre-ious dose. b. >i-e *ea?ened -accine li?e !5D must not be gi-en to indi-idual *ho are immunocompromised due to malignant disease. @. Measles and =PH -accines are most sensiti-e to heat. They must be strictly maintained at E%< 1 +3 5. &. Haccines are sa#e and e##ecti-e *ith mild side e##ects a#ter -accination. %3. Fo eAtra doses must be gi-en to childImother *ho missed a dose. %%.Di-ing doses o# a -accine at less than : *ee?s inter-al may lessen the anti body response. >engthening the inter-al leads to higher antibody le-els. %+.Practice 6"6= #irst eApiry #irst out rule, and % syringe one needle one child policy must strictly implemented. ; child is said to be Fully Immunized Child *hen heIshe recei-es % dose o# !5D, . doses o# epa !, . doses o# DPT, . doses o# =PH, and % dose o# Measles be#ore hisIher % st !irthday.,.