IMMUNITY/ EPI

IMMUNITY
•THE ABILITY OF THE BODY TO RESIST INFECTIOUS
AGENTS. SUCH PROTECTION AGAINST SPECIFIC
DISEASES IS DUE TO THE PRESENCE OF
ANTIBODIES WHICH CAN WEAKEN THE DISEASE
PRODUCING AGENT.
 IMMUNIZATION
•IS GIVING VACCINES TO A CHILD SO THAT HIS
BODY CAN PRODUCE ANTIBODIES THAT WILL
PROTECT HIM.
NATURAL IMMUNITY
• PRESENT WHEN IMMUNITY EXIST, ALTHOUGH THE
PERSON HAS NOT HAD THE DISEASE OR BEEN GIVEN
ANY FORM OF IMMUNIZATION AGAINST IT.
• E.G. FROM PLACENTA (LASTS FROM BIRTH TO 6
MONTHS)
TYPES OF IMMUNITY
 ACTIVE IMMUNITY
• ANTIBODIES ARE PRODUCED BY THE BODY IN RESPONSE TO AN
ANTIGEN.
• MAY BE ACQUIRED BY HAVING HAD THE DISEASE OR BY
INOCULATION WITH ANTIGENS SUCH AS DEAD ORGANISMS OR
TOXINS OF ORGANISMS.
❖ NATURAL – ANTIBODIES ARE FORMED IN THE PRESENCE OF
ACTIVE INFECTION (LIFELONG) EX. CHICKEN POX.
❖ ARTIFICIAL – ANTIGENS (VACCINES OR TOXOIDS) ARE
ADMINISTERED TO STIMULATE ANTIBODY PRODUCTION; THE
IMMUNITY MUST BE REINFORCED BY BOOSTER SHOTS.
 PASSIVE IMMUNITY
• IS RELATIVELY SHORT LIVED AND IS ACQUIRED BY TRANSFERENCE OF
ANTIBODIES FROM MOTHER TO CHILD OR BY INOCULATION OF SERUM
WHICH CONTAINS ANTIBODIES FROM AN IMMUNE PERSON OR ANIMAL.
(GAMMA GLOBULIN FOUND IN THE BLOOD IS THE MOST FREQUENT
SOURCE OF HUMAN ANTIBODIES)
❖ NATURAL – ANTIBODIES ARE TRANSFERRED NATURALLY FROM AN
IMMUNE MOTHER TO HER BABY THROUGH THE PLACENTA OR IN THE
COLOSTRUM.
❖ ARTIFICIAL – IMMUNE SERUM (ANTIBODY) FROM AN ANIMAL OR
ANOTHER HUMAN IS INJECTED.
 IMMUNITY

RESISTANCE

ACTIVE PASSIVE

NATURAL ARTIFICIAL NATURAL ARTIFICIAL

GLOBULINS
DISEASES Vaccines/ Toxoid ANTIBODIES
COLOSTRUM
Body produces (6 months – 1 ANTI SERUM
PLACENTA
antibodies year
 EXPANDED PROGRAM OF
IMMUNIZATION
• EPI - LAUNCHED IN JULY 1976 BY DOH IN COOPERATION WITH WHO AND UNICEF

• PD 996: COMPULSORY BASIC IMMUNIZATION FOR INFANTS AND CHILDREN BELOW 8 YEARS
OLD
• RATIONALE
• REDUCE THE MORBIDITY (INCIDENCE) AND MORTALITY (DEATHS) AMONG INFANTS AND
CHILDREN CAUSED BY THE 6 CHILDHOOD IMMUNIZABLE DISEASES.

• RA 10152 MANDATORY INFANTS AND CHILDREN HEALTH IMMUNIZATION OF 2011

 PRINCIPLES OF EPI

• PROGRAM BASED ON EPIDEMIOLOGICAL SITUATION

• SCHEDULES ARE BASED ON THE OCCURRENCE AND
CHARACTERISTICS OF THE DISEASE
• MASS APPROACH IS UTILIZED
• WHOLE COMMUNITY IS PROTECTED RATHER THAN THE
INDIVIDUAL
• IMMUNIZATION IS A BASIC HEALTH SERVICE
• IT SHOULD BE PROVIDED BY THE RHU
Target for Immunization Program

a. Infant: 12months old

b. School Entrants: 6-7 years old
c. Pregnant Mother
Infants:
1 BCG
3 Hepa B
3 DPT
1 Measles
3 OPV

School entrants: 1 booster dose of BCG

Pregnant mothers: 5 Tetanus Toxoid
 ROUTINE IMMUNIZATION SCHEDULE FOR
INFANTS
FIC – FULLY IMMUNIZED CHILD (1 BCG, 3 OPV, 3 DPT, 3 HB,1 MEASLES BEFORE THE 1ST
Minimum age at Number BIRTHDAY)
of Minimum interval Site of Health teachings
Vaccines 1st dose doses/ doses between doses/ Route administration

