EXPANDED PROGRAM ON IMMUNIZATION

Immunity

Condition of being protected against a particular disease

2 Types of Immunity

* Natural/Innate
* Adaptive

Natural/Innate Immunity

The body's inborn system to protect itself and fight infections

Adaptive Immunity

This develops as a result of exposure to a disease-causing organism so that next time the body meets it again, it can defend itself

Antigen

Substance that causes the body to produce specific antibodies

Antibody

Substance that is produced by the immune system and defends the body against infections.

Naturally Acquired Active Immunity

* Resulting from infection
* eg: COVID-19 creates antibodies

Artificially Acquired Active Immunity

* Injection of Antigen (vaccine: attenuated, killed, toxoid, recombinant DNA)
* Giving a copy of the microorganism will trigger the immune system to produce antibodies against the real microorganism to prevent infection

Naturally Acquired Passive Immunity

* Transplacental or colostrum
* Antibodies gained by the mother either through infections or vaccine will be transferred to the baby

Artificially Acquired Passive Immunity

* Injection of antibody
* eg: antiserum, immunoglobulin
* Giving the body the antibodies needed to fight off or prevent an infection

Artificially Acquired Active

Identify the type of immunity:

Animal handlers get rabies vaccinations to protect themselves from potential exposure to the virus through bites or scratches

Naturally Acquired Passive

Identify the type of immunity:

Plasma therapy is one of the techniques currently being tested against COVID-19. Patients who have recovered successfully from the disease donate plasma from their blood.

Naturally Acquired Active

Identify the type of immunity:

A patient developed chickenpox when she was a kid. Despite having an officemate who has chickenpox now, she did not get sick.

Artificially Acquired Passive

Identify the type of immunity:

ER personnel attended to a patient who got injured by a rusty metal. He was given Tetanus antitoxin to neutralize the tetanospasmin

Immunization

* Beneficial and cost-effective disease prevention.
* Process of inducing immunity against a specific disease through vaccines.
* Passive (administration of antibody-containing preparations) or active (stimulation of the immune system)
* Protection is usually long-term if not lifetime

Smallpox

This disease was widespread in the 18th century and resulted in a very high death rate.

Variolation

Intentionally infecting a healthy person with the "matter" taken from a patient sick with a mild attack of the disease

Cowpox

Persons who suffered an attack of \___ (a relative of smallpox)- a relatively harmless disease that could be contracted from cattle could not take the smallpox.

Edward Jenner

The father of immunization.

May 1796

In \____, Jenner found a young dairymaid who had fresh cowpox lesions on her hand.

Sarah Nelmes

The young dairymaid who had fresh cowpox lesions on her hand was named:

May 14

On \___, using matter from the young dairymaid's lesions, he inoculated an eight-year-old boy who never had smallpox.

James Phipps

The eight-year-old boy who was inoculated with cowpox and then smallpox was named:

9 days

The eight-year-old boy who was inoculated with cowpox was ill for how many days?

July 1

On ___, Jenner intentionally inoculated the boy again, this time with smallpox matter. No disease developed: protection was complete.

Live Attenuated Vaccines

* Attenuated (weakened) form of the "wild" virus or bacterium
* Immune response is similar to natural infection

1-2 doses

How many doses does a live attenuated vaccine need for long term immunity?

Inactivated Vaccines

* Giving of microorganism killed through heat or chemical methods'
* This type of vaccine is used to remind the body to produce antibodies.

3-5 doses including boosters

How many doses does an inactivated vaccine need for long term immunity?

Expanded Program on Immunization

EPI stands for:

1976

The EPI was established in \___ by the WHO

Expanded Program on Immunization

This program ensures that children/infants and mother have access to routinely recommend infant/childhood vaccines.

1) tuberculosis
2) poliomyelitis
3) diphtheria
4) tetanus
5) pertussis
6) measles

Six vaccine-preventable diseases were initially included in the EPI:

1.4 million

WHO estimated that \___ million of deaths among children under 5 years were due to diseases that could have been prevented by routine vaccination.

1979

The EPI began in \___ in the Philippines.

