philippine expanded program of immunization
DESCRIPTION
A discussion and a report on the Philippine Expanded program on ImmunizationTRANSCRIPT
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Philippine EPINayssa Alleyah Marohom Pacote
DOH-PCSHC Intern 2012-2013Pedia-EAMC
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Vaccines in the EPI
BCG Hepatitis B Measeles Oral Polio Vaccine (OPV) DTwP Hib MMR RV
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Other Recommended Vaccines
DTaP Hepatitis A HPV IPV Influenza MMRV Pneumococcal Tdap Varicella
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Vaccines for Special Groups:
Typhoid Meningococcal Rabies
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BCG
Given Intradermally (ID) Given at the earliest possible age after
birth, (1st 2 months of life) PPD is recommended prior to BCG
Vaccination if any of the following are present:› Suspected congenital TB› Hx of close contact to known or suspected
infectious cases of TB› Clinical findings suggestive of TB and/or CXR
suggestive of TB
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The dose of BCG is 0.05 ml for infants <12 months and 0.1 ml for children > or = 12 months of age.
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DTaP/DTwP Diptheria and Tetanus Toxoids and
Acellular Pertussis Vaccine IM Minimum age of 6 weeks with a minimum
interval of 4 weeks. The 4th dose may be given as early as 12
months provided there is minimum interval of 6 months from the 3rd dose.
The 5th dose may not be given if the 4th dose was administered at age 4 years or older.
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Hepatitis B Vaccine
IM 1st dose = 1st 12 hours of life, and may
be counted as part of the 3-dose primary series
At least 4 weeks apart The 3rd dose preferably given not
earlier than 24 weeks of age.
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A 4th dose is needed for the following:
3rd dose given at age less than 24 weeks Using EPI schedule of birth, 6th and 14
weeks Preterm infants less than 2kgs, 1st
dose=birth› Preterm infants with HBsAg (-) mothers may
be given the 1st dose of HBV at 30 days of chronological age regardless of weight, and this can be counted as part of the 3-dose primary series
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Mother is HBsAg (+), administer HBV and HBIG (0.5 ml) within 12 hours of life.
If HBsAg status is unkown, administer HBV within 12 hours of life and determine mother’s HBsAg as soon as possible.
If HBsAg (+), administer HBIG no later than 7 days of life.
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Hib
Haemophilus Influenzae Type B Conjugate Vaccine
IM Minimum age of 6 weeks, minimum
interval of 4 weeks 1st dose = bet 7-11 months of age, 2nd
dose should be given at least 4 weeks later and 3rd dose = at least 8 weeks from 2nd dose
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A booster dose should be given between 12-15 months with an interval of 6 months from the 3rd dose.
1 dose of Hib = unimmunized children age 5 years or older who have sickle cell disease, leukemia, HIV infection, or who has splenectomy.
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Measles
SC Children who received a dose of
measles containing vaccine at less than 12 months should be given 2 additional doses beginning at 12 through 15 months of age and separated by at least 4 weeks, (MMR)
May be given as early as 6 months of life
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MMR
Measles, Mumps, Rubella SC Minimum age = 12 months 2nd dose = age 4 through 6 May be administered at an earlier age
provided the interval bet 1st and 2nd dose = 4 weeks
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Children below 12 months of age given any measles-containing vaccine (Measles, MR, MMR) should be given 2 additional doses of MMR.› 1st dose = 12 to 15 months of age› 2nd dose = age 4 through 6 years
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Children 12 months or older given any measles-containing vaccine (Measles, ME, MMR) should be given one dose of MMR vaccine, separated by at least 4 weeks from the 1st measles-containing vaccine.
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OPV
Poliovirus Vaccine PO Minimum age of 6 weeks with
minimum interval of 4 weeks Final dose should be given on or after
the 4th birthday and at least 6 months after the previous dose
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If 4 or more doses have been given prior to age 4 years, an additional dose should be administered at age 4 through to 6 years.
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RV
Rotavirus Vaccine PO The monovalent human rotavirus
vaccine (RV1) is given as a 2-dose series
1st dose = 6 weeks of age 2nd dose = not later than 24 weeks of
age
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The pentavalent human bovine rotavirus vaccine (RV5) is given as a 3-dose series,
1st dose = between 6 weeks to 14 weeks of age
3rd dose = not later than 32 weeks of age
Interval between doses is 4 weeks
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Hepatitis A Vaccine
IM Recommended for all children > 12
months. 2nd dose = is given 6 to 12 months
after the 1st dose.
