NATIONAL

IMMUNIZATION
PROGRAM (NIP)

HYACINTH ERICKA FRANZEIN OLIVO LIWANAG BSN 2B 1

BACKGROUND OF THE
NATIONAL IMMUNIZATION
PROGRAM (NIP)
The last version of the Manual of
Operations (MOP) for the Expanded
Program on Immunization (EPI) was
issued in 1995. As a reference, it
guided health workers to deliver
immunization services based on
national protocols and standards.

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To date, the NIP provides immunity
against 14 vaccine- preventable
The national government budget
diseases (VPDs) from only six in 1976.
for NIP increased from PhP 3
It expanded its population coverage
million in early 2000 to almost Php
beyond infants and pregnant
4 billion in 2016.
women to include school children,
adolescents/youth, senior citizens
and those in special situations.

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 Explain the rationale and foundation of the NIP’s design,
1 development and implementation as an effective public

PURPOSE AND health intervention in preventing illness and death;

OBJECTIVES 2
Describe the strategic approaches to increase access to
immunization services in the country and the principles, key
features, guides and steps which can be used or adapted locally;

Define the package of good-quality immunization services

3 for specific segments of the population to ensure increased
and sustained immunity against common VPDs;

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The Benefits of Immunization

“VACCINES SAVE LIVES”

~ Vaccines are cost-effective
The increase in life expectancy ~Vaccines protect children from VPDs
during the 20th century was that once were top killers and disablers
largely due to increased child worldwide.
survival and reduced deaths due ~Immunization prevents disease
to infectious diseases. This was transmission from one generation to
another, freeing the next generation
brought about largely by from the threat of disease.
immunization.
~ Vaccines also prevent the spread of
these diseases among families, loved
ones and neighbours, resulting in
healthier communities.

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CONSEQUENCES OF
NON-VACCINATION

Unvaccinated children can develop diseases resulting in

prolonged or long-term disabilities.

Sick children are unable to go to school

Prolonged treatment and out-of-pocket spending burdens

families with medical expenses and lost time at work.

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 LEGAL BASIS OF > The fundamental law of the land – the 1987 Philippine

THE NATIONAL
Constitution – says that “The State shall adopt a comprehensive
approach to health development which shall endeavor to make
essential goods, health and other social services available to all

IMMUNIZATION people at affordable cost. There shall be priority for the needs of
the underprivileged, sick, elderly, disabled, women, and children”

PROGRAM (Article XIII, Section 11, 1987)

The Philippine Immunization Program is mandated and >Mandatory Infants and Children Health
supported by the following laws and policies. Immunization Act of 2011

RA No. 10152 otherwise known as the Mandatory Infants and

> DOH Administrative Order No. 39 Children Health Immunization Act of 2011 mandated the adoption
of a comprehensive, mandatory and sustainable immunization
April 21, 2003: DOH AO No. 39, s. 2003 provided the program against VPDs among all infants and children: (a) Tb; (b)
“Policy for the Nationwide Implementation of the EPI” DPT; (c) Poliomyelitis; (d) Measles; (e) Mumps; (f) Rubella or German
measles; (g) Hep B; (h) H. Influenza Type b (HIb); and (h) other types
as may be determined by the DOH Secretary.
▪ Signed by Pres. B.C.Aquino on July 2, 2011

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BCG
BCG vaccine has a
documented protective effect
against meningitis and
disseminated TB in children. It
does not prevent primary
infection and, more
importantly, does not prevent
reactivation of latent
pulmonary infection, the
principal source of bacillary
spread in the community.

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HEPATITIS B
Hepatitis B is a vaccine-
preventable liver infection
caused by the hepatitis B virus
(HBV). Hepatitis B is spread
when blood, semen, or other
body fluids from a person
infected with the virus enters
the body of someone who is
not infected.

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PENTAVALENT Protection from: Diphtheria, Pertussis, Tetanus,

VACCINE
Influenza B and Hepatitis B
When to give: 6, 10 and 14 weeks
Diphtheria infects the throat and tonsils, making it
hard for children to breathe and swallow. Severe cases
can cause heart, kidney and/or nerve damage.
Pertussis (whooping cough) causes coughing spells
that can last for weeks. In some cases, it can lead to
troubled breathing, pneumonia, and death.
Tetanus causes very painful muscle contractions. It
can cause children’s neck and jaw muscles to lock
(lockjaw), making it hard for them to open their
mouth, swallow, breastfeed or breathe. Even with
treatment, tetanus is often fatal.
Influenza is an acute respiratory infection caused by
influenza viruses which circulate in all parts of the
world. Influenza can cause severe illness or death
especially in people at high risk.

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ORAL POLIO
VACCINE
Oral poliovirus vaccines (OPV)
are the predominant vaccine
used in the fight to eradicate
polio. There are different types of
oral poliovirus vaccine, which
may contain one, a combination
of two, or all three different
serotypes of attenuated vaccine.
Each has their own advantages
and disadvantages over the
others.

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INACTIVATED
POLIO VACCINE
is an inactivated vaccine (killed virus)
that stimulates a very good humoral
response (antibodies in the blood) in
children after only 1 or 2 doses. IPV
also prevents children from excreting
virus in their mouths as effectively as
OPV and hence to the extent that
polioviruses are transmitted through
oral secretions, IPV is very effective at
blocking that type of transmission.

