Epi Powerpoint

7/27/2019 Epi Powerpoint

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TheExpanded Programon Immunization(EPI)


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TheExpanded Program onImmunization(EPI)

in the Philippines began in

July 1979. And, in 1986,

made a response to the

Universal Child

Immunization goal.
http://en.wikipedia.org/wiki/Philippineshttp://en.wikipedia.org/wiki/Philippines


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The four major strategies

include:

Sustaining high routine Full

Immunized Child (FIC) coverage of at

least 90% in all provinces and cities, Sustaining the polio-free country for

global certification

Eliminating measles by 2008,

Eliminating neonatal tetanus by 2008.


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Routine Immunization

Schedule for Infants

The standard routine immunization

schedule for infants in the

Philippinesis adopted to provide maximum

immunity against the seven vaccine

preventable diseases in the countrybefore the child's first birthday


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The fully immunized child

must have;

completed BCG 1

DPT 1, DPT 2, DPT 3

OPV 1, OPV 2, OPV 3 HB 1, HB 2, HB 3

and ANTI- measles vaccinesbefore the child is 12 months ofage.


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Vaccine Minimum Ageat 1st Dose

Number

of Doses DoseMinimum Interval

Between Doses Route Site Reason

Bacillus Calmette-Gurin Birth or anytime afterbirth 1 dose 0.05 mL none Intradermal

Right deltoid region of the

arm

BCG given at earliest

possible age protects the

possibility of TB

meningitis and other TB

infections in which infants

are prone[3

Diphtheria-Pertussis-

Tetanus Vaccine 6 weeks old 3 doses 0.5 mL6 weeks(DPT 1), 10

weeks (DPT 2), 14 weeks

(DPT 3)Intramuscular

Upper outer portion of the

thigh, Vastus Lateralis (L-

R-L)An early start with DPT

reduces the chance of

severe pertussis.[4

Oral Polio Vaccine 6 weeks old 3 doses 2-3 drops 4 weeks Oral Mouth

The extent of protection

against polio is increased

the earlier the OPV is

given.

Keeps the Philippines

polio-free.[5

Hepatitis B Vaccine At birth 3 doses 0.5 mL 4 weeks interval IntramuscularUpper outer portion of the

thigh, Vastus Lateralis (R-

L-R)

An early start of Hepatitis

B vaccine reduces the

chance of being infected

and becoming a carrier.[6]

Prevents liver cirrhosis

and liver cancer which are

more likely to develop if

infected with Hepatitis B

early in life.[7][8]About 9,000 die of

complications of Hepatitis

B. 10% of Filipinos have

Hepatitis B infection[9]

Measles Vaccine

(not MMR)9 months old 1 dose 0.5 mL none Subcutaneous Upper outer portion of the

arms, Right deltiodAt least 85% of measles

can be prevented by

immunization at this

age.[10]
http://en.wikipedia.org/wiki/DPT_vaccinehttp://en.wikipedia.org/wiki/DPT_vaccinehttp://en.wikipedia.org/wiki/DPT_vaccinehttp://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Measles_Vaccinehttp://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Measles_Vaccinehttp://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/DPT_vaccinehttp://en.wikipedia.org/wiki/DPT_vaccinehttp://en.wikipedia.org/wiki/DPT_vaccinehttp://en.wikipedia.org/wiki/DPT_vaccinehttp://en.wikipedia.org/wiki/DPT_vaccine


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General Principles in

Infants/Children Immunization

Because measles kills, every infant needsto be vaccinated against measles at theage of 9 months or as soon as possible

after 9 months as part of the routine infantvaccination schedule.

It is safe to vaccinate a sick child who issuffering from a minor illness (cough, cold,diarrhea, fever or malnutrition) or who hasalready been vaccinated against measles.


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If the vaccination schedule is interrupted,it is not necessary to restart. Instead, theschedule should be resumed using

minimal intervals between doses to catchup as quickly as possible.

Vaccine combinations (few exceptions),

antibiotics, low-dose steroids (less than20 mg per day), minor infections with lowfever (below 38.5 Celsius)


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diarrhea, malnutrition, kidney or liverdisease, heart or lung disease, non-

progressive encephalopathy, well

controlled epilepsy or advanced age, arenot contraindications to vaccination.

