Kaymika Milford

University of The Bahamas

School of Nursing and Allied Health Profession

NURS 316: Family & Community Health Nursing

Immunization Assignment
Explain the Expanded Program on Immunization. (Include its historic overview,
objectives, purpose, and aim)

The Expanded Programme on Immunization (EPI) was initiated in 1974 to extend the success

of eradicating smallpox and provide life-saving immunizations to all children worldwide.

This initiative has developed into what is now well recognized as the Essential Immunization

initiative (Essential Programme on Immunization, 2024). In July 1979, the Expanded

Program on Immunization in The Bahamas was initiated, even though immunizations had

been administered there since the early 1950s. The objective established in 1977 was to

provide immunization for diphtheria, pertussis, tetanus, poliomyelitis, measles, and TB to all

children worldwide by 1990(Expanded Programme.3 on Immunization, 1988). The objectives

for today's Expanded Program on Immunization are as follows: To provide immunization for

infants under the age of one against Diphtheria, Pertussis, Tetanus (DPT), Haemophilus

Influenza type b (Hib), Hepatitis B, Pneumococcus, and Poliomyelitis. To provide

immunizations for children at the age of one against measles, mumps, rubella (MMR), and

varicella to safeguard their health. To safeguard school-aged children (male and female) nine

years old and above from Human Papillomavirus (HPV). To preserve immunity against

childhood infections in nursery, preschool, primary, and secondary school children. The

objective is to safeguard college students from Vaccine-Preventable Diseases in campus

settings. The aim is to protect expectant mothers and infants from Tetanus and Pertussis. The

purpose is to preserve postnatal women from measles, mumps, and rubella and to avert the

occurrence of Congenital Rubella Syndrome (CRS) in newborns. To protect children,

pregnant women, the elderly, those with chronic non-communicable diseases (CNCDs), and

the public against the Seasonal Influenza Virus. To safeguard the elderly against

Pneumococcal Disease. The objective is to ensure long-lasting safeguarding of the

community from COVID-19 transmission. (Department of Public Health, 2024)

Outline all the current immunization schedules available for children and adults

in The Bahamas.

The current immunization schedule is outlined as follows:

1. At two months, patients are given the vaccines for DPT, Hib, Hepatitis B, Injectable

Polio, Conjugate Pneumococcal-13, and Rotavirus.

2. At four months, patients are given the vaccines for DPT, Hib, Hepatitis B,

Injectable Polio, Conjugate Pneumococcal-13, and Rotavirus.

3. At six months, children are given the vaccines for DPT, Hib, Hepatitis B, Oral

Polio, Conjugated Pneumococcal-13, and Seasonal Influenza.

4. At twelve months, they are given the vaccines for 1st MMR (Measles, Mumps, and

Rubella) 1st Varicella. At fifteen months are given the vaccines for 4th DPT, Hi, Hep

B (1st booster), 2nd MMR and Conjugate Pneumococcal-13

5. Children aged four to five are given DPT (pediatric), Oral Polio, and Varicella

vaccines.

6. Children nine years old and older are given HPV.

7. Ten to Twelve years old are given the T-Dap vaccine.

8. Every Ten years, adults are given the T-Dap.

9. Six months and older receive seasonal influenza annually.

10. Five years and older receive the COVID-19 vaccine annually.

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Describe how vaccines are kept potent from the manufacturer.

The cold chain is an organizational structure that involves the storage and transportation of

vaccines from when they are produced until they are given to the recipient. Temperature

management is crucial for maintaining the potency of vaccinations throughout storage and

transportation. Vaccines sensitive to freezing should be stored in a refrigerator with a

temperature range of 2 to 8 degrees Celsius. Vaccines sensitive to heat should be stored in a

freezer with a temperature range of -15 to 25 degrees Celsius. Vaccines should be carried

using vaccine carriers equipped with properly placed ice packs. Before placing the ice pack in

the airlines, it must be allowed to reach room temperature until the formation of 'frost' on the

surface or the presence of water in the ice pack ceases. This process is referred to as ice pack

conditioning. It is vital to store vaccines and diluents apart from the ice packs to prevent the

labels from getting wet and the freeze-sensitive vaccine from freezing. Minimize the duration

of transportation and promptly unpack vaccines upon arrival at the health facility or

designated immunization area. An adequately insulated vaccine carrier can maintain vaccines

at temperatures ranging from 2 to 8 degrees Celsius for 24 hours.

State 10 ways that the vaccines are kept potent in the clinics.

The methods used to ensure the preservation of vaccines in a clinic are as follows: It is

crucial to have a thermometer in the refrigerator and to check it twice on each working day,

documenting the results. Storing only vaccines and diluents in the fridge is essential to ensure

the vaccines' integrity. Constantly opening the refrigerator door might increase temperature,

which may compromise the effectiveness of the vaccines—ensuring an airtight closure of the

refrigerator door. To ensure the functioning of the fridge, it is essential to place it on a level

surface and keep the electrical socket away from areas with heavy foot activity—

monitoring and documenting refrigerator temperature twice daily. The refrigerator should be

kept 4 to 6 inches away from the wall and away from direct sunlight. Vaccines are not kept on

the door's shelf because the temperature is not low enough. Vaccines should be arranged in

the refrigerator to allow air to circulate around the fridge freely. Place the temperature chart

on the front of the refrigerator to be visible to everyone.

State the recommended level of immunization for The Bahamas (b) state the
actual level of immunization for The Bahamas for 2022-2023.

The recommended vaccination coverage level for the Bahamas is 95% for all vaccines. The

immunization coverage rate for the third dose of the pentavalent vaccine is 86%. The

vaccination coverage rate for the first dose of the MMR vaccine is 80.5%. The coverage rate

for the second dose of the MMR vaccine is 65%.

State the actual level of five (5) regional countries for 2022-2023. Give a
summary of your findings.
The tables below depict the levels of each Immunization in 5 regional countries. China has
the highest coverage level compared to the others listed here. While on the other hand the
United States has the lowest coverage level.

Level of vaccination in the United States

Diphtheria, Tetanus, Pertussis (4+ doses DTP, DT, or DTaP): 80.4%
Polio (3+ doses): 92.5%
Measles, Mumps, Rubella (MMR) (1+ doses): 90.8%
Haemophilus influenzae type b (Hib) (primary series + booster dose): 80.0%
Hepatitis B (Hep B) (3+ doses): 91.4%
Combined 7-vaccine series: 69.7%.
Chickenpox (Varicella) (1+ doses): 90.3%
Pneumococcal conjugate vaccine (PCV) (4+ doses): 81.4%

Level of vaccination in Trinidad and Tobago.

DTP-containing vaccine, 1st dose 97%
DTP-containing vaccine, 3rd dose 93%
Hib, 3rd dose 93%
Hep B, 3rd dose 93%
Polio, 3rd dose 94%
MMR 1st and 2nd dose 92%
Pneumococcal conjugate vaccine, final dose 93%

Level of vaccination in Australia.

MMR 1st dose 96%
Hib, 3rd dose 94%
DTP-containing vaccine, 1st dose 98%
DTP-containing vaccine, 3rd dose 94%
Pneumococcal conjugate vaccine, final dose 96%
Polio, 3rd dose 94%
Level of vaccination in China
MMR 1st dose 99%
DTP-containing vaccine, 3rd dose 99%
Hep B, 3rd dose 99%
Inactivated polio-containing vaccine, 1st dose 99%

Level of Immunization in France

MMR 1st Dose 94%
DTP-containing vaccine, 3rd dose 96%
Hep B, 3rd dose 95%
Inactivated polio-containing vaccine, 1st dose 99%