PD No. 996

This Presidential Decree provides compulsory basic immunization for infants and children below 8 years

1) Bacillus Calmette-Guérin (BCG)
2) Diphtheria, Pertussis, Tetanus (DPT)
3) Oral Polio Vaccine (OPV)
4) Measles

The free vaccines for ages 8 and below during the initial program of EPI:

1) Reaching of Every Barangay (REB)
2) Supplementary Immunization Activities (SIA)
3) SVPDS

The strategies used for routine immunization for Infants/Children/Women were:

BCG vaccine

* Prevents TB meningitis

right or left deltoid

injection site of BCG

At birth or for school entrants

appropriate age for BCG

1 dose

number of doses for BCG

Hepatitis B Vaccine

* Prevents Hepatitis B

Intramuscular injection (vastus lateralis)

injection site for Hepa B

6 weeks of age

appropriate age for Hepa B

3 doses

number of doses for Hepa B

4 weeks

interval time for Hepa B

Oral Polio Vaccine

* Prevents Polio
* Administered through the mouth
* 6 weeks of age
* 3 doses
* 4 weeks interval

administered through the mouth

way of getting OPV

6 weeks of age

appropriate age for OPV

3 doses

number of doses for OPV

4 weeks

interval time for OPV

Rotavirus vaccine

* Prevents childhood diarrhea due to Rotavirus

Administered through the mouth

way of getting Rotavirus vax

2 doses

number of doses for Rotavirus vax

1. Diptheria
2. Pertussis
3. Tetanus
4. HiB
5. HBV

Pentavalent vaccine is composed of:

Corynebacterium diphtheriae

Diphtheria is a respiratory disease caused by:

Bordetella pertussis

Pertussis, also known as whooping cough, is caused by

Clostridium tetani

Tetanus causes muscle spasms and caused by:

Haemophilus influenza type B

HiB meningitis vaccine of children caused by:

DPT Vaccine

* diphtheria
* pertussis
* tetanus

6 weeks

appropriate age for DPT

3 doses

number of doses for DPT

4 weeks

interval time for DPT

intramuscular injection (vastus lateralis)

injection site for DPT

Measles vaccine

* Prevents Measles

9 months

appropriate age for measles

subcutaneous injection

injection site for measles

1 dose

number of doses for measles

MMR vaccine

1. Mumps
2. Measles
3. Rubella

Rubulavirus

Mumps is caused by:

Morbillivirus

Measles is caused by:

Rubellavirus

Rubella is caused by:

live attenuated bacteria

Content of BCG

live attenuated virus

Content of OPV and Measles

weakened bacterial toxins

Content of Diphtheria and Tetanus

killed/inactivated bacteria

Content of Pertussis

derived from plasma (plasma derivatives) DNA recombinants

Content of Hepa B

1. Severe illness
2. Allergy
3. Immunosuppression

General Contraindications of Vaccines:

Herd Immunity

Refers to immunized individuals that provide indirect protection to susceptible members of a population.

1 BCG
3 DPT
3 HBV
3 OPV
1 Measles

Target for Immunization Program:

Infants: 12 months old

5 Tetanus toxoid

Target for Immunization Program:

Pregnant mothers

1 booster of BCG

Target for Immunization Program:

School entrants: 6-7 y/o

Cold Chain System

* Keeping/transporting the vaccine in cold temperatures to maintain the potency of the vaccine.
* The system used for storing vaccines in good condition
* \

vaccine supply chain or immunization supply chain

The cold chain system is also known as the:

-15°C to -25°C

Temperature for freezing vaccines.

2°C to 8°C

Temperature for body temp. vaccines.

OPV and Measles

Vaccines that are the most sensitive to heat and require freezing temp.:

BCG and TT

Vaccines that are the least sensitive to heat and require body temp.:

RA 10152

The "Mandatory Basic Immunization Services for Infants and Children repealing PD 996" is known as:

1. HiB
2. DPT-HBV-HiB
3. Rotavirus
4. Pneumococcal vaccine (PCV)

The free vaccines for ages 5 and below during the program of RA 10152:

BCG

No \___ vaccine can be given to a child positive with HIV or AIDS.

30

No food __ minutes after giving OPV.

DPT2, DPT3

___ or ___ is not given to a child who has had convulsions or shock w/in 3 days the previous dose but you can give DT.

egg

Assess the child for allergy to ___ before giving measles vaccine

9

Measles vaccine should be given as soon as the child is _ months old regardless of whether other vaccines will be given on that day

True

True or False:

Vaccination schedule should not be restarted from the beginning even if the interval between doses exceeded

scar

Repeat BCG vaccination if the child does not develop a ____ after the first injection

True

True or False:

Use one syringe, one needle per child during vaccination

True

True or False:

A child with diarrhea who is due for OPV should receive a dose of OPV during the visit but do not count the dose