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HPV
Human Papillomavirus Vaccine IM Primary vaccination consists of 3-dose
series administered to females 10-18 years of age.
Bivalent HPV : 0, 1, 6 months Quadrivalent HPV: 0, 2, 6 months Minimum interval between 1st and 2nd dose
is at least 1 month and for the 2nd and 3rd dose is at least 3 months.
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Influenza
IM or SC All children from 6 months to 18 years
should receive influenza vaccine. 6 months to 8 years = 2 doses It is recommended that children ages 6
months to 8 years old who received at least one dose of the 2011 vaccine will require only one dose of the 2012 vaccine.
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Children who received single dose of influenza vaccine for 2 consecutive years should continue receiving single annual doses.
Annual vaccination should preferably be given between February to June, but may be given throughout the year.
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MMRV
Measles, Mumps, Rubella, Varicella SC For healthy children 12 months to 12
years of age. 2nd dose of MMRV is administered at 4-
6 years old or at an earlier age provided the interval between the 1st and 2nd dose is at least 3 months.
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PCV/PPV
Pneumococcal Conjugate Vaccines / Pneumococcal Polysaccharide Vaccine
IM PCV = Minimum age is 6 weeks PPV = 2 years of age A single dose of PCV is recommended
for healthy children 2 to 5 years with any incomplete PCV schedule.
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PPV is recommended for high risk children > 2 years of age in addition to PCV.
PPV sshould be administered at least 8 weeks after PCV
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Varicella Vaccine
SC 1st dose – age 12 to 15 months 2nd dose – 4-6 years or at an earlier age
provided the interval between the 1st and 2nd month is at least 3 months.
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A 2nd dose of the vaccine is recommended for children, adolescents, adults who previously received only one dose of the vaccine.
All individual > 13 years and without previous evidence of immunity should receive 2 doses of varicella vaccine at least 4 weeks apart.
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Td and Tdap
Tetanus and Diptheria Toxoids and acellular pertussis
IM Td booster doses should be given every
10 years. A single dose of Tdap can be given in
place of the due Td dose and can be administered regardless of the interval sine the last tetanus and diptheria toxoid-containing vaccine.
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7-18 years of age who are not fully immunized with DPT Vaccine should be given a single dose of Tdap. Remaining doses are given as Td.
Never been immunized with DPT vaccine = 3 dose series of tetanus containing vaccine 0,1,6 months sched. A single dose of Tdap is given, 1st dose. Remaining doses are given as Td.
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Typhoid
IM Travelers Outbreak situations Single dose as early as 2 years of age
with revaccination every 2 to 3 years if there is continued exposure to S.typhi
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Meningococcal Vaccine
Tetravalent meningococcal (MCV4) = IM
Meningococcal polysaccharide (MPSV 4) = SC
Bivalent meningococcal polysaccharide A and C = IM/SC
Individuals at high risk (anatomic or functional asplenia, compliment or factor deficencies, HIV)
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2-18 years of age = 2-dose primary series of MCV4 given at 2 months apart
If MPSV4 or bivalent meningococcal polysaccharide A and C vaccines were used as the 1st dose, a 2nd dose using MCV4 should be given with minimum interval of 2 months from the 1st dose.
Reactivation with MCV4 is recommended 3 to 5 years following completion of the primary series, to those who remain at risk
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Outbreak situations, MCV 4 may be given to those <2 years of age. Minimum age of 3 months using 2 doses 3 months apart.
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Rabies
IM / ID 2 recommended regimens for pre-
exposure prophylaxis (5-14)› IM dose : PVRV 0.5 ml of PCEVC 1ml on
days 0, 7, 21, or 28› ID dose: PVRV or PCECV 0.1 ml given on 1,
7, and 21 0r 28.
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Given at the gluteal area ID regimen, a repeat dose should be
given if vaccine is inadvertently given SC
Will require only one booster dose on day 0 and 3. IM or ID
Periodic booster doses in the absence of exposure are not recommended for the general population.
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Thank you!