Expanded Program On

Immunization
EXPANDED PROGRAM ON
IMMUNIZATION

-established in 1976
-ensure that infants/children and
mothers have access to routinely
recommended infant/childhood
vaccines.
Seven vaccine-preventable
diseases
1. Tuberculosis
2. Poliomyelitis
3. Diphtheria
4. Tetanus
5. Pertussis
6. Measles
7. Hepa B
Over-all Goal
To reduce the morbidity and
mortality among children
against the most common
vaccine-preventable diseases.
Specific Goals
1.To immunize all infants/children against
the most common vaccine-preventable
diseases.

2.To sustain the polio-free status of the

Philippines.

3. To eliminate measles infection.

4.To eliminate maternal and neonatal
tetanus

5.To control diphtheria, pertussis,

hepatitis b and German measles.

6.To prevent extra pulmonary

tuberculosis among children.
Republic Act No. 10152
-“Mandatory Infants and Children Health
Immunization Act of 2011”

-President Benigno Aquino III

-July 26, 2010

-Basic immunization for children under 5

including other types that will be
determined by the Secretary of Health.
 STRATEGIES
1. Conduct of Routine Immunization for
Infants/Children/Women through the
Reaching Every Barangay (REB) strategy

2. Supplemental Immunization Activity (SIA)

3. Strengthening Vaccine-Preventable Diseases

Surveillance

4. Procurement of adequate and potent

vaccines and needles and syringes to all
health facilities nationwide
Polio
-poliomyelitis
-caused by poliovirus
-crippling and potentially
infectious
-infects the person’s brain and
spinal cord causing paralysis
Diptheria
-bacterial infection
-affects the nose and throat
-cause breathing problems
and swallowing
Measles
-caused by a virus
-airborne
-infects the respiratory tract
Neonatal Tetanus
-infection occurs at
unhealed umbilical stump
(non-sterile equipment)
Pertusis
-whooping cough
- “100 day cough”
- Highly contagious respiratory
disease
Tuberculosis
-affects the lungs
-airborne
Hepatitis B
-viral infection
-attacks the liver
-transmitted through blood or
other body fluids
Poliomyelitis
-OPV (Oral Polio Vaccination)
-6 weeks old
-3 doses (2-3 drops)
-4 weeks
- Oral
-The extent of protection against
polio is increased the earlier the OPV
is given
Measles
-MCV
-Measles-Containing Vaccine
-9 months old
-2 dose (0.5 mL)
- Subcutaneous
- Upper outer portion of the arms
-At least 85% of measles can be
prevented by immunization at this
age
Hepatitis B
-HEPATITIS
- At birth
-3 doses (3 doses)
-4 weeks interval
- Intramuscular
- Upper outer portion of the thigh
-Prevents liver cirrhosis and liver
cancer
 Diphtheria-Pertusis-Tetanus
-DPT
-6 weeks old
-3 doses (0.5 mL)
-6 weeks(DPT 1), 10 weeks (DPT 2),
14 weeks (DPT 3)
- Intramuscular
- Upper outer portion of the thigh
- An early start with DPT reduces the
chance of severe pertussis
Tuberculosis
-BCG (Bacillus Calmette-Guérin)
-at birth
-1 dose (0.05 mL)
- none
- Intradermal
- Right deltoid region of the arm
-BCG given at earliest possible age
protects the possibility of TB
meningitis and other TB infections in
which infants are prone
 Minimum Percent
Vaccine Duration of Protection
Age/Interval Protected
 protection for the mother for
TT1 At 20th weeks AOG 0%
the first delivery
 infants born to the mother
will be protected from
TT2 At least 4 weeks later 80% neonatal tetanus
 gives 3 years protection for
the mother
 infants born to the mother
will be protected from
TT3 At least 6 months later 95% neonatal tetanus
 gives 5 years protection for
the mother
 infants born to the mother
will be protected from
TT4 At least 1 year later 99% neonatal tetanus
 gives 10 years protection for
the mother
 gives lifetime protection for
the mother
TT5 At least 1 year later 99%
 all infants born to that mother
will be protected
Systems for tracing defaulters
In this section you will learn how you trace (track)
defaulters. Defaulters are those infants who started the
routine EPI immunizations but failed to complete the
schedule for whatever reason. If you trace defaulters
regularly every month, it will make the task of follow-up
much easier. You may be able to contact the mothers
directly, or ask other members of the community to help
you to find them. Try to ensure that every infant receives
the immunizations that are overdue. There are many
ways to monitor and follow-up on defaulters. Here we
describe two tracking systems that can easily be used.
Using the EPI Registration Book
At the end of each month, review
the EPI Registration Book to identify
infants and mothers who have not
received doses of vaccine at the
appropriate time, according to the
recommended EPI schedule.
Using reminder cards
Make reminder cards, which are copies of the infant’s immunization cards. File them in a box
behind the divider for the month when the infant’s next immunization is due (Figure 10.8). Refer to
these every month to identify the defaulters.

