Expanded Program on Immunization (Philippines)

Last updated

The Expanded Program on Immunization(EPI) in the Philippines began in 1976 [1] through Presidential Decree No. 996 signed by President Ferdinand Marcos. [2] And, in 1986, made a response to the Universal Child Immunization goal. The four major strategies include: [3]

Contents

  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 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. [4]

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 [5]
Diphtheria-Pertussis-Tetanus Vaccine
6 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. [6]
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. [7]
Hepatitis B Vaccine
At 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. [8]
Prevents liver cirrhosis and liver cancer which are more likely to develop if infected with Hepatitis B early in life. [9] [10]
About 9,000 died of complications of Hepatitis B. 10% of Filipinos have Hepatitis B infection [11]
Measles Vaccine

(not MMR)

9 months old
1 dose
0.5 mL
none
Subcutaneous
Upper outer portion of the arms, Right deltoidAt least 85% of measles can be prevented by immunization at this age. [12]

General Principles in Infants/Children Immunization

Tetanus Toxoid Immunization Schedule for Women

When given to women of childbearing age, vaccines that contain tetanus toxoid (TT or Td) not only protect women against tetanus, but also prevent neonatal tetanus in their newborn infants. [19]

VaccineMinimum
Age/Interval		Percent
Protected		Duration of Protection
TT1
At 20th weeks AOG
0%
  • protection for the mother for the first delivery
TT2
At least 4 weeks later
80%
  • infants born to the mother will be protected from neonatal tetanus
  • gives 3 years protection for the mother
TT3
At least 6 months later
95%
  • infants born to the mother will be protected from neonatal tetanus
  • gives 5 years protection for the mother
TT4
At least 1 year later
99%
  • infants born to the mother will be protected from neonatal tetanus
  • gives 10 years protection for the mother
TT5
At least 1 year later
99%
  • gives lifetime protection for the mother
  • all infants born to that mother will be protected

In June 2000, the 57 countries that have not yet achieved elimination of neonatal tetanus were ranked and the Philippines was listed together with 22 other countries in Class A, a classification for countries close to maternal and neonatal tetanus elimination. [20]

Care for the Vaccines

To ensure the optimal potency of vaccines,a careful attention is needed in handling practices at the country level. These include storage and transport of vaccines from the primary vaccine store down to the end-user at the health facility, and further down at the outreach sites. [21] Inappropriate storage, handling and transport of vaccines won't protect patients and may lead to needless vaccine wastage. [22]

A "first expiry and first out" (FEFO) vaccine system is practiced to assure that all vaccines are utilized before its expiry date. Proper arrangement of vaccines and/or labeling of expiry dates are done to identify those close to expiring. Vaccine temperature is monitored twice a day (early in the morning and in the afternoon) in all health facilities and plotted to monitor break in the cold chain. Each level of health facilities has cold chain equipment for use in the storage vaccines which included cold room, freezer, refrigerator, transport box, vaccine carriers, thermometers, cold chain monitors, ice packs, temperature monitoring chart and safety collector boxes. [23]

Related Research Articles

<span class="mw-page-title-main">Vaccine</span> Pathogen-derived preparation that provides acquired immunity to an infectious disease

A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and recognize further and destroy any of the microorganisms associated with that agent that it may encounter in the future.

<span class="mw-page-title-main">DPT vaccine</span> Combination vaccine

The DPT vaccine or DTP vaccine is a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis, and tetanus. The vaccine components include diphtheria and tetanus toxoids and either killed whole cells of the bacterium that causes pertussis or pertussis antigens. The term toxoid refers to vaccines which use an inactivated toxin produced by the pathogen which they are targeted against to generate an immune response. In this way, the toxoid vaccine generates an immune response which is targeted against the toxin which is produced by the pathogen and causes disease, rather than a vaccine which is targeted against the pathogen itself. The whole cells or antigens will be depicted as either "DTwP" or "DTaP", where the lower-case "w" indicates whole-cell inactivated pertussis and the lower-case "a" stands for "acellular". In comparison to alternative vaccine types, such as live attenuated vaccines, the DTP vaccine does not contain any live pathogen, but rather uses inactivated toxoid to generate an immune response; therefore, there is not a risk of use in populations that are immune compromised since there is not any known risk of causing the disease itself. As a result, the DTP vaccine is considered a safe vaccine to use in anyone and it generates a much more targeted immune response specific for the pathogen of interest.

