The Expanded Program on Immunization (EPI) was established in July 1976 to ensure that infants/children and mothers have

access to routinely recommended infant/childhood vaccines. In 1986, it is made as a response to the Universal Child Immunization goal. Six vaccinepreventable diseases were initially included in the EPI: Tuberculosis Poliomyelitis Diphtheria Tetanus Pertussis Measles Program Objectives/Goals: Over-all Goal: To reduce the morbidity and mortality among children against the most common vaccine-preventable diseases. Specific Goals 1. To immunize all infants/children against the most common vaccine-preventable diseases. 2. To sustain the polio-free status of the Philippines. 3. To eliminate measles infection. 4. To eliminate maternal and neonatal tetanus 5. To control diphtheria, pertussis, hepatitis b and German measles. 6. To prevent extra pulmonary tuberculosis among children. Program four (4) major strategies include: 1. sustaining high routine Full Immunized Child (FIC) coverage of at least 90% in all provinces and cities; 2. sustaining the polio-free country for global certification; 3. eliminating measles by 2008; and 4. eliminating neonatal tetanus by 2008. Routine Schedule for Immunization Every Wednesday as immunization day and adopted in all parts of the country Done Monthly in Barangay Health Stations and quarterly in remote areas of the country

Minimum age at first dose: Number of doses : Interval between doses: Target disease:

Oral Polio Vaccine 6 weeks old 3 doses 4 weeks Poliomyelitis A viral disease that can affect nerves and can lead to partial or full paralysis. The polio virus enters the body through the mouth, usually from hands contaminated with the stool of an infected person.

Minimum age at first dose: Number of doses : Target disease:

Measles Vaccine 9 months old 1 dose Measles An infectious disease caused by a virus. It spreads easily from person to person. The main symptom of measles is an itchy skin rash. The rash often starts on the head and moves down the body

Minimum age at first dose: Number of doses : Interval between doses: Target disease:

Diphtheria-Pertussis-Tetanus Vaccine 6 weeks old 3 doses 6 weeks(DPT 1), 10 weeks (DPT 2), 14 weeks (DPT 3) Neonatal Tetanus A form of generalized tetanus that occurs in newborns. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument.

Minimum age at first dose: Number of doses : Interval between doses: Target disease:

Hepatitis B Vaccine at birth 3 doses 4 weeks interval Hepatitis B An infection is caused by the hepatitis B virus (HBV).It is obtained through contact with the blood or body fluids (such as semen, vaginal fluids, and saliva) of a person who has the virus.

Minimum age at first dose: Number of doses : Target disease:

Bacillus Calmette-Gurin Vaccine Birth or anytime after birth 1 dose Tuberculosis A bacterial infection that mainly affects the lungs. It spread through inhalation of tiny droplets from the coughs or sneezes of an infected person.

Bacillus Calmette-Gurin Vaccine Minimum age at first Birth or any time after birth dose: Number of doses : 1 dose Dose 0.05 mL

Minimum Interval Between Doses Route Site Reason and Target Disease

none Intradermal Right deltoid region of the arm Tuberculosis A bacterial infection that mainly affects the lungs. It spread through inhalation of tiny droplets from the coughs or sneezes of an infected person. BCG given at earliest possible age protects the possibility of TB meningitis and other TB infections in which infants are prone

Hepatitis B Vaccine Minimum age at first dose: Number of doses : Dose Minimum Interval Between Doses Route Site Reason and Target Disease

at birth 3 doses 0.5 mL 4 weeks interval Intramascular Upper outer portion of the thigh, Vastus Lateralis (R-L-R) Hepatitis B An infection is caused by the hepatitis B virus (HBV).It is obtained through contact with the blood or body fluids (such as semen, vaginal fluids, and saliva) of a person who has the virus. An early start of Hepatitis B vaccine reduces the chance of being infected and becoming a carrier.[6] Prevents liver cirrhosis and liver cancer which are more likely to develop if infected with Hepatitis B early in life.[7][8] About 9,000 died of complications of Hepatitis B. 10% of Filipinos have Hepatitis B infection

Diphtheria-Pertussis-Tetanus Vaccine Minimum age at first 6 weeks old dose: Number of doses : 3 doses Dose 0.5 mL Minimum Interval 6 weeks(DPT 1), 10 weeks (DPT 2), 14 weeks (DPT 3) Between Doses Route Intramascular Site Upper outer portion of the thigh, Vastus Lateralis (R-L-R) Reason and Target Neonatal Tetanus Disease A form of generalized tetanus that occurs in newborns. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument.