      
Figure 10.8  Box for storing immunization reminder cards. (Source: WHO 2001, Immunization in
Practice, Module 7, Monitoring and Using your Data, Figure 7F, p.11)
The Field Health Service Information System (FHSIS) is a
major component of the network information sources
developed by the Department of Health (DOH) to better
manage its nationwide health service delivery activities.
The FHSIS was designed to provide the basic service data
needed to monitor activities in each health program.
Target Client List (TCL)

The Target Client Lists constitute the second

“building block” of the FHSIS and are
intended to serve several purposes.
First is to plan and carry out patient care and service
delivery. Such lists will be of considerable value to
midwives/nurses in monitoring service delivery to
clients in general and in particular to groups of
patients identified as “targets” or part of the
“eligible” group for one or another program of the
Department
A second purpose of Target Client Lists is to
facilitate the monitoring and supervision of
service delivery activities. A third purpose is to
report services delivered. Again, the objective is
to avoid having to go back to individual
patient/family records in order to complete the
FHSIS Reporting. A fourth purpose of the Target
Client Lists is to provide a clinic-level database
which can be accessed for further studies
Child Care Indicators and Corresponding Target Client List
 Target Client List for Under
One Year Old Children
The Target Client List for Under One Year Old Children
should include all children under one year old eligible for
immunization against the seven (7) vaccine preventable
diseases (VPD), iron supplementation, newborn screening
and breastfeeding.
Column 1: DATE OF REGISTRATION – In this column,
write the month, day and year an infant was seen at the
clinic or at home for health services.

Column 2: DATE OF BIRTH – In this column, write the

month, day and year of birth. This column is
important for immunization schedule.
Column 3: FAMILY SERIAL NUMBER – Indicate in this
column the number that corresponds to the number of
the family folder or envelope or individual treatment
record. This column will help you to easily facilitate
retrieval of your record.

Column 4: NAME OF CHILD – Write the complete

name of the child.
Column 5: SEX – Write the sex of infant. M for male
and F for female.

Column 6: COMPLETE NAME OF MOTHER – In this

column, write the name of the mother

Column 7: COMPLETE ADDRESS – Record the client’s

permanent place of residence. This column will help
you to monitor or follow-up with the client.
Column 8: DATE OF NEWBORN SCREENING – This is
divided into two sub-columns. The first sub-column
refers to those who were only given a referral, and the
second sub-column refers to newborn screening done
in your health center. Only write the date.

Column 9: CHILD PROTECTED AT BIRTH (CPAB) – Write

the Tetanus Toxoid Status of the mother in the sub-
column TT STATUS and Date the mother was assessed
of her TT status.
Column 10: MICRONUTRIENT SUPPLEMENTATION–
This column consists of 2 sub- columns. For Vitamin A
Supplementation column, write the age in months and
the date Vitamin A was given, and on the Iron column
write the birth weight of the infant and the date iron
was started and completed.

Column 11: DATE IMMUNIZATION RECEIVED – Indicate

in these columns the exact date the child received
each antigen or vaccine.
Routine Immunization Schedule for
Infants
Column 12: DATE FULLY IMMUNIZED – Write the
exact date the child was given the last dose of the
scheduled immunization which makes the child a fully
immunized child.
Note: A Fully Immunized Child (FIC) is a child that has
received all of the following:
• One dose of BCG at birth or anytime before
reaching 12 months.
• Three (3) doses each of DPT, OPV and Hepatitis B
as long as the 3rd dose is given before the child
reaches 12 months of age.
• One dose of anti-measles vaccine before reaching
12 months.
Column 13: CHILD WAS EXCLUSIVELY BREASTFED – This
column is divided into 6 sub- columns. For sub-columns
“1st to 5th month”, put a check if the child was
exclusively breastfed, while in the sub- column “6th
month”, write the date if the child was exclusively
breastfed.
Column 14: REMARKS – Write the reasons why a child
failed to return for the next immunization schedule or
why a child reaching 1 year of age was not fully
immunized, to include illnesses, hospitalization, and
other data of importance to the child.
Monthly Report Form for Child Care (M1)