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{{Short description|Childhood immunization schedule}}
The '''Expanded Program on Immunization''' '''(EPI)''' in the [[Philippines]] began in
# sustaining high routine Full Immunized Child (FIC) coverage of at least 90% in all provinces and cities;
# sustaining the polio-free country for global certification;
# eliminating measles by 2008; and
# eliminating neonatal tetanus by 2008.
==Routine Schedule of Immunization==
Every Wednesday is designated as immunization day and is adopted in all parts of the country. Immunization is done monthly in barangay health stations, quarterly in remote areas of the country.
==Routine Immunization Schedule for Infants==
The standard routine immunization schedule for infants in the Philippines is adopted to provide maximum immunity against the seven vaccine preventable diseases in the country before the child's first birthday. The fully immunized child must have completed BCG 1, DPT 1, DPT 2, DPT 3, OPV 1, OPV 2, OPV 3, HB 1, HB 2, HB 3 and measles vaccines before the child is 12 months of age.<ref>{{cite news
{| class="wikitable"
|-
! Vaccine
! Minimum Age <br />at 1st Dose
! Number <br />of Doses
! Dose
! Minimum Interval Between Doses
! Route
! Site
! Reason
|-
| [[Bacillus Calmette-Guérin]]
|
|
|
| {{center|none}}
| BCG given at earliest possible age protects the possibility of TB meningitis and other TB infections in which infants are prone<ref name='PMID: 15628980'> {{cite journal|title=Protective effect of neonatal BCG vaccines against tuberculous meningitis.|journal=Bosnian Journal of Basic Medical Sciences|date=2004-02|first=S.|last=Puvacic|coauthors=|volume=4|issue=1|pages=46-9|id= |url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=15628980|format=|accessdate=2007-05-11}}</ref>▼
| {{center|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<ref name='
|-
| [[
|
|
|
| {{center|6 weeks(DPT 1), 10 weeks (DPT 2), 14 weeks (DPT 3)}}
| An early start with DPT reduces the chance of severe pertussis<ref> {{cite journal|title=Immunisation | journal=Dialogue on Diarrhoea Online | date=1987 | issue=30 | pages=1-6 |url=http://rehydrate.org/dd/su30.htm | accessdate=2007-05-11}}</ref>.▼
| {{center|Intramuscular}}
| Upper outer portion of the thigh, Vastus Lateralis (L-R-L)
▲| An early start with DPT reduces the chance of severe pertussis.<ref>
|-
| [[
|
|
|
| {{center|4 weeks}}
| The extent of protection against polio is increased the earlier the OPV is given. <br />Keeps the Philippines polio-free<ref> {{cite journal|title=Public Health Dispatch: Acute Flaccid Paralysis Associated with Circulating Vaccine-Derived Poliovirus --- Philippines, 2001|journal=Morbidity and Mortality Weekly Report|date=2001-10-12|first=|last=Centers for Disease Control and Prevention|coauthors=|volume=50|issue=40|pages=874-5|id= |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5040a3.htm|format=|accessdate=2007-05-11}}</ref>.▼
| {{center|Oral}}
| Mouth
▲| The extent of protection against polio is increased the earlier the OPV is given. <br />Keeps the Philippines polio-free.<ref>
|-
| [[
|
|
| {{center|0.5 mL}}
| {{center|Intramuscular}}
| An early start of Hepatitis B vaccine reduces the chance of being infected and becoming a carrier<ref> {{cite journal|title=Effects of Universal Vaccination for Hepatitis B|journal=Annals of Internal Medicine|date=2001-11-06|first=Y. H.|last=Ni|coauthors=M.H. Chang, L.M. Huang, H.L. Chen, H.Y. Hsu, T.Y. Chiu, K.S. Tsai, and D.S. Chen|volume=135|issue=9|pages=S53|id= |url=http://www.annals.org/cgi/content/summary/135/9/796|format=|accessdate=2007-05-12}}</ref>. <br /> Prevents liver cirrhosis and liver cancer which are more likely to develop if infected with Hepatitis B early in life<ref> {{cite web|url=http://www.chop.edu/consumer/jsp/division/generic.jsp?id=75730 |title=A Look at Each Vaccine: Hepatitis B Vaccine |accessdate=2007-05-11 |work=Vaccine Education Center |publisher=The Children's Hospital of Philadelphia }}</ref> <ref name='PMID: 9197213'> {{cite journal|title=Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group.|journal=The New England Journal of Medicine|date=1997-06-26|first=MH|last=Chang|coauthors=C.J. Chen, M.S. Lai, H.M. Hsu, T.C. Wu, M.S. Kong, D.C. Liang, W.Y. Shau, D.S. Chen|volume=336|issue=26|pages=1906-7|id= |url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=9197213&dopt=Abstract|format=|accessdate=2007-05-12}}</ref>. <br />About 9,000 die of complications of Hepatits B. 10% of Filipinos have Hepatitis B infection<ref>{{cite news | first=Tessa R. | last=Salazar | coauthors= | title=Cancer Preventable Says US Doctor | date=2004-05-24 | publisher= | url =http://liver.stanford.edu/files/040529manilla_times.pdf | work =The Philippine Daily Inquirer | pages = | accessdate = 2007-05-11 | language = }}</ref>▼
| Upper outer portion of the thigh, Vastus Lateralis (R-L-R)
▲| An early start of Hepatitis B vaccine reduces the chance of being infected and becoming a carrier.<ref>
|-
| [[Measles Vaccine]] <br />
|
|
|
| {{center|none}}