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PNEUMOCOCCAL Pneumococcal conjugate vaccine helps protect against bacteria that
CONJUGATE cause pneumococcal disease. There are three pneumococcal
conjugate vaccines (PCV13, PCV15, and PCV20). The different vaccines
VACCINE are recommended for different people based on their age and medical
status.
PCV13
Infants and young children usually need 4 doses of PCV13, at ages 2,
4, 6, and 12–15 months.
Older children (through age 59 months) may be vaccinated with
PCV13 if they did not receive the recommended doses.
Children and adolescents 6–18 years of age with certain medical
conditions should receive a single dose of PCV13 if they did not
already receive PCV13.
PCV15 or PCV20
Adults 19 through 64 years old with certain medical conditions or
other risk factors who have not already received a pneumococcal
conjugate vaccine should receive either:
a single dose of PCV15 followed by a dose of pneumococcal
polysaccharide vaccine (PPSV23), or
a single dose of PCV20.
Adults 65 years or older who have not already received a
pneumococcal conjugate vaccine should receive either:
a single dose of PCV15 followed by a dose of PPSV23, or
a single dose of PCV20.

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MEASLES,
MUMPS, RUBELLA
(MMR) vaccine protects against four diseases:
measles, mumps, rubella, and varicella
(chickenpox). This vaccine is only licensed for
use in children 12 months through 12 years of
age.CDC recommends that children get one
dose of MMRV vaccine at 12 through 15
months of age, and the second dose at 4
through 6 years of age. Children can receive
the second dose of MMRV vaccine earlier than
4 through 6 years. This second dose of MMRV
vaccine can be given 3 months after the first
dose. A doctor can help parents decide
whether to use this vaccine or MMR vaccine.

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TETANUS
DIPHTHERIA Td vaccine can prevent tetanus and
diphtheria.
Tetanus enters the body through cuts
or wounds. Diphtheria spreads from
person to person.
TETANUS (T) causes painful
stiffening of the muscles. Tetanus
can lead to serious health problems,
including being unable to open the
mouth, having trouble swallowing
and breathing, or death.
DIPHTHERIA (D) can lead to
difficulty breathing, heart failure,
paralysis, or death.

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HUMAN
PAPILLOMAVIRUS
This vaccine can prevent most cases of
cervical cancer if the vaccine is given
before girls or women are exposed to
the virus. This vaccine can also prevent
vaginal and vulvar cancer. In addition,
the vaccine can prevent genital warts,
anal cancers, and mouth, throat, head
and neck cancers in women and men.

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Milestones of the Immunization Program in the Philippines:
Vaccines Introduced by the Program

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Implementation Status of the National Immunization Program

1. REDUCTION OF DEATH AND ILLNESS DUE TO VPDS.

THE SIGNIFICANT REDUCTION OF MORTALITY AND
MORBIDITY RATES DUE TO DIPHTHERIA, PERTUSSIS, TB
AND MEASLES FROM 1989 TO 2009 SHOWS THAT
VACCINES ARE EFFECTIVE IN CURBING DEATHS AND
ILLNESSES AMONG NEWBORNS, INFANTS AND
CHILDREN.

OVER THE PAST 25 YEARS, ILLNESS DUE TO DIPHTHERIA,

PERTUSSIS, NT AND TB DROPPED BEGINNING 1995-1997.
THIS CONTINUED UNTIL 2016.

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 2. Philippine Commitment to International Declarations on
Immunization.
THE PHILIPPINES IS A SIGNATORY TO FOUR INTERNATIONAL DECLARATIONS ON
IMMUNIZATION. THESE ARE:

MATERNAL- ACCELERATED
POLIO MEASLES
NEONATAL HEPATITIS B
ERADICATION ELIMINATION
TETANUS CONTROL
ELIMINATION This continues to be a
The Philippines was MNTE (MNTE)
in the challenge for the NIP. Coverage at birth
certified polio-free Philippines has There was an increased improved from
since 2000 and has been validated for incidence of Measles
2009 to 2015.
remained so to 16 regions except during the outbreak of
However, there is
date. for ARMM in 2015. 2013-2014. Case Fatality
still a need to
National MNTE Ratio (CFR) among
laboratory and
maximize
validation has been
epidemiologically vaccination of
achieved in 2017.
confirmed measles newborns.
cases increased.

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New Vaccine Development Establishing Priorities

ABSTRACT
This report describes a method designed to aid
government decision makers in establishing
priorities for accelerated development of vaccines
against diseases of importance in developing
countries. The method is based on a quantitative
model in which vaccine candidates are ranked
according to their potential health benefits
(reduction of morbidity and mortality). The model
also provides the capacity to utilize “affordability”
(willingness to pay for benefit) as a supplementary
criterion.

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New Vaccine Development Establishing Priorities

The committee believes that final selection of

priorities should be made after decision makers
have evaluated certain nonquantifiable
considerations discussed in the report, but not
incorporated into the model. These include the
goals of the agency and its schedule for achieving
them, considerations of equity or intent in the
distribution of benefits, the opportunity and need
for the agency to exert influence on development,
the balance of the desired portfolio of vaccine
development projects, and certain other
nonquantifiable factors relating to the diseases and
alternative control approaches.

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New Vaccine Development Establishing Priorities

Implementing the method requires substantial

amounts of information about diseases and
vaccine characteristics. Data having the
desired degree of reliability are not always
available, however. When data are unavailable,
expert judgments are required to quantify
factors that are incorporated into the
calculations. Scientific opinions differ on some
of these judgments (e.g., the probability of
success), and uncertainty surrounds much of
the data (e.g., disease incidence and efficacy).

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"Success is not final. Failure
is not fatal. It is the courage
to continue that counts." -
Winston Churchill

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THANK
YOU!