<span class="mw-page-title-main">Vaccination schedule</span> Series of vaccinations

A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness.

<span class="mw-page-title-main">Booster dose</span> Additional administration of vaccine

A booster dose is an extra administration of a vaccine after an earlier (primer) dose. After initial immunization, a booster provides a re-exposure to the immunizing antigen. It is intended to increase immunity against that antigen back to protective levels after memory against that antigen has declined through time. For example, tetanus shot boosters are often recommended every 10 years, by which point memory cells specific against tetanus lose their function or undergo apoptosis.

In immunology, passive immunity is the transfer of active humoral immunity of ready-made antibodies. Passive immunity can occur naturally, when maternal antibodies are transferred to the fetus through the placenta, and it can also be induced artificially, when high levels of antibodies specific to a pathogen or toxin are transferred to non-immune persons through blood products that contain antibodies, such as in immunoglobulin therapy or antiserum therapy. Passive immunization is used when there is a high risk of infection and insufficient time for the body to develop its own immune response, or to reduce the symptoms of ongoing or immunosuppressive diseases. Passive immunization can be provided when people cannot synthesize antibodies, and when they have been exposed to a disease that they do not have immunity against.

Immunization during pregnancy is the administration of a vaccine to a pregnant individual. This may be done either to protect the individual from disease or to induce an antibody response, such that the antibodies cross the placenta and provide passive immunity to the infant after birth. In many countries, including the US, Canada, UK, Australia and New Zealand, vaccination against influenza, COVID-19 and whooping cough is routinely offered during pregnancy.

<span class="mw-page-title-main">Hepatitis B vaccine</span> Vaccine against hepatitis B

Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and those born premature. It is also recommended that health-care workers be vaccinated. In healthy people, routine immunization results in more than 95% of people being protected.

A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by State or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.

<span class="mw-page-title-main">Neonatal tetanus</span> Medical condition

Neonatal tetanus is a form of generalised tetanus that occurs in newborns. Infants who have not acquired passive immunity from an immunized mother are at risk. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. Neonatal tetanus mostly occurs in developing countries, particularly those with the least developed health infrastructure. It is rare in developed countries.

The Expanded Program on Immunization is a World Health Organization program with the goal to make vaccines available to all children.

<span class="mw-page-title-main">Measles vaccine</span> Vaccine used to prevent measles

Measles vaccine protects against becoming infected with measles. Nearly all of those who do not develop immunity after a single dose develop it after a second dose. When the rate of vaccination within a population is greater than 92%, outbreaks of measles typically no longer occur; however, they may occur again if the rate of vaccination decreases. The vaccine's effectiveness lasts many years. It is unclear if it becomes less effective over time. The vaccine may also protect against measles if given within a couple of days after exposure to measles.

A vaccine-preventable disease is an infectious disease for which an effective preventive vaccine exists. If a person acquires a vaccine-preventable disease and dies from it, the death is considered a vaccine-preventable death.

<span class="mw-page-title-main">Health in France</span> Overview of health in France

Average life expectancy in France at birth was 81 years in 2008. A new measure of expected human capital calculated for 195 countries from 1990 to 2016 and defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status was published by the Lancet in September 2018. France had the ninth highest level of expected human capital with 25 health, education, and learning-adjusted expected years lived between age 20 and 64 years.

<span class="mw-page-title-main">Tetanus vaccine</span> Vaccines used to prevent tetanus

Tetanus vaccine, also known as tetanus toxoid (TT), is a toxoid vaccine used to prevent tetanus. During childhood, five doses are recommended, with a sixth given during adolescence.