BCG Birth or any time 1 / 0.05mL ID Right deltoid Do not massage the site if
after birth injection

DPT 6 weeks 3 / 0.5mL 4weeks/ IM Upper outer portion Give paracetamol for fever
of the thigh

OPV 6 weeks 3 / 2 drops 4weeks/ Oral Mouth NPO for 30 minutes

Hepa B At birth 3 / 0.5mL 6weeks interval from Upper outer portion Give paracetamol for fever
1st-2nd dose, 8weeks of the thigh
interval from 2nd-3rd dose/
IM
Measles 9 months 0.5mL IM Deltoid region of the Records all immunization
upper arm
 PRINCIPLES OF VACCINATION

1. NO BCG TO A CHILD BORN POSITIVE WITH HIV OR AIDS

2. DPT IS NOT GIVEN TO A CHILD WHO HAS RECURRENT CONVULSIONS OR
ACTIVE NEUROLOGIC DISEASE
3. DPT2 OR DPT3 IS NOT GIVEN TO A CHILD WHO HAS HAD CONVULSIONS OR
SHOCK W/IN 3 DAYS THE PREVIOUS
4. DON’T IMMUNIZE CHILDREN BEFORE REFERRAL
5. MODERATE FEVER, MALNUTRITION, MILD RESP. INFECTION, COUGH,
DIARRHEA & MILD VOMITING AREN’T CONTRAINDICATION TO VACCINATION.
 PRINCIPLES OF VACCINATION

6. SAFE TO ADMINISTER ALL EPI VACCINES ON THE SAME DAY AT DIFFERENT

SITES OF THE BODY.
7. NO FOOD 30 MINUTES AFTER GIVING OPV.
8. ASSESS THE CHILD FOR ALLERGY TO EGG BEFORE GIVING MEASLES VACCINE.
9. MEASLES VACCINE SHOULD BE GIVEN AS SOON AS THE CHILD IS 9 MONTHS
OLD REGARDLESS OF WHETHER OTHER VACCINES WILL BE GIVEN ON THAT DAY.
10. VACCINATION SCHEDULE SHOULD NOT BE RESTARTED FROM THE BEGINNING
EVEN IF THE INTERVAL BETWEEN DOSES EXCEEDED.
 PRINCIPLES OF VACCINATION

11. IT IS SAFE AND EFFECTIVE WITH MILD SIDE EFFECTS AFTER VACCINATION.
12. DO NOT REPEAT BCG VACCINATION IF THE CHILD DOES NOT DEVELOP A
SCAR AFTER THE FIRST INJECTION.
13. STRICTLY FOLLOW THE PRINCIPLE OF NEVER, EVER RECONSTITUTE THE
FREEZE-DRIED VACCINES TO ANY DILUENTS.
14. USE ONE SYRINGE, ONE NEEDLE PER CHILD DURING VACCINATION.
15. DURING VACCINATION, CLEAN THE SKIN WITH COTTON BALL, MOISTENED
WITH WATER ONLY (BOILED H20).
BCG ∙ For tuberculosis
∙ Primary complex
∙ c/a: Mycobacterium Tuberculosis
∙ MOT: airborne
∙ S&Sx: night sweats, afternoon low grade fever, chronic cough.
∙ Mantoux Test: 10mm or more (+) reaction, check after 48-72 hours

DIPHTHERIA ∙ Kleb’s-Loffler
∙ Infectious disease characterized by the formation of PSEUDOMEMRANE (commonly in
tonsils)
∙ c/a: Corynebacterium Diphtheriae
∙ MOT: respiratory droplet (from nose and throat)
∙ S&Sx: Pseudo membrane, low grade fever, sore throat, hoarseness of voice

PERTUSIS - Whooping cough

- Characterized by repeated attacks of coughing typically ending in an inspiratory “whoop”
- c/a: Corynebacterium Diphtheriae
- MOT: airborne (through discharges from respiratory tract and mucus membrane)
POLIOMYELITIS
- Acute infectious disease that affects the anterior horn cells of the spinal cord, medulla, cerebellum,
midbrain
- c/a: poliovirus 1,2,3 (that’s why there’s need for trivalent vaccine)
- MOT: fecal-oral route
- S&Sx: slight fever, headache, stiffness of the neck and back, widespread pain
MEASLES
- Rubeola, 7 day measles
- c/a: Rubeola Virus
- MOT: Droplet
- S/Sx: moderate to high fever, KOPLIK’S SPOTS (small, whitish, pinpoint spots located in the inner
cheeks)
HEPA B
- MOT: blood of infected person and body fluids
- S/Sx: fever, marked anorexia, fatigue