Republic of the Philippines * a” Department of Health Eastern Visayas Center for Health Development sacoue PRIMAS National Immunization Program Regional Advisory No. 01-2024 TO: ALL PROVINCIAL/CITY HEALTH OFFICES, RURAL HEALTH UNITS, AND. OTHER ERNED HEALTH FACILITIES ae FROM: MILAGROSSABYACION C. BOLITO, MD, MPH fies Public Health Services Cluster. SUBJECT: BIVALENT ORAL POLIO VACCINE SUPPLEMENTAL IMMUNIZATION DATE: ACTIVITY (bOPV SIA) FOR CY 2024 February 29, 2024 RATIONALE Following the World Health Organization (WHO) declaration that the Philippines was Polio- free in 2021, The Department of Health (DOH) has continuously endeavored to maintain this status through environmental and disease surveillance, and increasing immunization coverage. However, duc to the restrictions during the COVID-19 pandemic, immunization coverage for the Polio vaccine has plateaued at 70%, and about 600,000 children born each ‘year during the pandemic have incomplete or no polio vaccine, thus increasing the risk of a polio outbreak. The Department of Health implemented a nationwide Measles-Rubella and bivalent Oral Polio Vaccine Supplemental Immunization Activity (MR-bOPV SIA) last May to June 2023, prioritizing areas with the highest risk of outbreaks for polio. This yielded a bOPV coverage of 81.8%, For the year 2024, the DOH aims to implement the second phase of bOPV SIA to vaccinate children in the remaining municipalities and barangays. General Guidelines 1. Al stakeholders shall actively participate in catch-up and vaccination for all eligible children, especially those with missed or zero doses of OPV, 2. The catch-up program in 2024 shall aim to achieve the following targets: a. At least 95% of infants and children aged 0-23 months in all regions have completed three (3) doses of bivalent oral poliovirus (bOPV); and b. At least 95% of all 24-59 months are given 1 dose of BOPV regardless of polio immunization status 3, All stakeholders shall identify opportunities for providing immunization services in activities with the same target population. om EveHSoR7.09 Frm Ravan § ‘Government Center, Brgy. Candahug, Palo, Leyte, Philippines 6501 + Tel/Fax Nos: (053) 888-2735 h.tegionaloft n.gov.oh + www.r08.doh.gov.phRepublic of the Philippines “a Department of Health Eastern Visayas Center for Health Development Specific Guidelines: A Preparatory Activities 1, Provincial and Local Health Units shall map and engage all non-government agencies, champions, medical professional societies, civil society organizations, partners, ete, who are providing support to the immunization program. 2, Provincial and Local Health Units shall develop plans, map human resources, and determine additional funding requirements for the implementation of this activity. 3, Provincial and Local Health Units, with the assistance of PDOHO, shall be responsible for the orientation and training of non-health personnel on the administration and handling of BOP (as necessary). 4. The 2023 projected population for 0-59 months issued by the Epidemiology Bureau shall be used as the target number of eligible children for OPV administration, and basis for the allocation of vaccines, ancillaries and other commodities. 5, Barangay Local Officials shall disseminate bOPV administration and catch-up immunization schedule through the barangay general assembly. 6. Barangay Health Workers and Volunteers shall conduct house-to-house visits to reiterate the OPV administration catch-up immunization schedule. Social Preparation, Advocacy, and Communication. The following activities may be done at the Provincial and Municipal level. 1, Incorporate demand generation strategies to the regional catch-up macro-plan/micro-plan for bOPV catch-up vaccination. 2. Conduct advocacy meetings with different stakeholders such as local chief executives, local health board, private medical societies, civil service organizations, youth groups, at. 3. Deploy social mobilizers to inform and educate the community in line with the updated communication package and risk communication messaging Campaign Schedule and Strategies The catch-up and SIA for bOPV shall be implemented in March to August of 2024, The following strategies may be implemented for this roll-out. However, this does not limit implementers to develop strategies they see fit to meet the activity’s objectives: 1, Incorporated into the LGU and barangay immunization schedule for intensified routine and catch-up activities for all antigens; 2. Side activity during the monthly 4Ps Family Development Sessions and required monthly check-up for beneficiaries with 0-59 months old children; 3. Vaccination drive as a kick-off activity for the World Immunization Week. 4. Other routine activities at the primary care facility which caters to the same age group or their caregivers such as family planning counseling sessions, prenatal check-ups, oral health services, etc. Government Center, Brgy. Candahug, Palo, Leyte, Philippines 6501 + Tel/Fax Nos: (053) 888-2735 {doh regionaloffice@ro8 doh.gov.ph + wwwr08.doh.gov.phRepublic of the Philippines “ao Department of Health Eastern Visayas Center for Health Development 5. Setting temporary/fixed vaccination posts such as transport terminals, plaza, playgrounds, basketball court, malls, church, and in sitios where most children are situated. 