The Concept and Importance of Vaccination

Immunization is the process by which vaccines are introduce into the body before infection sets in.

Vaccines are administered to induce immunity thereby causing the recipient’s immune system to react to the vaccine that produces antibodies to fight infection.

There are several general principles which apply in

vaccinating children: It is safe immunologically

effective to administer all EPI vaccines on the same day at different site of the body.

The vaccination schedule should not be restarted from the beginning even if the interval between doses exceeded the recommended interval by months or years.

It is safe and effective with mild side effects after vaccination. Local reaction, fever and systematic symptoms can result as part of the normal immune response.

Giving doses of a vaccines at less than the recommended 4 weeks interval may lessen the antibody response. Lengthening the interval between doses of vaccines leads to higher antibody levels.

No extra doses must be given to children who missed a dose of DPT/HB/OPV/Tetanoid Toxoid. The vaccination must be continued as if no time had elapse between doses.

False contraindications to immunization are children with malnutrition, low grade fever, mild respiratory infections and other minor illnesses and diarrhea should not be considered a contraindication to OPV vaccination. Repeat BCG vaccination if the child does not develop a scar after the 1st injection.

Use one syringe one needle per child during vaccination.

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 20mg 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[14].

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.

Routine Immunization Schedule For Infants

The standard routine immunization schedule for infants is adopted to provide maximum immunity against the seven vaccines preventable diseases before a child’s first day. 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 child’s 1st birthday.

Vaccines

Minimum Age at 1st dose

Number of doses

Minimum interval between doses

Reason

BCG Birth or anytime after birth

1 BCG given at earliest possible age protects the possibility of TB meningitis and other TB infectious in which infants are prone.

Vaccines

Minimum Age at 1st dose

Number of doses

Minimum interval between doses

Reason

DPT 6 weeks 3 4 weeks An early start with DPT reduces the chance of severe pertussis

Vaccines

Minimum Age at 1st dose

Number of doses

Minimum interval between doses

Reason

OPV 6 weeks 3 4 weeks The extent of protection against polio is increased the earlier OPV is given.

Vaccines Minimum Age at 1st dose

Number of doses

Minimum interval between doses

Reason

Hepa B At birth 3 6 weeks interval from 1st dose to 2nd dose and 8 weeks interval from 2nd dose to 3rd dose

An early start of Hepa B reduces the chances of being infected and becoming a carrier. Prevent liver cirrhosis and liver cancer. About 9000 die of complications of HB. 10% of Filipinos have chronic HB infection.

Vaccines

Minimum Age at 1st dose

Number of doses

Minimum interval between doses

Reason

Measles 9 months At least 85% measles can be prevented by immunization at this age. Prevent deaths, malnutrition, pneumonia, diarrhea.

Vaccines

Dose Route of Administration

Site of Administration

BCG Infants 0.05 mL

Intradermal Right deltoid

DPT 0.5 mL Intramuscular

Upper outer portion of the thigh

OPV 2 drops or depending on manufacturer’s instructions

Oral mouth

Vaccines

Dose Route of Administration

Site of Administration

Measles 0.5 mL Subcutaneous

Outer part of the upper arm

Hepa B 0.5 mL Intramuscular

Upper outer portion of the thigh

Tetanus Toxoid

0.5 mL Intramuscular

Deltoid region of the upper arm

F VACCINE MINIMUM

AGE/INTERVAL

PERCENT PROTECTED

DURATION OF

PROTECTION

TT1 As early as possible during pregnancy

TT2 At least 4 weeks later

80% •Infants born to the mother will be protected from neonatal tetanus•Gives 3 yrs protection for the mother

TT3 At least 6 mos later

95% •Gives 5 yrs protection for the mother

TT4 At least 1 yr later

99% •Gives 10 yrs protection for the mother

TT5 At least 1 yr later

99% •Gives lifetime protection for the mother•All infants born to that mother will be protected

EPI VACCINES AND ITS CHARACTERISTICS

TYPE/FORM OF VACCINES

STORAGE TEMPERATURE

Most sensitive to heat Oral Polio ( live attenuated)

Measles (freeze died)

-15c to – 25c ( at the freezer) -15c to -25c ( at the freezer)

Least sensitive to Heat

DPT/ Hep B

“D” Toxoid which is a weakened toxin

“P” Killed bacteria

“T” Toxoid which is a weakened toxin

+2c to +8c ( in the body of the ref)

Hep B +2c to +8C In the body of refrigerator

BCG ( freeze died)

Tetanus Toxiod

2c to +8C In the body of refrigerator

EPI TARGET DISEASES

MEASLES TUBERCULOSIS DIPTHERIA PERTUSSIS POLIOMYELITIS NEONATAL TETANUS HEPATITIS B