Contrary to what the majority of doctors

may think, vaccines against hepatitis Band tetanus can be applied in any period

of the pregnancy.


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There are very few true contraindication and

precaution conditions.

Only two of these conditions are generallyconsidered to be permanent:

severe (anaphylactic) allergic reaction to a

vaccine component or following a prior doseof a vaccine, and encephalopathy not due to

another identifiable cause occurring within 7

days of pertussis vaccination.


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Only the diluents supplied by themanufacturer should be used to

reconstitute a freeze-dried vaccine. A sterile needle and sterile syringe

must be used for each vial for adding

the diluents to the powder in a singlevial or ampoule of freeze-driedvaccine.


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The only way to be completely safe

from exposure to blood-borne

diseases from injections, particularlyhepatitis B virus (HBV), hepatitis C

virus (HCV), and human

immunodeficiency virus (HIV) is touse one sterile needle, one sterile

syringe for each child.


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Tetanus Toxoid Immunization

Schedule for Women

When given to women of

childbearing age, vaccines that

contain tetanus toxoid (TT or Td)not only protect women against

tetanus, but also prevent neonatal

tetanus in their newborn infants

Mi i P t


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Vaccine MinimumAge/Interval

Percent

Protected Duration of Protection

TT1 As early as possibleduring pregnancy 80%

protection for the mother for

the first delivery

TT2 At least 4 weeks later 80% infants born to the mother will

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



the mother

TT4 At least 1 year later 99%

infants born to the mother will



the mother

TT5 At least 1 year later 99% gives lifetime protection for

the mother all infants born to that mother

will be protected


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a classification for countriesclose to maternal and neonatal

tetanus elimination.

In June 2000, the 57 countries

that have not yet achievedelimination of neonatal tetanus

were ranked and the Philippines

was listed together with 22 other

countries in Class A,


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Care for the Vaccines

To ensure the optimal potency ofvaccines

a careful attention is needed in handling

practices at the country level. These include storage and transport of

vaccines from the primary vaccine store

down to the end-user at the health facility


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Care for the Vaccines

and further down at the outreach

sites Inappropriate storage,

handling and transport of vaccineswont protect patients and may lead to

needless vaccine wastage.


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(FEFO)

A "first expiry and first out"

vaccine system is practiced to

assure that all vaccines areutilized before its expiry date.


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Proper arrangement of

vaccines

Proper arrangement of vaccines and/or

labelling of expiry dates are done to

identify those close to expiring.

Vaccine temperature is monitored twice a

day (early in the morning and in the

afternoon) in all health facilities and plotted

to monitor break in the cold chain.


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cold chain equipment

Each level of health facilities has foruse in the storage vaccines whichincluded

cold room, freezer, refrigerator, transport box, vaccine carriers,

thermometers, ice packs,

cold chain monitors

temperature monitoring chart

and safety collector boxes


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References

^Public Health Nursing in the Philippines. Manila,

Philippines: National League of Philippine

Government Nurses, Inc. 2007. p. 141.ISBN978-971-

91593-2-2.

^"Six Out of Ten Children 12 to 23 Months Are Fully

Immunized". Final Results from the 2002 Maternaland Child Health Survey(National Statistics Office).

2003-06-02. Retrieved 2007-05-11.

^ Puvacic, S.; Dizdarevi, J; Santi, Z; Mulaomerovi,

M (2004-02). "Protective effect of neonatal BCGvaccines against tuberculous meningitis". Bosnian

Journal of Basic Medical Sciences4 (1): 46

9. PMID15628980.
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References

^"Immunisation". Dialogue on Diarrhoea Online (30): 16. 1987.

Retrieved 2007-05-11.

^ Centers for Disease Control and Prevention (2001-10-12). "Public

Health Dispatch: Acute Flaccid Paralysis Associated with Circulating

Vaccine-Derived Poliovirus --- Philippines, 2001". Morbidity and

Mortality Weekly Report50 (40): 8745. PMID11666115. Retrieved2007-05-11.

^ Ni, Y. H.; M.H. Chang, L.M. Huang, H.L. Chen, H.Y. Hsu, T.Y. Chiu,

K.S. Tsai, and D.S. Chen (2001-11-06). "Effects of Universal

Vaccination for Hepatitis B".Annals of Internal Medicine135 (9): 796

800. PMID11694104. Retrieved 2007-05-12.

^"A Look at Each Vaccine: Hepatitis B Vaccine". Vaccine Education

Center. The Children's Hospital of Philadelphia. Archived from the

original on 2007-06-29. Retrieved 2007-05-11.
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References

^ Chang, MH; C.J. Chen, M.S. Lai, H.M. Hsu, T.C.