An early start with DPT reduces the chance of severe pertussis.

Measles Vaccine (not MMR) Minimum age at first 9 months old

dose: Number of doses : Dose Minimum Interval Between Doses Route Site Reason and Target Disease

1 dose 0.5 mL none Subcutaneous Upper outer portion of the arms, Right deltiod Measles An infectious disease caused by a virus. It spreads easily from person to person. The main symptom of measles is an itchy skin rash. The rash often starts on the head and moves down the body At least 85% of measles can be prevented by immunization at this age. occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument.

Oral Polio Vaccine Minimum age at first dose: Number of doses : Dose Minimum Interval Between Doses Route Site Reason and Target Disease

6 weeks old 3 doses 2-3 drops 4 weeks Oral Mouth Poliomyelitis A viral disease that can affect nerves and can lead to partial or full paralysis. The polio virus enters the body through the mouth, usually from hands contaminated with the stool of an infected person. The extent of protection against polio is increased the earlier the OPV is given. Keeps the Philippines polio-free.

General Principle (Things to Remember) in Infants/Children Immunization 1) Measles Vaccine is IMPORTANT! Infant needs to be vaccinated against measles at the age of 9 months or as soon as possible after 9 months as part of the routine infant vaccination schedule. It is safe to vaccinate a sick child who is suffering from a minor illness (cough, cold, diarrhea, fever or malnutrition) or who has already been vaccinated against measles. 2) Dont worry if vaccination is INTERRUPTED! If the vaccination schedule is interrupted, it is not necessary to restart. Instead, the schedule should be resumed using minimal intervals between doses to catch up as quickly as possible. 3) There are VACCINE COMBINATIONS! Vaccine combinations (few exceptions), antibiotics, low-dose steroids (less than 20 mg per day), minor infections with low fever (below 38.5 Celsius), diarrhea, malnutrition, kidney or liver disease, heart or lung disease, non-progressive encephalopathy, well controlled epilepsy or advanced age, are not contraindications to vaccination. Contrary to what the majority of doctors may think, vaccines against hepatitis B and tetanus can be applied in any period of the pregnancy. 4) There are FEW CONTRAINDICATIONS!

There are very few true contraindication and precaution conditions. Only two of these conditions are generally considered to be permanent: severe (anaphylactic) allergic reaction to a vaccine component or following a prior dose of a vaccine, and encephalopathy not due to another identifiable cause occurring within 7 days of pertussis vaccination. 5) Reconstitute a freeze-dried vaccine in PROPER WAY! Only the diluent supplied by the manufacturer should be used to reconstitute a freezedried vaccine. A sterile needle and sterile syringe must be used for each vial for adding the diluent to the powder in a single vial or ampoule of freeze-dried vaccine.[15] 6) Always USE STERILE SYRINGE and NEEDLE! The only way to be completely safe from exposure to blood-borne diseases from injections, particularly hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) is to use one sterile needle, one sterile syringe for each child. BIBLIOGRAPHY ^ Public Health Nursing in the Philippines. Manila, Philippines: National League of Philippine Government Nurses, Inc. 2007. p. 141. ISBN 978-971-91593-2-2. ^ "General Recommendations on Immunizations" (PDF). Epidemiology & Prevention of VaccinePreventable Diseases--The Pink Book 10th Edition. Centers for Disease Control and Prevention. 2007-02-14. Retrieved 2007-05-12. Expanded Program on Immunization Manual. Manila, Philippines: Department of Health, Philippines. 1995.