Expanded programs on Immunization Flashcards by maria ru

organizational component of DOH charged
with preventing disease, disability, and death
from vaccine-preventable diseases in children
and adults.

National immunization program (NPI)

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what is immunization?

through vaccine you introduces an antigen, and antigen produces antibody, to identify and neutralize harmful substances

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when is the launch of EPI?

1976

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decrease morbidity & mortality among
infants & children caused by 6 Immunizable diseases

Original objectives of EPI

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EPI Principles

The program is based on
epidemiological situation;
schedules are drawn on the basis
of the ___________ and
_____________of epidemiological
features of the disease.

occurrence and characteristics

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EPI Principles

The whole ___________ rather than just the
individual is to be protected, thus mass
approach is utilized.

community

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EPI Principles

Immunization is a basic health service &
integrated into the health services being
provided for by the ___________

RHU

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to reduce the morbidity and mortality among children against the most common vaccine preventable diseases

overall goal

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Children should be injected with tetanus

Never

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Importance of immunization

induce immunity

promote health

protect from diseases

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strategies:

Conduct of Routine Immunization for
Infants/Children/Women through
the _____________

Reaching Every Barangay (REB)
strategy

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Strategies:

Procurement of adequate and ___________ and __________and ___________to all
health facilities nationwide

potent vaccines and needles and syringes

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Strategies:

Strengthening Vaccine-Preventable
Diseases ___________

Surveillance

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Target age group of EPI

infants, children below 5 years old, women

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Mandatory Infants and
Children Health Immunization Act of 2011

Republic Act No. 10152

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Republic Act No. 10152- Mandatory Infants and
Children Health Immunization Act of 2011

Basic immunization for children under 5 including
other types that will be determined by the___________

secretary of health

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Cold Chain Logistic
Management

Daily record> monthly report> analysis> annual statistics and estimates> request for supply> manufacturer> airport> DOH> LGU> Health Care Center> Vaccination Mother and Child

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At RITM and Region there is __________

walk in cooler, walk in freezer, iced line

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At the Province and City Health Vaccine Room there is
__________

transport boxes, Deep freezer(DF) 300 liter, Iced Line Refrigerator (ILR) 300, Vaccine Box

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Guidelines of Cold Chain
Management

All vaccine refrigerators or freezers
shall be used exclusively for __________

EPI vaccines

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Guidelines of Cold Chain
Management

Vaccines are stored according to the
__________ requirement for each antigen

temperature

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Guidelines of Cold Chain
Management

Regular temp. __________

monitoring

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Guidelines of Cold Chain
Management

__________ plan for emergency measures

contingency

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vaccine most sensitive to heat

oral polio, measles, MMR

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storage temperature of vaccines most sensitive to heat

-15 to -25 C

Storage temperature of least sensitive to heat

+2 to +8 C

vaccines least sensitive to heat

pentavalent, BCG, Tetanus Toxoid, PCV-13, IPV, Rotavirus and HPV

combination refrigerator/freezer unit

-group vaccines by type -keep vaccine 2-3 inches aways from walls and other boxes -post do not unplug stickers on electrical outlet, plug in one unit per outlet -place thermometer probe in the center -no vaccines in door, fill space with frozen packs -no vaccines on top shelf -no vaccines in drawers or on floor of refrigerator , fill space with cold packs or water jugs

Multi-dose liquid vaccines(OPV, DPT, TT, and Hepatitis B) may be used in the next immunization sessions for up to maximum of ____________, provided that all the conditions are met

4 weeks

following conditions should be met for vaccine to be used in the next immunization

-expiry date has not passed -the vaccine has not been contaminated -the vials have been stored under appropriate cold chain conditions -the vaccine vial septum has not been submerged in water -the vaccine vial monitor on the vial, if attached, has not reached the discard point

vaccine vial monitor stage: the inner square is lighter than the outer circle, if the expiry date has not passed, USE THE VACCINE

vaccine vial monitor stage: as the time passes the inner square is still lighter than the outer circle. If the expiry date has not passed. USED THE VACCINE

vaccine vial monitor stage: DISCARD POINT: the color of the inner square matches that of the outer circle, DO NOT USE THE VACCINE

vaccine vial monitor stage: Beyond the discard point. the color of the inner square is darker that the inner circle.

