Principles of EPI: Community Health Nursing Expanded Program For Immunization (EPI)

COMMUNITY HEALTH NURSING derivative 0.
5ml
Measles Weakened Freeze 1 SU
EXPANDED PROGRAM FOR IMMUNIZATION virus dried- BCU
(EPI) 0.5ml
Principles of EPI
1. Epidemiological situation Schedule of Vaccines
2. Mass approach Vaccine Age at Interval Protection
3. Basic Health Service 1st dose between
dose
The 7 immunizable diseases BCG At birth BCG is given
1. Tuberculosis at the earliest
2. Diptheria possible age
3. Pertussis protects against
4. Measles the possibility
5. Poliomyelitis of TB infection
6. Tetanus from the other
7. Hepatitis B family
members
Target Setting DPT 6 weeks 4 weeks An early start
 Infants 0-12 months with DPT
 Pregnant and Post Partum Women reduces the
 School Entrants/ Grade 1 / 7 years old chance of
severe pertussis
Objectives of EPI OPV 6weeks 4weeks The extent of
 To reduce morbidity and mortality rates protection
among infants and children from six childhood against polio is
immunizable disease increased the
earlier OPV is
Elements of EPI given.
 Target Setting Hepa B @ birth @birth,6th An early start
 Cold chain Logistic Management- Vaccine week,14th of Hepatitis B
distribution through cold chain is designed to week reduces
ensure that the vaccines were maintained the chance of
under proper environmental condition until the being infected
time of administration. and becoming a
 Information, Education and Communication carrier.
(IEC) Measles 9m0s.- At least 85%
 Assessment and evaluation of Over-all 11m0s. of measles can
performance of the program be prevented by
 Surveillance and research studies immunization
at this age.
Administration of vaccines
Vaccine Content Form & # of Rou  6 months – earliest dose of measles given in
Dosage Dose te case of outbreak
s  9months-11months- regular schedule of
BCG Live Freeze 1 ID measles vaccine
(Bacillus attenuated dried  15 months- latest dose of measles given
Calmette bacteria Infant-  4-5 years old- catch up dose
Guerin) 0.05ml  Fully Immunized Child (FIC)– less than 12
Preschool months old child with complete immunizations
-0.1ml of DPT, OPV, BCG, Anti Hepatitis, Anti
DPT DT- liquid- 3 IM measles.
(Diphtheria weakened 0.5ml
Pertussis toxin Tetanus Toxiod Immunization
Tetanus) P-killed Schedule for Women
bacteria Vaccine Minimum % Duration of
OPV (Oral weakened liquid- 3 Oral age interval protected Protection
Polio virus 2drops TT1 As early as 0% 0
Vaccine) possible
Hepatitis B Plasma Liquid- 3 IM TT2 4 weeks later 80% 3 years
TT3 6 months 95% 5 years
later
TT4 1year 99% 10 years
later/during
next
pregnancy
TT5 1 year 99% Lifetime
later/third
pregnancy
 There is no contraindication to immunization
except when the child is immunosuppressed or is
very, very ill (but not slight fever or cold). Or if
the child experienced convulsions after a DPT or
measles vaccine, report such to the doctor
immediately.
 Malnutrition is not a contraindication for
immunizing children rather; it is an indication for
immunization since common childhood diseases
are often severe to malnourished children.
Cold Chain under EPI

 Cold Chain is a system used to maintain potency
of a vaccine from that of manufacture to the time it
is given to child or pregnant woman.
 The allowable timeframes for the storage of
vaccines at different levels are:
 6months- Regional Level
 3months- Provincial Level/District Level
 1month-main health centers-with ref.
 Not more than 5days- Health centers using
transport boxes.
 Most sensitive to heat: Freezer (-15 to -25 degrees
C)
 OPV
 Measles
 Sensitive to heat and freezing (body of ref. +2 to
+8 degrees Celsius)
 BCG
 DPT
 Hepa B
 TT
 Use those that will expire first, mark “X”/
exposure, 3rd- discard,
 Transport-use cold bags let it stand in room
temperature for a while before storing DPT.
 Half life packs: 4hours-BCG, DPT, Polio, 8 hours-
measles, TT, Hepa B.
 FEFO (“first expiry and first out”) – vaccine is
practiced to assure that all vaccines are utilized
before the expiry date. Proper arrangement of
vaccines and/or labeling of vaccines expiry date
are done to identify those near to expire vaccines.

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Cold Chain under EPI

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