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Expanded Program for Immunization

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					Expanded Program for Immunization (EPI)
Principles of EPI include: 1. Epidemiological situation 2. Mass approach 3. Basic Health Service

The 7 Immunizable Diseases are: 1. Tuberculosis 2. Diphtheria 3. Pertussis 4. Measles 5. Poliomyelitis 6. Tetanus 7. Hepatitis B ADMINISTRATION OF VACCINES Number of Content Form & Dosage Doses Freeze dried; Live attenuated Infant – 0.05 ml 1 bacteria Pre-school – 0.1 ml DT- weakened toxin; Liquid – 0.5 ml 3 P-killed bacteria Weakened virus Liquid – 2 drops 3 Plasma derivative Liquid – 0.5 ml 3 Freeze dried – Weakened virus 1 0.5ml

Vaccine BCG DPT OPV Hepa B Measles

Route ID IM Oral IM SQ

SCHEDULE OF VACCINES Vaccine Age at 1st dose Interval between Dose Protection

BCG

At birth

DPT

6 weeks

4 weeks

DPT

OPV

6 weeks

4 weeks At birth, 6th week, 14th week

Poliomyelitis

Hepa B

At birth

Hepa B

Measles

9 mos. – 11 mos.

Measles

    

6 months – earliest dose of measles given in case of outbreak 9 months-11 months – regular schedule of measles vaccine 15 months – latest dose of measles given 4-5 years old – catch up dose Fully Immunized Child (FIC) – less than 12 months old child with complete immunizations of DPT, OPV, BCG, anti-Hepatitis and antiMeasles

Vaccine

Minimum Age Interval

% Protected 0%

Duration of Protection 0

TT1

As early as possible

TT2

4 weeks later

80%

3 years

TT3

6 months later 1 year later or during next pregnancy 1 year later or third pregnancy

95%

5 years

TT4

99%

10 years

TT5

99%

Lifetime





There is no contraindication to immunization except when the child is immunosuppressed or is very, very ill (but not slight fever or cold). Or if the child experienced convulsions after a DPT or measles vaccine, report such to the doctor immediately. Malnutrition is not a contraindication for immunizing children rather; it is an indication for immunization since common childhood diseases are often severe to malnourished children.

Cold Chain under EPI: Cold Chain is a system used to maintain potency of a vaccine from that of manufacture to the time it is given to child or pregnant woman. The allowable timeframes for the storage of vaccines at different levels are:    6 months – Regional Level 3 months – Provincial Level or District Level 1 month – main health centers with refrigerator

Not more than 5 days – health centers using transport boxes. Most sensitive to heat: Freezer (-15 to -25 degrees C)  OPV  Measles Sensitive to heat and freezing: Body of Refrigerator (+2 to +8 degrees C)  BCG  DPT  Hepa B  TT  Use those that expire first, mark “X” or exposure, 3rd – discard.  Transport – use cold bags; let it stand in room temperature for a while before storing DPT.  Half life packs: 4 hours – BCG, DPT, Polio; 8 hours – Measles, TT, Hepa B.  FEFO (“first expiry and first out”) – vaccine is practiced to assure that all vaccines are utilized before the expiry date.  Proper arrangement of vaccines and/or labeling of vaccines expiry date are done to identify those near to expire vaccines.


				
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posted:6/27/2009
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