Every Wednesday is designated as immunization day and is adopted in all parts of the country.

In barangay health station immunization is done monthly while in far flung areas it is done quarterly. However, some areas adopted local practices to provide everyday vaccination in their areas to cover all targets.

The standard routine immunization schedule for infants is adopted to provide maximum immunity against the seven vaccine preventable diseases before a childs birthday. A child is said to be Fully Immunized Child When a Child receives one Dose of BCG, 3 doses of OPV, 3 doses of DPT, 3 doses of HB and one dose of measles before a childs first birthday.

VACCINE

MINIMUM AGE at 1st DOSE

NUMBER OF DOSES

MINIMUM INTERVAL BETWEEN DOSES

REASON

BCG

Birth or anytime after birth

DPT

6 weeks

4 weeks

OPV

6 weeks

4 weeks

BCG is given at earliest possible age to protects the possibility of TB meningitis and other TB infectious in which infants are prone. An early start with DPT reduces the chance of severe pertussis The extent of protection against polio is increased the earlier the OPV is given

VACCINE

MINIMUM AGE at 1st DOSE At birth

NUMBER OF DOSES 3

Hep B

MINIMUM INTERVAL BETWEEN DOSES 6 weeks interval from 1st dose to 2nd dose, and 8 weeks interval from 2nd dose to third dose

REASON

An early start of Hep B reduces the chance of being infected and becoming a carrier. Prevent a liver cirrhosis and liver cancer.

Measles

9 months

At least 85% of measles can be prevented by immunization at this age. Prevents deaths , malnutrition, pneumonia, diarrhea

Tetanus toxoid vaccination for women is important to prevent tetanus in both mother and the baby. When two doses of TT injection given at one month interval between each dose during pregnancy or even before pregnancy period the baby is protected against neonatal tetanus. Completing the five doses following the schedule provide lifetime immunity.

VACCINE
TT1

TT2

MINIMUM AGE/INTERVAL As early as possible during pregnancy At least 4 weeks later

PERCENT PROTECTED

DURATION OF PROTECTION

80%

TT3

At least 6 months later

95%

Infants born to the motherwill be protected from neonatal tetanus Gives 3 years protection for the mother Infants born to the mother will be protected from neonatal tetanus Gives 5 years protection for the mother

VACCINE TT4

MINIMUM AGE/INTERVAL At least one year later

PERCENT PROTECTED 99%

DURATION OF PROTECTION Infants born to the mother will be protected from neonatal tetanus Gives 10 years protection for the mother Gives life time protection for the mother All infants born to that mother will be protected

TT5

At least one year later

99%

Vaccines are substances very sensitive at various temperatures. To avoid spoilage and maintain its potency, vaccines need to be stored at correct temperature.

Type/Form of Vaccines Most sensitive to Oral Polio heat Measles Least sensitive to DPT/Hep B heat D Toxoid which is a weakened toxin P Killed Bacteria T Toxoid which is a weakened toxin Hep B BCG (freeze dried) Tetanus Toxoid

STORAGE TEMPERATURE -15OC (at the freezer) -15oC (at the freezer)

+2oC to +8oC (in the body of the refrigerator)

When handling, transporting and storing vaccines, special care must be given to provide quality potent vaccines among the targets. A first expiry and first out (FEFO) vaccine is practiced to assure that all vaccines are utilized before its expiry date. Proper arrangement of vaccines and or labelling of vaccines expiry date are done to identify those near to expire vaccines.

Temperature monitoring of vaccines is done in all levels of health facilities to monitor vaccine temperature. This is done twice a day early in the morning and in the afternoon before going home. Temperature is plotted everyday in a temperature monitoring chart to monitor break in the cold chain.

Each level of health facilities has cold chain equipment for use in the storage of vaccines. These are: cold room, freezer, refrigerator, transport box, vaccine carrier. Other cold chain logistics supplies includes: thermometers, cold chain monitor, ice packs, temperature monitoring charts, safety collector box. These are essentials in proper management of vaccines and other EPI logistics.

VACCINE

DOSE

BCG DPT
OPV

Infants 0.05 ml 0.5 ml

2 drops or depending on manufacturers instructions 0.5 ml 0.5 ml 0.5 ml

ROUTE OF ADMINISTRATION Intradermal Intramuscular Oral

SITE OF ADMINISTRATION Right Deltoid of the Arm Upper outer Portion of the thigh Mouth

Measles Hep B Tetanus Toxoid

Subcutaneous Intramuscular Intramuscular

Outer part of the upper arm Upper outer portion of the thigh Deltoid Region of the upper arm

As a nurse you need to: Actively master list infants eligible for vaccination in the community Immunize infants following the recommended immunization schedule, route of administration, correct dosage and following the proper cold chain storage of vaccines.

As a nurse you need to: Observe aseptic technique on immunization and use syringe and one needle per child. These reduces blood borne diseases and promote safety injection practices. Dispose used syringe and needles properly by using collector box and disposed it in the septic vault to prevent health hazard

As a nurse you need to: Inform, educate and communicate with the parents
To create awareness/motivate to submit their children for vaccination To provide health teachings on the importance and benefits of immunization, importance of the follow up dose to avoid defaulters and normal course of vaccine To inform immunization schedule as adopted by local units

As a nurse you need to: Conduct health visits in the community to assess other health needs of the community and be able to provide package of health services to targets Identify cases of EPI target diseases per standard case definition Manage vaccine properly by following the recommended storage of vaccines

As a nurse you need to: Record the children given with vaccination in the target client list Submit report and record of children vaccinated, cases and deaths on diseases, vaccine received and utilized and any other EPI related reports.

As a nurse you need to: Identify and actively search cases and deaths of EPI target diseases following standard case definition.

It Ends here......
REFERENCE: Public Health Nursing in the Philippines