Universal Immunisation Programme (UIP) is a vaccination programme launched by the Government of India in 1985. It became a part of Child Survival and Safe Motherhood Programme in 1992 and is currently one of the key areas under the National Health Mission since 2005. The programme now consists of vaccination for 12 diseases- tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, measles, hepatitis B, rotaviral gastroenteritis, Japanese encephalitis, rubella, pneumonia and Pneumococcal diseases. Hepatitis B and Pneumococcal diseases were added to the UIP in 2007 and 2017 respectively. The cost of all the vaccines are borne entirely by the Government of India and is funded through taxes with a budget of ₹7,234 crore (US$910 million) in 2022 and the program covers all residents of India, including foreign residents.

<span class="mw-page-title-main">World Immunization Week</span> Global public health campaign

World Immunization Week is a global public health campaign to raise awareness and increase rates of immunization against vaccine-preventable diseases around the world. It takes place each year during the last week of April.

<span class="mw-page-title-main">Non-specific effect of vaccines</span> Unintended side effects of vaccines which may be beneficial or bad

Non-specific effects of vaccines are effects which go beyond the specific protective effects against the targeted diseases. Non-specific effects can be strongly beneficial by increasing protection against non-targeted infections. This has been shown with two live attenuated vaccines, BCG vaccine and measles vaccine, through multiple randomized controlled trials. Theoretically, non-specific effects of vaccines may be detrimental, increasing overall mortality despite providing protection against the target diseases. Although observational studies suggest that diphtheria-tetanus-pertussis vaccine (DTP) may be highly detrimental, these studies are at high risk of bias and have failed to replicate when conducted by independent groups.

DTaP-IPV-HepB vaccine is a combination vaccine whose generic name is diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated polio vaccine or DTaP-IPV-Hep B. It protects against the infectious diseases diphtheria, tetanus, pertussis, poliomyelitis, and hepatitis B.

<span class="mw-page-title-main">Vaccination policy of the United States</span> Overview of the vaccination policy in the United States of America

Vaccination policy of the United States is the subset of U.S. federal health policy that deals with immunization against infectious disease. It is decided at various levels of the government, including the individual states. This policy has been developed over the approximately two centuries since the invention of vaccination with the purpose of eradicating disease from the U.S. population, or creating a herd immunity. Policies intended to encourage vaccination impact numerous areas of law, including regulation of vaccine safety, funding of vaccination programs, vaccine mandates, adverse event reporting requirements, and compensation for injuries asserted to be associated with vaccination.

<span class="mw-page-title-main">Vaccination in India</span>

Vaccination in India includes the use of vaccines in Indian public health and the place of vaccines in Indian society, policy, and research.

