NATIONAL IMMUNIZATION

PROGRAM (NIP)
 National Immunization Program

Terms:
• IMMUNIZATION is the process by which vaccines are
introduced into the body (Childhood Immunization,
2016).

• VACCINES are administered to induce immunity

thereby causing the recipient’s immune system to react
to the vaccines that produce antibodies to fight the
disease.
 National Immunization Program

Terms:

• ANTIGEN is any substance capable of mobilizing our

immune system and provoking an immune response.

• ANTIBODIES also referred to as immunoglobulins, or Igs,

are soluble proteins produced by the body in response to an
antigen.
 ACQUIRED IMMUNITY
ACTIVE Immunity PASSIVE
• Antibodies are •Antibodies are obtained
developed inside the from the serum of an immune
body human or animal donor
•Long lasting • Short period

Antibodies made Antibodies transmitted

after exposure to an NATURAL from mother to baby (via
active infection placenta and breastmilk)

Antigens Antibodies
administered to ARTIFICIAL acquired from an
stimulate immune serum
antibody e.g. from animal to
vaccination human
 National Immunization Program

• Expanded Program on Immunization (EPI) was

launched by the World Health Organization (1974)

• Philippines: EPI was launched by the DOH in

cooperation with WHO and UNICEF (July 1976)

• Objective:
“To reduce the morbidity and mortality among
infants and children caused by the seven childhood
diseases”
 National Immunization Program

• EPI was changed to National Immunization Program (NIP)

2016

• Goal:
“To reduce the morbidity and mortality among
children against the most common vaccine-preventable
diseases.”

• Wednesday is the designated immunization day in

government health facilities unless revised by local
traditions or customs (DOH, 2003).
 National Immunization Program

Basis:
PD 996 RA 7846

Basic infant
Compulsory
immunization Hep. B
Immunization
- against certain vaccination
diseases shall be
compulsory for
infants and
children below
eight years of age
 National Immunization Program

Basis:

RA 10152 (2010)

“Mandatory Infants and Children Health Immunization Act of 2011”

- states that mandatory basic immunization shall be given for

free at any government hospital or health center to infants and
children up to five (5) years of age.
 National Immunization Program

General Principles: MY VACCINES

M easles/MMR vaccine is given as the child reaches 9 months old.

Y ou should never reconstitute freeze dried vaccines in anything other

than the diluent supplied for them.
V accination should not be restarted.

A bsolute contraindications:
▪ Convulsions/shock/anaphylaxis/severe hypersensitivity reaction after
a previous dose of vaccine
▪ Immunosuppressed

C ough, diarrhea, vomiting, any minor illness, premature or low-

birth weight, malnutrition are not contraindications.
IT IS SAFE TO IMMUNIZE INFANTS EVEN IF THEY
ARE MILDLY ILL.
 National Immunization Program

General Principles:

C hild that need to be hospitalized should not be immunized.

I mplement one syringe, one needle per child during vaccination.

(auto-disabled syringe)
N o more than one dose of the same vaccine should be given to a
woman or child in one session.

E ffective and safe to administer all vaccines on the same day at

different sites.

S ubsequent doses of same vaccine should be given at correct

intervals.
Immunization Card
 Site of
Route of Side Effects/Adverse
Vaccine Dosage Adminis-
National Immunization Program
administration
tration
Reactions

•Koch’s Phenomenon
Bacillus Calmette Right deltoid •Swelling/abscess
0.05 ml Intradermal (ID)
region of the arm •Lymadenitis
Guerin (BCG)

Upper, outer •Fever

Intramuscular
Hepatitis B 0.5ml portion of the •Local soreness and redness
(IM)
thigh
Intramuscular Upper, outer •Fever, soreness
Pentavalent •Crying for more than 3 hours
0.5ml (IM) portion of the
Vaccine thigh
•Usually none
•Mouth
•Fever, redness, pain, or
Oral Polio Vaccine 2 drops Oral •Upper, outer
swelling at the site
IPV 0.5ml IM portion of the
•Vaccine Associated Paralytic
thigh
Polio (VAPP) – very rare
Intramuscular Upper, outer •Mild fever
PCV 0.5ml (IM) portion of the •Tenderness or swelling at the
thigh site
•Malaise, fever, rash 5-12 days
Subcutaneous Outer part of the
MMR 0.5ml later
(SQ) upper arm
•Encephalitis, anaphylaxis (rare)
National Immunization Program

BCG Vaccination

MMR/MR
Vaccination
National Immunization Program

x x
 National Immunization Program

Target Age group for NIP: 0 – 23 months old

Criteria for a FULLY IMMUNIZED CHILD (FIC)

• 1 dose of BCG
• 3 doses of PENTAVALENT vaccine
• 3 doses of OPV
• 2 doses of MMR (9 months; 12months up to 12months + 28 days)

Target: Before the child reaches 12months + 28 days

• If the child completed the routine vaccination beyond 12months

+ 28 days, it is termed as
• Completely Immunized Child (CIC)
 National Immunization Program

What to do for ZERO Dose Kids?

A) What vaccines can be given with complete confidence when no record is
available?
OPV and MCV: Multiple doses are completely safe
Pentavalent (DTP-Hep.B-Hib): in absence of any record a single dose is
safe.
For children UNDER 12 MONTHS:
• If it is very likely that the child is completely unimmunized, it is
preferable to give the whole immunization series of vaccine doses
except birth doses
Penta (3 doses), OPV (3 doses) and MCV (2 doses).

