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					                   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.

				
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