Wu, M.S. Kong, D.C. Liang, W.Y. Shau, D.S. Chen

(1997-06-26). "Universal hepatitis B vaccination in

Taiwan and the incidence of hepatocellular carcinoma

in children. Taiwan Childhood Hepatoma StudyGroup". The New England Journal of

Medicine336 (26): 1855

1859. doi:10.1056/NEJM199706263362602. PMID91

97213. ^ Salazar, Tessa R. (2004-05-24). "Cancer

Preventable Says US Doctor" (PDF). The Philippine

Daily Inquirer. Archived from the original on 2007-02-

21. Retrieved 2007-05-11.
http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://en.wikipedia.org/wiki/Digital_object_identifierhttp://dx.doi.org/10.1056/NEJM199706263362602http://en.wikipedia.org/wiki/PubMed_Identifierhttp://www.ncbi.nlm.nih.gov/pubmed/9197213http://www.ncbi.nlm.nih.gov/pubmed/9197213http://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://web.archive.org/web/20070221195427/http:/liver.stanford.edu/files/040529manilla_times.pdfhttp://web.archive.org/web/20070221195427/http:/liver.stanford.edu/files/040529manilla_times.pdfhttp://liver.stanford.edu/files/040529manilla_times.pdfhttp://liver.stanford.edu/files/040529manilla_times.pdfhttp://web.archive.org/web/20070221195427/http:/liver.stanford.edu/files/040529manilla_times.pdfhttp://web.archive.org/web/20070221195427/http:/liver.stanford.edu/files/040529manilla_times.pdfhttp://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)http://www.ncbi.nlm.nih.gov/pubmed/9197213http://www.ncbi.nlm.nih.gov/pubmed/9197213http://en.wikipedia.org/wiki/PubMed_Identifierhttp://dx.doi.org/10.1056/NEJM199706263362602http://en.wikipedia.org/wiki/Digital_object_identifierhttp://en.wikipedia.org/wiki/Expanded_Program_on_Immunization_(Philippines)


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References

^ Orenstein, WA; L.E. Markowitz, W.L.

Atkinson, A.R. Hinman (1994-05). "Worldwide

measles prevention". Israel Journal of Medical

Sciences30 (56): 46981. PMID8034506. ^"Measles (Catch Up Campaigns) - Toolkit

for Volunteers". Health Initiative 2010. African

Red Cross & Red Crescent. Archived fromthe

original on 2007-04-15. Retrieved 2007-05-12.

^ Zimmerman, Richard Kent (2000-01-

01). "Practice Guidelines - The 2000Harmonized Immunization
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References

^"Management of the Traveler: Vaccination". Travel Medicine.

Portal de Sade Pblica. 1997. Retrieved 2007-05-12.

^"General Recommendations on

Immunizations" (PDF). Epidemiology & Prevention of Vaccine-

Preventable Diseases--The Pink Book 10th Edition. Centers for

Disease Control and Prevention. 2007-02-14. Retrieved 2007-

05-12.

^ Department of Vaccines and Biologicals (2000-12). "WHO

Recommendations for Diluents" (PDF). Vaccines and Biologicals

Update(World Health Organization): pp. 3. Retrieved 2007-05-

12.

^ Hoekstra, Edward. "Immunization: Injection Safety". UNICEF

Expert Opinion (UNICEF). Retrieved 2007-05-12.
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References

^"Tetanus - The Disease". Immunization, Vaccines and

Biologicals. World Health Organization. Retrieved 2007-05-12.

^"Maternal and Neonatal Tetanus" (PDF). UNICEF. 2000-11.


^"Temperature Sensitivity of Vaccines" (PDF). Immunization,Vaccines and Biologicals (World Health Organization). 2006-08.


^"Handle Vaccines with Care". British Columbia Center for

Disease Control. Archived from the original on 2007-10-07.

Retrieved 2007-05-12. ^Expanded Program on Immunization Manual. Manila,

Philippines: Department of Health, Philippines. 1995.
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