• If the child is likely to be partially immunized give only

OPV (3 doses), Penta (1 dose) and MCV (2 doses).
 National Immunization Program

Other Vaccines:
✓ PCV 23 (Senior Citizens)
✓ Human Papilloma Virus (HPV) Vaccine - Quadrivalent

Target: Girls aged 9-10 years old

Dosage and Route: 0.5ml, IM
Site: Left deltoid arm
Number of doses:
1st: at the time of visit at age between 9-10
2nd: 6 months after first dose
Contraindications:
▪ Moderate or severe acute illnesses
▪ Pregnant women
 Tetanus Diphtheria (Td) for Pregnant Mothers

Protect-
Vaccine Minimum Time Interval Duration of Protection
ion
At first contact or as early
Td1 as possible during None None
pregnancy
• Gives 3 years protection for the
mother
Td2 At least 4 weeks after Td1 80%
• Infants born to the mother will be
protected from neonatal tetanus
Gives 5 years protection for the
Td3 At least 6 months after Td2 95%
mother
At least 1 year after Td3 Gives 10 years protection for the
Td4 99% mother
At least 1 year after Td4 Gives LIFETIME protection for the
Td5 100%
mother
 Cold Chain Management

COLD CHAIN
The cold chain is a system for storing and transporting
vaccines in good condition from the manufacturer to the person
being immunized. The system includes vaccines, immunization
supplies and cold chain equipment. It is also referred to as the
vaccine supply chain.
 Cold Chain Management
Vaccine Type Form Storage Temperature

BCG Live, attenuated Freeze dried

Plasma-derived;
Hep. B Liquid
RNA recombinant
Toxoid,
+2 to +8°C
Pentavalent conjugate, killed Liquid
bacteria (body of the
refrigerator)
MMR Live, attenuated Freeze dried

IPV Inactivated Liquid

PCV Conjugate Liquid
-15 to -25°C (freezer) or
OPV Live, attenuated Liquid +2 to +8°C (body of the
refrigerator)
Cold Chain Management
 Cold Chain Management

Ensure the Safety and Viability of the Vaccines

1. “First expiry and first out (FEFO)” vaccine policy is
practiced.
2. End of the month is the last date by which the vaccine
can be used (if not specified).
3. Temperature monitoring of vaccines is done twice a day.
4. Vaccines must be placed in a special cold pack during
immunization sessions.
National Immunization Program
 Cold Chain Management

Multi-Dose Vial Policy (MDVP)

Multi-dose vials vaccines from which one or more doses have

been removed during an immunization session may be used in
subsequent sessions for FOUR WEEKS provided the following
conditions are met:
✓ Expiry date has not passed.
✓ Vaccines are stored under appropriate cold chain conditions.
✓ Vaccine vial septum has not submerged in water.
✓ Aseptic technique has been used to withdraw all doses.
✓ The Vaccine Vial Monitor (VVM) has not reached its discard
point.
Vaccine Vial Monitor
 Cold Chain Management

Guidelines on Implementing MDVP

▪ Hep. B, Td, bOPV and IPV are vaccines covered by MDVP.

▪ All reconstituted vaccines should be discarded 6 hours after
opening or at the end of an immunization session, whichever
comes first. These include BCG, MR, MMR.
▪ A flu vaccine with no VVM is to be discarded seven days after
opening.
▪ All single dose vaccines such as Pentavalent, Rotavirus, PCV, HPV
are NOT covered by MDVP.
National Immunization Program
 Cold Chain Management

Shake Test
Cold Chain Management
 Individual Treatment Record

INDIVIDUAL TREATMENT RECORD FOR EXPANDED PROGRAM ON IMMUNIZATION

May 18, 2022

Date of FIRST visit: _________________ Registered at LRC Yes No
June 28, 2019
Date of BIRTH: _____________________ PHIC ID # _____________________ NHTS-PR ID# _____________________

DANIELA MARIE COSA TORRES

NAME OF CHILD: ________________________________________________ SEX Male Female
MARIANE COSA TORRES
COMPLETE NAME OF MOTHER: _______________________________________ 18
Age ________ NONE - HOUSEWIFE
Occupation _______________

COMPLETE NAME OF FATHER: DINGDONG COSA TORRES

_______________________________________ 23
Age ________ DRIVER
Occupation _______________

PUROK 7, BRGY. 76-A BUCANA, DAVAO CITY 0933-1775846

COMPLETE ADDRESS: _________________________________________________ Contact Number ____________________

SPMC June 28, 2019 TD2

Place of Delivery _________________ Date Given Vit. K _____________ TT Status of Mother ________________
NSD June 28, 2019 YES
Type of Delivery _________________ Date Given Hep.B _____________ Child Protected at Birth ______________
LIVEBIRTH June 29, 2019 June 29, 2019
Outcome __________________________ Date Given BCG _____________ Date Newborn Screening Done ________

Birthweight 2900 GRAMS

_________________________ Initiated Breastfeeding
June 28, 2019
_______________
NORMAL
Newborn Screening Result___________
NONE
Complications during birth and delivery ___________________________________________________________________
 Individual Treatment Record

DETAILS OF IMMUNIZATION VISITS

Name and Signature of Health

Date and Vital Signs Physical Assessment Treatment/Interventions/Services Given Provider and Schedule of Next
Visit

Date 5/18/22
_________ Age: 12 mos. + 17 days
Height 55cms.
_________
PCV1, OPV1, Penta 1 – given
Weight 5.0
_________ •Well baby Catherine F. Tambis, RN, MAN
• No history of Health teachings done
HR _________
convulsions – noted FP: LAM
RR _________
36.7°C • With mild cough noted
Temp _________ TCB: 5/18/22
MUAC _________
Feeding Breastfeeding
_________