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  WINTER Template National Immunization Program 01
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  02 Vaccines available forRegion 12 Immunization protects children from deadly diseases. All children have the right to this protection…
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  Vaccines available forRegion 12 • Hepatitis B • BCG • bOPV • IPV • Pentavalent • PCV13 • Measles-Containing Vaccine (MCV) • MMR 03
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  Vaccines available forRegion 12 • MR • HPV School-based / Adolescent group • PPV23 • Flu Senior Citizens 04
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  Fully-Immunized Child Any childwho received the following vaccines before his/her 1st birthday: • 1 dose of BCG • 3 doses of OPV • 3 doses of Pentavalent • 1 dose of MCV 05
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  VACCINE 61 y.o.61-64 y.o. 65 y.o Pneumo- coccal Poly- saccharide Vaccine (PPV23) (L) Senior Citizen Immunization 06
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  VACCINE 61 y.o.61-64 y.o. 65 y.o Polyvalent Influenza Vaccine (R) Senior Citizen Immunization 07
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  Common Questions About HepatitisB Vaccine • If a baby was not given HepB within 24 hours birth dose, until when can we give HepB vaccine? 08
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  Common Questions About HepatitisB Vaccine • We can give HepB to a baby until the age of 7 days. • This dose shall be recorded under the more than 24 hours column in the EPI TCL. 09
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  Common Questions About BCG •Formation of scar - It is neither necessary nor the only indication of success of BCG vaccine. 10
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  Common Questions About BCG •Formation of scar - If no scar is visible at all after 6 months, one need to to Mantoux Test. - if (-) MT, BCG should be repeated. 11
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  WINTER Template Common Questions About PentavalentVaccine • Can we give it to older children? - Target age group is 1 ½ months to 11 months. 12
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  WINTER Template Common Questions About PentavalentVaccine - In cases where a child received his/her Penta1 at age 10months, Penta2 at 11months, he/she may still be given the Penta3 at 12 months to complete the recommended doses. 13
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  WINTER Template Common Questions About PentavalentVaccine - It shall not be given to children 2 years old and above because the risk for AEFI is higher. 14
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  WINTER Template Catchment Areas Annual Eligible Population (2.7% ofTotal Pop) Suggested Number of Sessions 4,000 – 7,999 120 -239 1 per week 2,000 – 3,999 60 – 119 1 every 2 weeks 0 – 1,999 0 – 59 1 per month Recommended Vaccination Sessions 15
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  16 Common Questions About InactivatedPolio Vaccine • It shall be administered together with the 3rd dose of OPV. What if a health worker forgot to give one dose of IPV to a child who received his OPV3 today?
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  17 Common Questions About InactivatedPolio Vaccine • The missed dose of IPV can still be given. However, the policy on the administration of IPV together with OPV3 is to ensure that the child will get an optimum immune response.
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  18 Common Questions About Contraindicationsfor SC Immunization • Severe anaphylactic reactions to previous PPV23 or flu vaccine • Severe allergic reactions to egg & egg products (egg proteins), chicken feathers • Severe allergic reaction to latex gloves, antibiotics such as neomycin or polymyxin
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  Sensitivity to heat mostsensitive least sensitive  BCG after reconstitution  OPV  Measles (both before & after reconstitution)  BCG (before recon)  Penta / Hib, DT  Td, TT, Hepatitis B 19
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  Sensitivity to cold mostsensitive least sensitive  Hep B, Td, TT  Penta, Hib, IPV  BCG (before recon)  Measles 20
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  General Principles • Itis SAFE and IMMUNOLOGICALLY EFFECTIVE to administer all EPI vaccines on the same day at different sites of the body 21
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  General Principles • Onlythe diluent supplied by the manufacturer should be used to reconstitute a freeze-dried vaccine. 22
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  General Principles • Thediluents may be stored outside the cold chain BUT • Keep diluents for at least 24 hours before use in ILR to ensure that vaccines & diluents are at same temperature when being reconstituted. 23
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  General Principles • Thediluents may be stored outside the cold chain BUT • Keep diluents for at least 24 hours before use in ILR to ensure that vaccines & diluents are at same temperature when being reconstituted. 24
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  General Principles • Useof conditioned ice packs must be practiced. 25
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  General Principles • Conditionedice packs - Keep them out of freezer to allow them to “sweat” and cracking sound of water would be heard on shaking the ice packs. - This will protect “T” series vaccines from getting frozen. 26
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  General Principles • Donot use saline water or add salt for filling. • Never use day carrier containing two (2) ice packs. 27
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  General Principles • Acombination of FIFO & FEFO vaccine system is practiced to assure that all vaccines are utilized before its expiry date. 28
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  General Principles Lapsed VaccinationSchedule • Health workers are encouraged to administer vaccines as close to the recommended intervals as possible. 29
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  General Principles Lapsed VaccinationSchedule • 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. 30
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  General Principles • Ifrecords cannot be located, after everything was done, the child should be considered susceptible and should be started on the age-appropriate vaccination schedule. Unknown or Uncertain Vaccination Status 31
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  General Principles • Healthworkers should adhere as closely as possible to recommended vaccination schedule. Spacing of multiple doses of the same antigen 32
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  General Principles • Administrationat recommended ages and in accordance with recommended intervals between doses of multi-dose antigens provide optimal protection. Spacing of multiple doses of the same antigen 33
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  General Principles • Dosesadministered TOO CLOSE together or at TOO YOUNG can lead to a sub-optimal immune response. Spacing of multiple doses of the same antigen 34
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  General Principles • However,administering a dose few days earlier the minimum interval or age is unlikely to have a substantially negative effect on the immune response to that dose. Spacing of multiple doses of the same antigen 35
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  General Principles • Dosesof any vaccine administered >5 days earlier than the minimum interval or age should not be counted as valid doses and should be repeated as age appropriate. Spacing of multiple doses of the same antigen 36
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  General Principles • Therepeat dose should be spaced after the invalid dose by the recommended interval. Spacing of multiple doses of the same antigen 37
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  General Principles • Cottonballs wet with saline / distilled water instead of alcohol shall be used to prepare the injection site. Preparation of Site 38
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  Wastage Unopened Vials Opened Vials Unavoid- able wastage Discardof • Remaining doses at end of the session • Reconstituted vaccines to be discarded after 6 hours Vaccine Wastage 39
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  Vaccine Wastage Wast- age Unopened VialsOpened Vials Avoid- able wastage • Unused & unopened vials thrice return from session site • Expiry • VVM in discard stage • Breakage loses • Over supply • Suspect ed contami nation 40
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  Vaccine Wastage Antigen Acceptable WastageRate Penta, PCV13 5% OPV 10% TT, HepB, IPV 15% Reconstituted vaccines • BCG • MCV 50% 25% PPV23 / Flu 10% 41
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  Proper disposal ofUnused Vaccines Recommended methods of disposal: 1. Pit burning 2. Burning in drum or concrete pipe 3. Incinerator 42
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  Proper disposal ofUnused Vaccines 1. Vaccines containing live microbes. These are BCG, OPV, and MCV. When disposing of live vaccines, the live microbes in the vaccine has to be destroyed first by autoclaving, burning or boiling for 5-10 minutes. 43
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  Proper disposal ofUnused Vaccines 1. Vaccines containing live microbes. The vaccine microbes are easily destroyed with disinfecting solutions such as 1% chloramine & hypochlorite. Opened vaccine vials for disposal can be placed in a disinfecting solution which has to be replaced everyday. 44