Expanded program of immunization dr faten m rabie
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Expanded Program of Immunization Dr. Faten M. Rabie. Objectives of the lecture. 1- Scope of the program 2- Objectives of the EPI 3- Strategies of the program 4-The target population 5- Schedule of immunization in KSA 6- Dose, route of administration and type of each vaccine.

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Expanded program of immunization dr faten m rabie
Expanded Program of ImmunizationDr. Faten M. Rabie


Objectives of the lecture
Objectives of the lecture

1- Scope of the program

2- Objectives of the EPI

3- Strategies of the program

4-The target population

5- Schedule of immunization in KSA

6- Dose, route of administration and type of each vaccine.

7- Contraindications of vaccination

8- Estimation of the eligibles

9- Records and reports

10- Defaulter tracing

11- Cold chain


Scope of the epi
Scope of the EPI

Experience with smallpox eradication program showed the world that immunization was the most powerful and cost-effective weapon against vaccine preventable diseases.

In 1974, the WHO launched its “ Expanded program of immunization” (EPI) against six most common preventable diseases (diphtheria, pertussis, tetanus, polio, tuberculosis and measles.


Expanded” means:

  • Expanding the number of diseases to be covered

  • Expanding the number of children and target population to be covered

  • Expanding coverage to all corners of the country and spreading services to reach the less privileged sectors of the society


Objectives of the epi
Objectives of the EPI

  • To reduce the morbidity and mortality of the major six childhood diseases.

  • To achieve 100% coverage for eligible children by an ongoing integrated program

  • To deliver an integrated immunization services through health centers, as primary health care service package

  • To develop a surveillance system which collect adequate information on the diseases preventable by immunization

  • To minimize the efforts and cost of treatment

  • To promote a new healthy generation


Strategies of the epi
Strategies of the EPI

  • Integrate vaccination sessions with PHC services

  • Appropriate measures to expand the vaccination coverage of the eligible population

  • Ensuring regular supply of potent vaccine

  • Strengthening the cold chain

  • Training of health personnel

  • Promotion of community participation

  • Incorporating health education activities related to EPI


Ensuring logistic support ( supplies and equipments)

Introducing a system for continuous monitoring and periodic evaluation

Undertaking operational research to find out deficiencies and difficulties in the program and suggest methods of improvement


Targets
Targets

  • Under 5-years children.

  • Women in the child bearing age (15-45 years).



Contraindications of vaccination
Contraindications of vaccination

  • There are only 3 contraindications:

  • Immune compromised child ( mainly AIDS) → no BCG

  • Child who develops convulsions after the first dose of DPT → DT

  • Severely ill child to the extent that he urgently referred to the hospital


Estimation of eligibles
Estimation of eligibles

  • The target population is estimated on the basis of total population as registered during survey and the increase in the population on the basis of birth rate and growth rate.

  • Example:

  • Annual growth rate …………………...4%

  • Total registered population………...1000

  • Birth rate………………………………..50l1000

  • No. of expected births = 0-1 year…………….50


  • No. in child bearing age…………………….20%

  • No. of pregnant women expected =

  • no. of 0-1 year infant =…………..50

  • No. of children under 2 years = double the no. of infants…….= 100

  • Estimated requirements of vaccine per episode of supply (for each vaccine calculated separately):

  • Total number of children to be vaccinated in one year x Number of doses to be given + 10% wastage


Periodicity of the supply
Periodicity of the supply

Example:

  • No. of children below 2 years of age:…..6126

  • No. of children below 2 years already immunized ……1126

  • No. of eligible = 6126-1126 ……….=5000

  • Proposed coverage………………...=85% = 4250

  • No. of doses of given to each……….3

  • Annual requirement …………….. …= 4250 x 3 + 10%= 12750 +1275 = 14025 doses

  • Monthly doses……..= 14025 ÷ 12 = 1169 doses

  • Convert doses into vials i.e if the vial contains 10 doses…………………………116 vial


Records and reports
Records and reports

  • Records are required for:

  • Monitoring of program progress.

  • Identification of defaulters.

  • Comparing with EPI-related disease situation.


Types of records:

  • Yearly vaccination register- by age, sex, nationality and dosage numbers.

  • Daily vaccination register- with identifying family register number.

  • Follow up register.

  • Stock indent register.

  • Immunization card ( details of immunization and the date of next visit).


Reports
Reports

  • Monthly immunization report showing total number of doses, age, sex, nationality are sent in the first week of each month.

  • This information would form a strong base for the development of a surveillance system for EPI and EPI related diseases.


Cold chain
Cold chain

  • Cold chain is a system of storing, transporting and distributing of vaccines in the correct temperature and way from the factory to the vaccinated child.

  • Cold chain is a corner stone of the EPI, because the vaccine loses the efficacy if incorrectly kept.


Cold chain levels
Cold chain levels

  • The central level.

  • Regional level.

  • Primary health care center level.


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