EXPANDED PROGRAM ON IMMUNIZATION [EPI] The Expanded Program on Immunization was launched in July 1976 by the Department of Health in cooperation with the World Health Organization and the UNICEF. It aims to control the occurrence of preventable diseases especially of the children. Furthermore its original objective was to reduce the morbidity and mortality among infants and children caused by the six childhood immunizable diseases: Tuberculosis, Diptheria, Pertussis, Tetanus, Hepatitis B, and Measles [Polio can also be added]. EPI has different principles, as follows: 1. The program is based on epidemiological situation; schedules are drawn on the basis of the occurrence and characteristic epidemiological features of the disease. 2. The whole community rather than just the individual is to be protected, thus mass approached is utilized. 3. Immunization is a basic health service and such it is integrated in to the health services being provided for by the Rural Health Unit. EPI also has some elements – 1. Target setting 2. Cold chain logistic management 3. Information, Education and Communication 4. Assessment and evaluation of the program’s overall performance 5. Surveillance, studies and research Immunization Schedule This Routine Immunization Schedule for Infants must be used in order to provide maximal immunity to the seven EPI diseases before the child’s first birthday. Minimum Vaccine Minimum Number Interval Reasons Age at 1st of Dose Between Dose Doses 1. BCG Birth or any 1 BCG given at the earliest time after possible age protects birth against the possibility of infection from other family members 2. DPT 6 weeks 3 4 weeks An early start with DPT reduces the chance of severe pertussis 3. OPV 6 weeks 3 4 weeks The extent of protection against polio is increased the earlier OPV is given 4. Hepatitis B 6 weeks 3 4 weeks An early start of Hepa B reduces the chance of being infected and becoming a carrier 5. Measles 9 months 1 At least 80% of measles can be prevented by immunization at this age. Note: BCG immunization shall be given to all school entrants both in private and public school regardless of the presence or absence of BCG scar. In addition, there is also the Tetanus Toxoid Immunization Schedule for Women. Vaccine Minimum Age Percent Duration of Protection Interval Protected TT1 As early as possible during 80% pregnancy TT2 At least 4 weeks 80% Infants born to the mother later will be protected from neo- natal tetanus Gives 3 years protection for the mother TT3 At least 6 90% Infants born to the mother months later will be protected from neo- natal tetanus Gives 5 years protection for the mother TT4 At least 1 year 99% Infants born to the mother later will be protected from neo- natal tetanus Gives 10 years protection for the mother TT5 At least 1 year 99% Gives lifetime protection for later the mother All infants born to that mother will be protected Note: If the woman received DPT in infancy 3 or 3 doses of DPT during infancy, this should be considered as TT1 and TT2. Succeeding doses will be TT3 and so forth. Reference: Reyala, et.al. Community Health Nursing Services in the Philippines. Community Health Nursing Section, National League of Philippine Government Nurses, Inc., 2000. pp. 108-113.