| At least 85% of measles can be prevented by immunization at this age<ref name='PMID: 8034506'> {{cite journal|title=Worldwide measles prevention|journal=Israel Journal of Medical Sciences|date=1994-05|first=WA|last=Orenstein|coauthors=L.E. Markowitz, W.L. Atkinson, A.R. Hinman|volume=30|issue=5-6|pages=469-81|id= |url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8034506&dopt=Abstract|format=|accessdate=2007-05-11}}</ref>. ▼
| {{center|Subcutaneous}}
| Upper outer portion of the arms, Right deltoid
▲| At least 85% of measles can be prevented by immunization at this age.<ref name='
|}
=
==Tetanus Toxoid Immunization Schedule for Women==
When given to women of childbearing age, vaccines that contain tetanus toxoid (TT or Td) not only protect women against tetanus, but also prevent neonatal tetanus in their newborn infants.<ref>{{cite web|url=https://www.who.int/immunization/topics/tetanus/en/index1.html |archive-url=https://web.archive.org/web/20060322063335/http://www.who.int/immunization/topics/tetanus/en/index1.html |url-status=dead |archive-date=March 22, 2006 |title=Tetanus - The Disease |access-date=2007-05-12 |work=Immunization, Vaccines and Biologicals |publisher=[[World Health Organization]] }}</ref>
{| class="wikitable"
|-
! Vaccine
! Minimum <br />Age/Interval
! Percent<br />Protected
! Duration of Protection
|-
| {{center|TT1}}
| At 20th weeks AOG
| {{center|0%}}
|
* protection for the mother for the first delivery
|-
| {{center|TT2}}
| At least 4 weeks later
| {{center|80%}}
|
* infants born to the mother will be protected from neonatal tetanus
* gives 3 years protection for the mother
|-
| {{center|TT3}}
| At least 6 months later
| {{center|95%}}
|
* infants born to the mother will be protected from neonatal tetanus
* gives 5 years protection for the mother
|-
| {{center|TT4}}
| At least 1 year later
| {{center|99%}}
|
* infants born to the mother will be protected from neonatal tetanus
* gives 10 years protection for the mother
|-
| {{center|TT5}}
| At least 1 year later
| {{center|99%}}
|
* gives lifetime protection for the mother
* all infants born to that mother will be protected
|}
In June 2000, the 57 countries that have not yet achieved elimination of neonatal tetanus were ranked and the Philippines was listed together with 22 other countries in Class A, a classification for countries close to maternal and neonatal tetanus elimination.<ref>{{cite news | title=Maternal and Neonatal Tetanus | date=November 2000 | publisher=UNICEF | url=http://www.unicef.org/immunization/files/MNTE_strategy_paper.pdf | access-date=2007-05-12 | archive-date=2007-01-11 | archive-url=https://web.archive.org/web/20070111051802/http://www.unicef.org/immunization/files/MNTE_strategy_paper.pdf | url-status=dead }}</ref>
==Care for the Vaccines==
To ensure the optimal potency of vaccines,a careful attention is needed in handling practices at the country level. These include storage and transport of vaccines from the primary vaccine store down to the end-user at the health facility, and further down at the outreach sites.<ref name='WHO/IVB/06.10'>{{cite news|title=Temperature Sensitivity of Vaccines |date=August 2006 |publisher=[[World Health Organization]] |url=https://www.who.int/vaccines-documents/DocsPDF06/847.pdf |work=Immunization, Vaccines and Biologicals |access-date=2007-05-12 |url-status=dead |archive-url=https://web.archive.org/web/20070219113617/http://www.who.int/vaccines-documents/DocsPDF06/847.pdf |archive-date=2007-02-19 }}</ref> Inappropriate storage, handling and transport of vaccines won't protect patients and may lead to needless vaccine wastage.<ref name='mbphysicianresources#2_2005'>{{cite news|title=Handle Vaccines with Care |publisher=British Columbia Center for Disease Control |url=http://www.bccdc.org/downloads/pdf/epid/reports/GP%202-HANDLE%20VACCINES%20WITH%20CARE.pdf?PHPSESSID=85793516774767a844e11dc04a118d5f |access-date=2007-05-12 }}{{dead link|date=February 2017|bot=medic}}{{cbignore|bot=medic}}</ref>
A "first expiry and first out" (FEFO) vaccine system is practiced to assure that all vaccines are utilized before its expiry date. Proper arrangement of vaccines and/or labeling of expiry dates are done to identify those close to expiring. Vaccine temperature is monitored twice a day (early in the morning and in the afternoon) in all health facilities and plotted to monitor break in the [[cold chain]]. Each level of health facilities has cold chain equipment for use in the storage vaccines which included cold room, freezer, refrigerator, transport box, vaccine carriers, thermometers, cold chain monitors, ice packs, temperature monitoring chart and safety collector boxes.<ref>{{cite book | title = Expanded Program on Immunization Manual | publisher = Department of Health, Philippines | year = 1995 | ___location = Manila, Philippines }}</ref>
{{Reflist}}
{{DEFAULTSORT:Expanded Program On Immunization (Philippines)}}
▲= References =
[[Category:Vaccination]]
[[Category:Healthcare in the Philippines]]
[[Category:Establishments by Philippine presidential decree]]
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