6. Side activity during the monthly 4Ps Family Development Sessions and required monthly check-up for beneficiaries with 0-59 months old children; D. Co-administration with Other Vaccines, Precautions and Contraindications 1. OPV shall be administered to all clinically healthy infants with a minimum interval of four weeks between doses. It may be given simultaneously with other vaccines given through an intramuscular, subcutaneous route without any interval. 2. Bivalent OPV (bOPV) may be administered concomitantly with monovalent (Rotarix) or pentavalent (Rotateq or Rotasiil) rotavirus vaccine. Although concomitant administration of OPV slightly reduced the immune response to rotavirus vaccine, there is currently no evidence that clinical protection against severe rotavirus gastroenteritis would be affected, (European Medicines Agency.https://www.ema.europa.cw) It is recommended that the sequence of the co-administration shall be: OPV first followed by Rotavirus vaccine then other recommended appropriate vaccines, (DM 2012-0157: Administration of Rotavirus Vaccine) 3. Infants and children with mild illnesses such as cough and colds may be given bOPV, followed by appropriate referral to a primary care provider for treatment and counseling. Postpone vaccination if the child has moderate to severe illness and refer to emergency care. 4. Immunosuppressed infants and children such as, but not limited to cancer patients ongoing chemotherapy, diagnosed with primary or secondary immunodeficiency such as severe combined immunodeficiency (SCID) or Human Immunodeficiency Virus (HIV) infection, or with history of prolonged use of systemic steroids, shall not be given polio vaccines or any live vaccines 5. Infants and children who exhibited allergic reactions or adverse reactions following the previous OPV administration may not receive the vaccine E, Recording and Reporting Refer to the infant or child’s vaccination card or Target Client list (TCL) to confirm their ‘immunization status. Consider the following for recording and reporting: 1, For infants 0-11 months old, record as routine dose and complete three doses at least 4 weeks apart. Review immunization records for missed doses for all antigen and schedule appropriately. Record vaccination as routine doses. 2, For children 12-23 months old, confirm the child’s immunization status. If the child completed 3 doses, may not give another dose. If the child has no vaccine or incomplete doses, vaccinate to complete 3 doses of bOPV. Complete other missed antigens and record as Completely Immunized Child (CIC). For children 24-59 months old, give one (1) dose of bOPV regardless of immunization status. This includes the children who have received the bOPV dose in the MR bOPV SIA implemented last May-June 2023. Government Center, Brgy. Candahug, Palo, Leyte, Philippines 6501 » Tel/Fax Nos: (053) 888-2735 {doh regionaloffice@ro8. doh.gov.ph + wwwr0B.doh gov.phRepublic of the Philippines at Department of Health Eastern Visayas Center for Health Development aconc PAeIAS, 4A weekly accomplishment report (Annex A) shall be submitted from the Rural Health UnilCity Health Office (except for HUC/ICC) to the Provincial Health Office every 1* day of the following week, and from the Provincial Health Office and HUC/ICC Health office to the Department of Health Eastem Visayas Center for Health Development every 2™ day of the following week from March to August ((incorporating accomplishments from January to February, if any, for the March reports). (Please see attached Annex A form for your reference) 5. All Line list data shall be submitted every 1* Monday of the following month to the Synchronized Electronic Immunization Repository (SEIR). (SEIR Reporting Form/System is still being finalized by DOH Central Office, for the meantime, please refer to the downloadable file to be used for submission) https://bit.lv/SEIROPVSIA2024 Please take note of the following (For Line list Reporting): *Using the line list link above kindly download first the form to excel file and input all necessary data * Codes will be provided once recording and reporting guidelines are finalized for SEIR. F. Monitoring 1, The Provincial Health Office, together with the Provincial DOH Offices and the Rural Health Units shall convene a weekly virtual meeting or as deemed necessary to monitor the progress, bottlenecks, and other concerns on the OPV roll-out. 2. Rapid Convenience Monitoring (RCM) through peer-to-peer strategy shall be done starting on the third month of implementation, and quarterly thereafter to monitor for routine immunization. G. Surveillance and Reporting of Adverse Events Following Immunization (AEFI) 1, All detected AEFIs both minor and serious, shall be reported to the nearest health facility ‘The existing DOH guidelines on AEFI surveillance and response under Administrative Order No. 2023-0007 “Revised Omnibus Guidelines on the Surveillance and Management of Adverse Events Following Immunization (AEFI)” shall be observed for this purpose; 2. AEFI cases needing hospitalization shall be managed and referred to the appropriate health facility following A.O. 2016-0025: “Guidelines on the Referral System for Adverse Events”. For your guidance and strict compliance. Government Center, Brgy. 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