Epi program (blood)

EXPANDED PROGRAM ON

IMMUNIZATION (EPI)PAKISTAN

By

Dr. Syed Sanowar AliAssociate Professor

Department of Community Health Sciences United Medical Dental College

IMMUNITYIt is the Defense mechanism of the body. Protection from an infectious disease. If you are immune to a disease, you can be exposed to it without becoming infected Vaccine: A product that stimulates a person’s immune system to produce immunity to a specific disease, protecting the person from that disease.

Immunization: A process by which a person becomes protected against a disease through vaccination. Active Immunity: When dead or live attenuated antigen is given to body to produce antibodies.Passive Immunity: When already prepared antibodies are given to body

Vaccination: The act of introducing a vaccine into the body to produce immunity to a specific disease.

Active ImmunityImmunity developed after contacting pathogens inside the body

Artificial Immunity

Passive Immunity

Natural Immunitye.g. Injection of attenuated live / killed organism or toxoide.g. Infection

Natural Immunity Artificial Immunitye.g. Injection of antibodies or antitoxin

e.g. Antibodies from mother

Immunity provided by antibodies or antitoxins provided from outside the body

PASSIVE IMMUNIZATIONACTIVE IMMUNIZATION

IMMUNIZATIONOR

VACCINATIONVaccination: The act of introducing a vaccine into the body to produce immunity to a specific disease.

Immunization: A process by which a person becomes protected against a disease through vaccination.

In EPI program ONLY

ACTIVE IMMUNIZATION

is done

EPI Global EPI Launched By WHO in MAY 1974. With Objective Of Reducing to a negligible level morbidity &

Mortality from Diphtheria, Pertusis, Tetanus, Poliomyelitis, TB & Measles to make immunization against these disease available to every child in the world by 1997.

Pakistan Started Its EPI programme in June-July 1978 with help of WHO & UNICEF.

Hep B Was also Inducted In Pakistan EPI in August 2002. Then HiB & Pneumococcal Vaccines

1. LIVE VACCINES2. DEAD VACCINES3. TOXOIDS4. Others

VACCINES

Route of Administration - Vaccines

Intra-Muscular(90°angle)

Sub-Cutaneous(45°angle)

Intra-Dermal(15 -20°angle)

Oral

2. Female Immunization

EPI program has two parts1. Child Immunization

1. CHILD IMMUNIZATION

EPI Vaccination Schedule Age Vaccines to

be givenDose Form Site Route of

AdministrationAt Birth BCG

OPV00.05 ml Powdered Deltoid

(Rt. Arm)Intra-Dermal

OralAt 6

WeeksPENTA1 (DPT1 + HBV1 + HiB1)

OPV10.5 ml Liquid Ant. Lat.

Lt. ThighIntra-Muscular

OralPCV1 0.5 ml Liquid Rt. Thigh Intra-Muscular

At 10 Weeks

PENTA2 (DPT2 + HBV2 + HiB2)



Oral

PCV2 0.5 ml Liquid Rt. Thigh Intra-Muscular

At 14 Weeks

PENTA3 (DPT3 + HBV3 + HiB3)



Oral

PCV3 0.5 ml Liquid Rt. Thigh Intra-Muscular

At 9 Months

Measles 0.5 ml Powdered Deltoid(Lt. Arm)

Sub- Cutaneous

At 15 Months

(Booster)

Measles 0.5 ml Powdered Deltoid(Lt. Arm)

Sub- Cutaneous

EPI Vaccination Schedule Vaccine BCG - (Live vaccine)BCG Bacillus Calmette –Guérin

Against Disease Tuberculosis

Ideal age(only one dose)

At Birth(within 1 week)

Dose 0.05 mlForm Powdered

Site Deltoid muscle (Rt. Arm)

Route of Administration

Intra-Dermal

Side Effect Rare – Scar after 3-6 months Immunity Achieved 80% against Pulmonary TB

100% against Tuberculous Meningitis (TBM)

Important : Instruction to mother about Scar

EPI Vaccination Schedule Vaccine OPV - (Live vaccine)OPV Oral Polio Vaccine

Against Disease Poliomyelitis

Ideal age (four doses) At Birth OPV0(within 1 week), 6 (OPV1),10 (OPV2) & 14 (OPV3) weeks

Dose Two drops

Form Liquid

Site Mouth

Route of Administration Orally

Side Effect No

Immunity Achieved 70% in Developing countries100% in Developed countries

EPI Vaccination Schedule Vaccine PENTA PENTA D + P+ T + HBV + HiB

(Toxoid-D&T, Dead-P& others HBV & HiB)

Against Disease Diphtheria, Pertussis, Tetanus, Hepatitis B & Haemophilus Influenza type B

Ideal age (three doses)

6 (Penta1),10 (Penta2) & 14 (Penta3) weeks

Dose 0.5 ml

Form Powdered

Site Anterio-Lateral site – Mid Left Thigh


Intra-Muscular

Side Effect Fever, tenderness injection site & Rarely fits

Immunity Achieved 95 – 98 %

EPI Vaccination Schedule Vaccine PCV

(other method)PCV Pneumococcal Vaccine

Against Disease Due to Pneumococcal bacteria (Pneumonia, Meningitis etc.)

Ideal age (three doses)

6 (PCV1),10 (PCV2) & 14 (PCV3) weeks

Dose 0.5 ml

Form LiquidSite Anterio-Lateral site – Mid Right Thigh


Intra-Muscular

Side Effect Generally No

Immunity Achieved 95 - 98%

EPI Vaccination Schedule Vaccine Measles (Live Vaccine)Against Disease Measles

Ideal age (two doses) At 9 months & 15 months (Booster)

Dose 0.5 ml

Form Powdered

Site Deltoid muscle (Lt. Arm)


Sub- Cutaneous


Immunity Achieved 95 - 98%

2. FEMALE IMMUNIZATION

EPI Vaccination Schedule

Vaccine TTTT Tetanus Toxoid

Against Disease Tetanus

Ideal age (five doses) According to schedule

Dose 0.5 ml

Form Liquid

Site Deltoid muscle – Left Arm


Intra-Muscular


Immunity Achieved 100%

Vaccination Schedule for Females 15- 45 years (Child Bearing Age - CBA)

Tetanus Toxoid

TT1 TT2 TT3TT4 TT5

Intra-Muscular

At 1st Contact as early as possible

OR during 7th months of Pregnancy

At least 4 Weeks

after TT1

At least 6-12 Months after TT2

At least 1 year after

TT3

At least 1 year after

TT4

Immunity Achieved

No 3 years 5 years 10 years 20 years OR Live long

Contraindications General Contraindications

Acute Illness esp. High grade fever Individual Vaccines

Whooping Cough (Pertussis) Appearance of Neurological Symptoms

But generally there is No absolute Contraindications

THANK YOU!!!!!!!

Epi program (blood)

Health & Medicine

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