Expended 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. Diptheria 3. Pertussis 4. Measles 5. Poliomyelitis 6. Tetanus 7. Hepatitis B Administration of vaccines: Vaccine Content BCG Live attenuated bacteria DPT OPV Hepa B Measles

Form & Dosage # of Doses Freeze dried infant1 0.05ml Preschool-0.1ml DT- weakened toxin liquid-0.5ml 3 P-killed bacteria weakened virus liquid-2drops 3 Plasma derivative Liquid-0.5ml 3 Weakened virus Freeze dried- 0.5ml 1 Interval between dose 4 weeks 4weeks @birth,6th week,14thweek

Route ID IM Oral IM Subcutaneous Protection DPT Poliomyelitis HepaB measles

Schedule of Vaccines: Vaccine Age at 1st dose BCG At birth DPT 6 weeks OPV 6weeks Hepa B @ birth Measles 9m0s.-11m0s.

6 months earliest dose of measles given in case of outbreak 9months-11months- 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, Anti measles. Vaccine TT1 TT2 TT3 TT4 Minimum age interval As early as possible 4 weeks later 6 months later 1year later/during next pregnany % protected 0% 80% 95% 99% Duration of Protection 0 3 years 5 years 10 years

TT5

1 year later/third pregnancy

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: o 6months- Regional Level o 3months- Provincial Level/District Level o 1month-main health centers-with ref. o Not more than 5days- Health centers using transport boxes. Most sensitive to heat: Freezer (-15 to -25 degrees C) o OPV o Measles Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celcius) o BCG o DPT o Hepa B o TT Use those that will expire first, mark X/ exposure, 3rd- discard, Transport-use cold bags, let it stand in room temperature for a while before storing DPT. Half life packs: 4hours-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.