EXPANDED PROGRAM ON IMMUNIZATION Flashcards

1
Q
  • Established in 1976
  • Legal Basis: Presidential Decree 996 (PD 996)
  • To ensure that infants/children and mothers have access to routinely recommended infant/childhood vaccines.
  • Six vaccine preventable diseases were initially included in the EPI: TB, poliomyelitis, diphtheria, tetanus, pertussis & measles
A

EXPANDED PROGRAM ON IMMUNIZATION

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2
Q
  • Compulsory Immunization against Hepatitis B
  • Provided for compulsory immunization against Hepatitis B for infants & children below 8 years old.
  • Provided for hepatitis B immunization within 24 hours after birth of babies of women with hepatitis B
A

REPUBLIC ACT OF 7846 (RA 7846)

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3
Q
  • National Immunization Program
  • Mandatory Infants and Children Health Immunization Act of 2011
  • Mandates basic immunization covering the vaccine-preventable diseases

Goals of the Program:
1. To immunize all infants/children against the most common vaccine-preventable diseases.
2. To sustain the polio-free status of the Philippines.
3. To eliminate measles infection.
4. To eliminate maternal and neonatal tetanus.
5. To control diphtheria, pertussis, hepatitis B, & German measles.
6. To prevent extrapulmonary TB among children.

A

REPUBLIC ACT OF 10152
(RA 10152)

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4
Q

Eligible Population

A

0 – 12 MONTHS (newborn/infants)

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5
Q

Principles

A
  1. Epidemiological Situation
  2. Mass Approach
  3. Basic Health Service
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6
Q
  • “weakened”
  • Very effective, provides lifelong protection in 1 or 2 shots.
  • Can’t give to weak immune system (like children with HIV infection)
    Vaccine:
  • Bacteria: Tuberculosis (BCG)
  • Virus: Oral Polio Vax., measles, Rotavirus, Yellow fever
    Ex.:
  • MMR vaccine (measles, mumps & rubella)
  • Anti-Measles Vaccine / Measles Containing Vaccine
  • Rotavirus
  • Smallpox
  • Chickenpox
A

Attenuated Vaccine - Live but altered (LAV)

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7
Q
  • Safer than LAV
  • Less effective than LAV
  • Not lifetime protection. Needs multiple doses over time
    Vaccine:
  • Bacteria: Whole-cell pertussis (wP)
  • Virus: Inactivated Polio Virus (IPV
    Ex.:
  • wP – whole cell Pertussis
  • IPV – inactivated polio vaccine
A

Inactivated Vaccine - Killed

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8
Q
  • Safe, can’t cause disease, no possibility of reversion to virulence
  • Require several doses, need adjuvant
    Vaccine:
  • Bacteria: Tetanus (TT)
  • Diphtheria toxoid
A

Toxoid Vaccine

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9
Q
  • Create response against the molecules in the pathogen’s capsule

Ex.:
- Haemophilus influenzae type b conjugate (Hib)
- Pneumococcal conjugate
- Hepatis B (HepB)
- Acellular pertussis (aP)
Org:
- Meningococcus
- Haemophilus influenzae type b (Hib)
- Pneumococcus

A

Conjugate subunit Vaccines

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10
Q

Tuberculosis

At birth, 0.05ml, ID, Right deltoid region (arm)

Live, attenuated bacteria

Freeze-dried, reconstituted w/ special diluent

A

BCG (Bacillus Calmette Guerin)

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11
Q

Diphtheria, Pertussis, Tetanus, Hepatitis B, Pneumonia, Meningitis

6, 10, 14 weeks, 0.5ml, IM, Anterolateral thigh muscle (Vastus Lateralis)

D - weakened vaccine
P - killed bacteria
T - weakened toxins

Diphtheria toxoid, inactivated pertussis bacteria, tetanus toxoid, recombinant DNA surface antigen, and synthetic conjugate of Haemophilus influenzae B bacilli

Liquid, clear

A

Pentavalent vaccine

DPT -HepB-Hib
(PENTAVALENT)
5-in-1 vaccine

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12
Q

At birth, 0.5ml, IM, Anterolateral thigh muscle (Vastus Lateralis)

