expanded program of immunization dr faten m rabie n.
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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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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

  • Under 5-years children.
  • Women in the child bearing age (15-45 years).
Schedule of immunization
  • Type of the vaccine
  • Dose of each vaccine
  • Route of administration
  • Precautions of vaccination
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


  • 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).
  • 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.