All opened vials of any vaccine must be __________ if sterile procedures have not been followed.

discarded

Freeze-dried vaccines, such as ____________ vaccines should be discarded after __________ reconstitution or at the end of the immunization session.

AMV & BCG, 6 hours

If the_________ of the vaccine is ___________, the vial/s should be thrown away.

potency, questionable

Compulsory basic immunization for infants and children below 8 y/o

Presidential Decree No.996

Implementing a United Nations goal on Universal Child Immunization by 1990

Presidential Proclamation No.6

Reaffirming the commitment of the Phil. to the Universal Child and Mother Immunization goal of the World Health Assembly

Presidential Proclamation No.46

Compulsory immunization against Hepa B for infants and children below 8 y/o

Republic Act 7846

Policies on the Nationwide Implementation of EPI

DOH Administrative Order No. 39 s. 2003

Implementing Guidelines on Hepatitis B Immunization for Infant

DOH Administrative Order No. 2006 - 0015

Providing for mandatory basic immunization services for infants and children up to five years old

Republic Act No. 10152

Administration of Rotavirus Vaccine for Infants

DOH Memorandum No. 2012-0153

Administration of Pneumococcal Conjugate Vaccine-13 (PCV 13)

DOH Memorandum No. 2014-0155

Administration of Inactivated Poliomyelitis Vaccine

DOH Memorandum No. 2015-0164

Guidelines in the Implementation of School-Based Immunization

DOH Memorandum No. 2015-0146

Administration of Rotavirus Vaccine for Infant

DOH Memorandum No. 2012 – 0153

Routine Schedule of Immunization Wednesday

designated as immunization day

Routine Schedule of Immunization BHS

monthly

Routine Schedule of Immunization Far flung areas

quarterly

childhood immunizable diseases

1. Tuberculosis (primary complex if less than 3 years old) 2. Diptheria 3. Pertussis 4. Neonatal Tetanus 5. Poliomyelitis 6. Hepatitis 7. Measles 8. Mumps 9. Rubella 10. Meningitis 11. Pneumonia 12. Diarrhea

Safe & immunologically effective to administer all EPI vaccines on the _________ at ___________of the body.

same day at different sites

Measles vaccine should be given as soon as the child is __________ old

9 months

Vaccination schedule should not be _____________ from the beginning

restarted

Vaccine should be given with the recommended ____________ interval

4 weeks

Strictly follow principle of never, ever reconstituting the freeze dried vaccine in anything other than the ___________ supplied with them

diluent

what are the False contraindications to immunization

low grade fever malnutrition mild respiratory infections diarrhea other minor illnesses

Repeat _________vaccination if the child does not develop a __________ after the first injection

BCG, scar

Generally, one should immunize unless the child is so sick that he needs to be ___________

hospitalized

what are the absolute contraindications to immunization

Severe hypersensitivity reaction to previous dose of vaccine sign and symptoms of severe dehydration Fever of 38.5 C and above

Absolute contraindications to DPT vaccine

-over 5y/o -convulsion or shock w/in 3 days of the most recent dose -active neurological disease

Absolute contraindications to BCG vaccine

with AIDS or other immune deficiency diseases - immunosuppressed - therapy with immunosuppressive agents or irradiation - after 1 y/o

Absolute contraindications to IPV

allergic reaction (anaphylaxis) to a previous dose temp. ≥ 39°C

Absolute contraindications to PCV 13

-allergic reaction (anaphylaxis) to a previous dose including diphtheria toxoid temp. ≥ 39°C

Absolute contraindications to rotavirus vaccine

-History of intussusceptions or intestinal malformations, predisposition to intussusceptions -ongoing acute gastroenteritis or serious febrile illness

Low birth wt. or prematurity are not contraindications to ___________vaccination

hepatitis B

Safe & effective with __________side effects after vaccination

mild

Doses of a vaccine less than the recommended _________ interval may lessen the antibody response

4 weeks

No __________ doses must be given to children/mother who missed a dose of DPT/OPV/TT/ Hepatitis B

extra

how many doses of tetanus toxoid with dipteria, recommended time of administration, duration of protection

