Showing posts with label EPI. Show all posts
Showing posts with label EPI. Show all posts

Thursday, October 20, 2011

EPI



Expanded Program on Immunization (Philippines)

The Expanded Program on Immunization (EPI) in the Philippines began in July 1979. And, in 1986, made a response to the Universal Child Immunization goal. The four 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,
  4. Eliminating neonatal tetanus by 2008.

Routine Schedule of Immunization

Every Wednesday is designated as immunization day and is adopted in all parts of the country. Immunization is done monthly in barangay health stations, quarterly in remote areas of the country.


Routine Immunization Schedule for Infants

The standard routine immunization schedule for infants in the Philippines is adopted to provide maximum immunity against the seven vaccine preventable diseases in the country before the child's first birthday. The fully immunized child must have completed BCG 1, DPT 1, DPT 2, DPT 3, OPV 1, OPV 2, OPV 3, HB 1, HB 2, HB 3 and measles vaccines before the child is 12 months of age.
VaccineMinimum Age
at 1st Dose
Number
of Doses
DoseMinimum Interval Between DosesRouteSiteReason
Bacillus Calmette-Guérin
Birth or anytime after birth

1 dose

0.05 mL

none

Intradermal
Right deltoid region of the armBCG given at earliest possible age protects the possibility of TB meningitis and other TB infections in which infants are prone
Diphtheria-Pertussis-Tetanus Vaccine
3 weeks old

3 doses

0.5 mL

6 weeks(DPT 1), 10 weeks (DPT 2), 14 weeks (DPT 3)

Intramuscular
Upper outer portion of the thigh, Vastus Lateralis (L-R-L)An early start with DPT reduces the chance of severe pertussis.
Oral Polio Vaccine
6 weeks old

3 doses

2-3 drops

4 weeks

Oral
MouthThe extent of protection against polio is increased the earlier the OPV is given.
Keeps the Philippines polio-free.
Hepatitis B Vaccine
birth or anytime after birth

3 doses

0.5 mL

4 weeks interval

Intramuscular
Upper outer portion of the thigh, Vastus Lateralis (R-L-R)An early start of Hepatitis B vaccine reduces the chance of being infected and becoming a carrier.
Prevents liver cirrhosis and liver cancer which are more likely to develop if infected with Hepatitis B early in life.
About 9,000 die of complications of Hepatits B. 10% of Filipinos have Hepatitis B infection
Measles Vaccine
(not MMR)

9 months old

1 dose

0.5 mL

none

Subcutaneous
Upper outer portion of the arms, Right deltiodAt least 85% of measles can be prevented by immunization at this age.


General Principles in Infants/Children Immunization

  • Because measles kills, every 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.
  • 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.
  • Vaccine combinations (few exceptions), antibiotics, low-dose steroids (less than 20 mg per day), minor infections with low fever (below 38.5º 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.
  • 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.
  • Only the diluent supplied by the manufacturer should be used to reconstitute a freeze-dried 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.
  • 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.

vaccines: BCG

Since tuberculosis is common in the Philippines, the BCG (Bacillus Calmette-Guérin (or Bacille Calmette-Guérin)  is one of the immunizations given at birth or soon after birth among Filipino babies (and even to foreigners born on the Philippine shores at that).

This is also included in the government's EPI thus, is covered by the Philhealth on hospital deliveries.

Below is an information on this vaccine from the CDC.



Vaccines and Preventable Diseases:

Tuberculosis (TB) Vaccination

BCG is a vaccine for TB. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG vaccine does not always protect people from getting TB. If you were vaccinated with BCG, you may have a positive reaction to a TB skin test.  This reaction may be due to the BCG vaccine itself or due to infection with the TB bacteria. Your positive reaction is more likely to mean you have been infected with TB bacteria...More
Tb vaccination

vaccines: DPT

DPT or DTaP includes three vaccine preventable diseases (diphtheria, pertussis, tetanus) that are much common in the Philippines. Fortunately, This comes free in government health centers with the DOH program on EPI (Expanded Program in Immunization).

I had my baby get his shits on the DPT at our local barangay.
The downside is that this type causes fever for about 24 hours. So, paracetamol drops is a must.

The combination vaccine which they mostly refer to as 5 in 1 which includes polio (IPV) and HiB aside from the three mentioned above, and 6 in 1 which adds hepatitis B, allows lesser shots for the baby also, there will be no fever after.
This doesn't come free though nor does it come cheap. But for those with the extra budget and little time, why not??!


Anyway, these succeeding information are again from CDC as with the other vaccine related posts I've made.


Vaccines and Preventable Diseases:

Diphtheria Vaccination
Pronounced (dif-THEER-ee-a)

Diphtheria causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death. There are several combination vaccines used to prevent diphtheria: DTaP, Tdap, DT, and Td.
Diphtheria vaccination

Pertussis (Whooping Cough) Vaccination
Pronounced (per-TUS-iss)

Whooping cough — known medically as pertussis — is a highly contagious respiratory tract infection. Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants. Whooping cough is most contagious before the coughing starts. The best way to prevent it is through vaccinations. The childhood vaccine is called DTaP. The whooping cough booster vaccine for adolescents and adults is called Tdap. Both protect against whooping cough, tetanus, and diphtheria.
Pertussis vaccination

Tetanus (Lockjaw) Vaccination

Tetanus (lockjaw) is a serious disease that causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 in 10 cases. Several vaccines are used to prevent tetanus among children, adolescents, and adults including DTaP, Tdap, DT, and Td.
Tetanus vaccination

vaccines: hepatitis B

This is a series of three shots. It is advisable to start it soion after birth due to the prevalence of undiagnosed hepa B cases in the Philippines.
As such, hospitals now give it and fortunately, it is also covered by the government's PhilHealth.

This is also included in the EPI. So, succeeding shots at 1 month (2nd dose) and 6 months are available at the local health centers.
Make sure that the third dose is after 6 months of age, else, a fourth dose is required.
Also, a fourth dose is required when the baby was born prematurely (born less than 37 weeks AOG).

Vaccines and Preventable Diseases:

Hepatitis B Vaccination
Pronounced (hep-ah-TY-tiss)

Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. 


Hepatitis B vaccine is available for all age groups to prevent HBV infection.
Hepatitis B vaccination

vaccines: polio

This is also included in the government's EPI.

The Philippines gives the oral polio vaccine (OPV) for free alongside the schedule for the DPT shots.


Vaccines and Preventable Diseases:

Polio Vaccination
Pronounced [PO-lee-oh]

Polio is an infectious disease caused by a virus that lives in the throat and intestinal tract. It is most often spread through person-to-person contact with the stool of an infected person and may also be spread through oral/nasal secretions. Polio used to be very common in the United States and caused severe illness in thousands of people each year before polio vaccine was introduced in 1955. Most people infected with the polio virus have no symptoms; however, for the less than 1% who develop paralysis it may result in permanent disability and even death.


There are two types of vaccine that protect against polio: inactivated polio vaccine (IPV) and oral polio vaccine (OPV). IPV, used in the United States since 2000, is given as an injection in the leg or arm, depending on patient's age. Polio vaccine may be given at the same time as other vaccines. Most people should get polio vaccine when they are children. Children get 4 doses of IPV, at these ages: 2 months, 4 months, 6-18 months, and booster dose at 4-6 years. OPV has not been used in the United States since 2000 but is still used in many parts of the world.
Polio vaccination



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