Plasma derived
RNA-recombinant, using Hepatitis B surface antigen (HBs Ag)

Cloudy, liquid

A

Hepatitis B vaccine (Monovalent)

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13
Q

Poliomyelitis

6, 10, 14 weeks, 2 drops, Oral, Mouth

GI mucosal immunity
Live, attenuated virus (trivalent)

Clear, pinkish liquid

A

Oral polio vaccine

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14
Q

6, 10 weeks, 1.5ml, Oral, Mouth

Live, attenuated virus

Clear, colorless liquid, in a
container with an oral applicator

A

Rotavirus vaccine

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15
Q

Weakened toxin

Clear, colorless liquid; sometimes
slightly turbid.

A

Tetanus toxoid

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16
Q

9-11 months, 0.5ml, SUBCU, Outer part of the upper arm

Live, attenuated virus

Freeze-dried, reconstituted with a special diluent

A

Anti-measles vaccine
(AMV1)

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17
Q

12-15 months, 0.5ml, SUBCU, Outer part of the upper arm

Live, attenuated viruses

Freeze-dried, reconstituted with a special diluent

A

Measles-mumps-rubella vaccine (AMV2)

18
Q

Least sensitive to heat
Most sensitive to cold

A

Pentavalent
Hep B
Diphtheria Tetanus Toxoid

2°C to 8°C
Body of Fridge

8 hours if room temp

19
Q

Most sensitive to heat

A

OPV
- 15°C to -25°C
Freezer

20
Q

Nationwide Immunization Day

21
Q

Barangay Health Station

22
Q

Far Flung Area

23
Q

Some areas, to cover all targets

24
Q

If more than one injection has
to be given on the same limb

A

Injection sites should be 2.5-5cm apart (1in)

25
FIC - Given BCG, three doses of OPV, three doses of DPT and hepatitis B vaccine or three doses of Pentavalent vaccine, and one dose of anti-measles vaccine before reaching one year of age
Fully Immunized Child
26
CIC - Completed their immunization schedule at the age of 12-23 months
Completely Immunized Child
27
CPAB - two doses of TT during this pregnancy, provided that the second dose was given at least a month prior to delivery; or at least three doses of TT anytime prior to pregnancy with this child
Child Protected At Birth
28
Vaccines confer immunity only when they are potent To retain the potency vaccines must be properly stored, handled, and transported System for ensuring the potency of a vaccine from the time of manufacture to the time it is given to an eligible client. Cold Chain Officer
Cold Chain
29
Maintain Potency
Proper Vaccine Storage First Expiry, First Out (FEFO) Principle Vaccine Vial Monitor Shake Test Max.: 48 hours at Vaccine carriers 5 days at Transport box 4 weeks (28 days) - mulit-dose vaccines, if all conditions are met 1 month in the Fridge Fridge 12 inches from the wall
30
Body of Refrigerator Temp
2°C to 8°C AMV, MMR, Rota, HBV, 5-in-1, RV, TT (damaged by freezing) Diluents
31
Freezer Temp
-15°C to -25°C OPV
32
Temperature monitoring
Twice a day (2x) Upon opening Before closing
33
Protect
BCG from sunlight Rota virus from light
34
Poliomyelitis 14 weeks, 0.5ml, IM, Vastus Lateralis Serum immunity (blood) Clear, liquid
Inactivated Polio Vaccine (IPV)
35
Pneumonia Meningitis 6, 10, 14 weeks, (For 2-5 yo. give 1 dose), 0.5ml, IM, Vastus Lateralis Clear, liquid
Pneumococcal Conjugate Vaccine
36
Mumps, Measles, German Measles 9 months and 12-15 months, 0,5ml, SUBCU, Outer Arm Live-attenuated virus Freeze-dried with special diluent
Measles, Mumps, Rubella (MMR)
37
DT Dose 1
As early as possible 0% 0
38
Vaccines that have special diluent and should be discarded 6 hours after reconstitution or after clinic hours
BCG, AMV, MMR
39
DT Dose 2
4 weeks after 80% 3 years
40
DT Dose 3
6 months after DT2 95% 5 years
41
DT Dose 4
1 year after DT3 99% 10 years
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DT Dose 5
1 year after DT4 99% Lifetime