Td1= Anytime during Pregnancy Td2 =1 month after dose 1= 3 years Td3 =6 months after dose 2 =5 years Td4 =1 year after dose 3 =10 years Td5= 1 year after dose 4= lifetime

Tetanus Diphtheria Immunization dose, site, and method

o.5ml, upper outer part, IM

<1/10,000

Very rare

1/1,000 & <1/100

Uncommon

>1/100

common

>1/10

very common

>1/10,000 & <1/1,000

rare

Vaccine Adverse Reactions OPV

Recipient Vaccine Associated Paralytic Polio (VAPP)-very rare

Vaccine Adverse Reactions IPV

Injection site erythema Injection site induration Injection site tenderness

Vaccine Adverse Reactions PCV

Fever >39°C Injection site reaction

Vaccine Adverse Reactions DPT

fever 100.1°F-102°F Injection site redness Swelling Pain Fussiness Drowsiness Anorexia Vomiting Persistent screaming Hypotonic hyporesponsive reaction Seizure Encephalopathy

Vaccine Adverse Reactions Hib

Fever Injection site reaction

Vaccine Adverse Reactions Hep B

Fever Headache Injection site pain Injection site redness Injection site swelling Anaphylaxis

Vaccine Adverse Reactions Rotavirus

Vomiting Diarrhea Irritability Fever

Vaccine Adverse Reactions Tetanus Toxoid

Pain Redness Swelling for a few days at the site of the injection

Vaccine Adverse Reactions Measles

Fever Rash

Wheal raised >small tender swelling abt. 10 mm (after 2wks.)> after 2-3 weeks swelling become small abscess w/c ulcerates > ulcer heals & leaves a scar (12 wks.)

Vaccine Adverse Reactions BCG

Acute inflammatory reaction 2-4 days of vaccination Koch's Phenomenon

BCG

ulcer w/c persists after 12 wks. or ulcer more than 10mm deep

Indolent ulceration, BCG adverse reaction

BCG Deep abscess at vaccination - refer to the physician for _________ Do not ____________ the area of injection. A scar will form ____________ after injection.

incision and drainage massage 12 weeks

MMR If the child has fever give ______________ or any appropriate antipyretic every __________ after immunization

paracetamol, q4h

Rotavirus Reassure parents and instruct them to give ____________ to the child.

antipyretic

DPT If the child has fever give paracetamol or any appropriate antipyretic every four hours after immunization. cold compress for ___________ for pain and soreness.

24 hours

OPV ___________ 30 minutes before and after OPV Do not touch the _____________ bottle to the tongue

NPO dropper

Measles Vaccine If the child has ___________give paracetamol or any appropriate antipyretic every four hours after immunization cold compress for 24 hours for ____________

fever pain and soreness

Tetanus Toxoid No __________ for pregnant For pain _________ compress 24 hours

medication cold

Infants who received one dose of BCG, three doses each of OPV, DPT, and Hepatitis B vaccines, and one dose of measles vaccine before reaching one year of age.

Fully Immunized Children

RITM means

Research institute for tropical medicine

what are they doing in RITM?

Biologicals production facilities Vaccine storage

RITM Vaccine storage

Storage and Distribution Department receives, rejects, quarantines, stores raw materials for vaccine production, and distributes local and imported vaccines

PITM biological production facilities

Purified Cobra Anti Venom BCG

Storage, Handling and Disposal of vaccines

unsafe storage spoiled vaccine prefilled vaccine

MCV (Measles-containing vaccine) Td (Tetanus-diphtheria) MR (Measles-Rubella) vaccines All school children enrolled in Grade _ & _

1 & 7

measles vaccination history if evidences show either zero or only 1 dose to ensure that these students received at least __ MCV by school entry

Students enrolled in grade 7 regardless of age shall be vaccinated w/ __ dose each of MR and Td vaccines on the _____ immunization session.

1, same

component strategy in the prevention of cervical cancer

Human Papillomavirus (HPV) Vaccine

All __ to __ years old female school children enrolled in Grade 4 shall be vaccinated w/ __ doses of quadrivalent HPV vaccine

9 to 13, 2

Dosage and Route of HPV

0.5 ml, IM, left deltoid arm

All students who received the first dose of HPV shall be given the second dose after ____________

6 months

Expanded programs on Immunization Flashcards

(112 cards)