References

  1. ↑ [bbbbb "Expanded Program on Immunization"]. Department of Health . Archived from the original on 21 February 2024. Retrieved 21 February 2024.{{cite web}}: Check |archive-url= value (help)
  2. ↑ "Presidential Decree No. 996, s. 1976". Official Gazette of the Republic of the Philippines . September 16, 1976. Retrieved 21 February 2024.
  3. ↑ Public Health Nursing in the Philippines. Manila, Philippines: National League of Philippine Government Nurses, Inc. 2007. p. 141. ISBN   978-971-91593-2-2.
  4. ↑ "Six Out of Ten Children 12 to 23 Months Are Fully Immunized". Final Results from the 2002 Maternal and Child Health Survey. National Statistics Office. 2003-06-02. Archived from the original on 2007-06-08. Retrieved 2007-05-11.
  5. ↑ Puvacic, S.; Dizdarević, J; Santić, Z; Mulaomerović, M (February 2004). "Protective effect of neonatal BCG vaccines against tuberculous meningitis". Bosnian Journal of Basic Medical Sciences . 4 (1): 46–9. doi: 10.17305/bjbms.2004.3460 . PMC   7245520 . PMID   15628980.
  6. ↑ "Immunisation". Dialogue on Diarrhoea Online (30): 1–6. 1987. Retrieved 2007-05-11.
  7. ↑ Centers for Disease Control and Prevention (CDC) (2001-10-12). "Public Health Dispatch: Acute Flaccid Paralysis Associated with Circulating Vaccine-Derived Poliovirus --- Philippines, 2001". Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. 50 (40): 874–5. PMID   11666115 . Retrieved 2013-10-31.
  8. ↑ Ni, Y. H.; M.H. Chang; L.M. Huang; H.L. Chen; H.Y. Hsu; T.Y. Chiu; K.S. Tsai; D.S. Chen (2001-11-06). "Effects of Universal Vaccination for Hepatitis B". Annals of Internal Medicine. 135 (9): 796–800. doi: 10.7326/0003-4819-135-9-200111060-00005 . PMID   11694104 . Retrieved 2007-05-12.
  9. ↑ "A Look at Each Vaccine: Hepatitis B Vaccine". Vaccine Education Center. The Children's Hospital of Philadelphia. Archived from the original on 2007-06-29. Retrieved 2007-05-11.
  10. ↑ Chang, MH; C.J. Chen; M.S. Lai; H.M. Hsu; T.C. Wu; M.S. Kong; D.C. Liang; W.Y. Shau; D.S. Chen (1997-06-26). "Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group". The New England Journal of Medicine. 336 (26): 1855–1859. doi: 10.1056/NEJM199706263362602 . PMID   9197213. S2CID   35206561.
  11. ↑ Salazar, Tessa R. (2004-05-24). "Cancer Preventable Says US Doctor" (PDF). The Philippine Daily Inquirer. Archived from the original (PDF) on 2007-02-21. Retrieved 2007-05-11.
  12. ↑ Orenstein, WA; L.E. Markowitz; W.L. Atkinson; A.R. Hinman (May 1994). "Worldwide measles prevention". Israel Journal of Medical Sciences. 30 (5–6): 469–81. PMID   8034506.
  13. ↑ "Measles (Catch Up". Archived from the original on 2007-04-15.
  14. ↑ Zimmerman, Richard Kent (2000-01-01). "Practice Guidelines - The 2000 Harmonized Immunization Schedule". American Family Physician. Archived from the original on 2004-09-29. Retrieved 2007-05-12.
  15. ↑ "Management of the Traveler: Vaccination". Travel Medicine. Portal de Saúde Pública. 1997. Archived from the original on 2007-05-18. Retrieved 2007-05-12.
  16. ↑ "General Recommendations on Immunizations" (PDF). Epidemiology & Prevention of Vaccine-Preventable Diseases--The Pink Book 10th Edition. Centers for Disease Control and Prevention. 2007-02-14. Archived from the original (PDF) on 2006-10-22. Retrieved 2007-05-12.
  17. ↑ Department of Vaccines and Biologicals (December 2000). "WHO Recommendations for Diluents" (PDF). Vaccines and Biologicals Update. World Health Organization. p. 3. Archived from the original (PDF) on 2007-03-06. Retrieved 2007-05-12.
  18. ↑ Hoekstra, Edward. "Immunization: Injection Safety". UNICEF Expert Opinion. UNICEF. Archived from the original on 2007-06-13. Retrieved 2007-05-12.
  19. ↑ "Tetanus - The Disease". Immunization, Vaccines and Biologicals. World Health Organization. Archived from the original on March 22, 2006. Retrieved 2007-05-12.
  20. ↑ "Maternal and Neonatal Tetanus" (PDF). UNICEF. November 2000. Archived from the original (PDF) on 2007-01-11. Retrieved 2007-05-12.
  21. ↑ "Temperature Sensitivity of Vaccines" (PDF). Immunization, Vaccines and Biologicals. World Health Organization. August 2006. Archived from the original (PDF) on 2007-02-19. Retrieved 2007-05-12.
  22. ↑ "Handle Vaccines with Care" (PDF). British Columbia Center for Disease Control. Retrieved 2007-05-12.[ dead link ]
  23. ↑ Expanded Program on Immunization Manual. Manila, Philippines: Department of Health, Philippines. 1995.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.