Expended Program for Immunization (EPI)

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by: shelz, nursing crib moderator

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	Form & Dosage	# of Doses	Route
BCG	Live attenuated bacteria	Freeze dried infant- 0.05ml Preschool-0.1ml	1	ID
DPT	DT- weakened toxin P-killed bacteria	liquid-0.5ml	3	IM
OPV	weakened virus	liquid-2drops	3	Oral
Hepa B	Plasma derivative	Liquid-0.5ml	3	IM
Measles	Weakened virus	Freeze dried- 0.5ml	1	Subcutaneous

 

Schedule of Vaccines:

Vaccine	Age at 1st dose	Interval between dose	Protection
BCG	At birth
DPT	6 weeks	4 weeks	DPT
OPV	6weeks	4weeks	Poliomyelitis
Hepa B	@ birth	@birth,6th week,14th week	HepaB
Measles	9m0s.-11m0s.		measles

 

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	Minimum age interval	% protected	Duration of Protection
TT1	As early as possible	0%	0
TT2	4 weeks later	80%	3 years
TT3	6 months later	95%	5 years
TT4	1year later/during next pregnany	99%	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:

Ø      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.

Ø      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.

Ø      Most sensitive to heat: Freezer (-15 to -25 degrees C)

o       OPV

o       Measles

Ø      Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celcius)

o       BCG

o       DPT

o       Hepa B

o       TT

Ø      Use those that will expire first, mark “X”/ exposure, 3^rd- discard,

Ø      Transport-use cold bags, let it stand in room temperature for a while before storing DPT.

Ø      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.

 

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