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The Expanded Program On Immunization (EPI)

The Expanded Program On Immunization (EPI). By Prof. Drs Asmaa ABelAziz Alaa Hassan. The Expanded Program On Immunization (EPI ). The Objectives of the lecture: State the objectives of EPI. Outlines the schedule of compulsory immunization of KSA.

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The Expanded Program On Immunization (EPI)

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  1. The Expanded Program On Immunization(EPI) By Prof. Drs Asmaa ABelAziz Alaa Hassan

  2. The Expanded Program On Immunization(EPI)

  3. The Objectives of the lecture: • State the objectives of EPI. • Outlines the schedule of compulsory immunization of KSA. • Recognize the scientific principles of immunization . • List the contraindications to vaccination. • Explain the four strategies for the vaccine delivery. • Define missed opportunity for immunization. • Mention the reasons for missed opportunity. • Define the cold chain. • Discuss the three components of the cold chain. • Interpret the tools for the cold chain monitoring.

  4. The objectives of EPI: 1. To achieve 100% coverage with all EPI vaccines. Example: The coverage rate for measles vaccine by the year 2002 in a city Y= The No. of the infants received measles vaccine in the year 2002 in city Y X100 The total No. of the targeted infants during the same year & locality

  5. 2. Eradication of polio to maintain polio free status.

  6. 3. Elimination of measles.

  7. 4. Reduce seroprevalence of (HBsAg)to <1% among under five. HBV

  8. 5.Elimination of Neonatal Tetanus .

  9. 6. To maintain zero level of diphtheria.

  10. 7.Prevention of severe forms of TB ( TB meningitis &military TB). 12 year old girl with TB meningitis

  11. 8. To reduce the incidence of whooping cough .

  12. 9-Reduce the incidence of Bacteria Meningitis due to haemophelus influenza

  13. 9. To maintain immunization safety. • 10.To prepare for introduction of new vaccines

  14. The Schedule of Compulsory Vaccination in KSA

  15. At birth

  16. 2ndmonth

  17. 4th month

  18. 6 th month

  19. 12th month

  20. 18th month

  21. 4- 6th years

  22. BCG (At birth) • Live attenuated variant. • 0.01ml . • ID injection in left deltoid (Why)

  23. HB Vaccine: • at birth,2nd,6th month • Recombinant, yeast derived HBs antigen • 0.5 ml IM anterolateral of the thigh

  24. OPV : (Sabin) • 2nd , 4th, 6th, 18th& 4- 6th years • OPV live attenuated ,2drops ,Oral

  25. Hib Vaccine Haemophilus influenzae type b • Severe bacterial infection, particularly among infants • During late 19th century believed to cause influenza • Immunology and microbiology clarified in 1930s

  26. Haemophilus influenzae type bPathogenesis • Organism colonizes nasopharynx • In some persons organism invades bloodstream and cause infection at distant site • Antecedent upper respiratory tract infection may be a contributing factor

  27. Haemophilus influenzae type b Clinical Features* *prevaccination era

  28. The Type of Hib vaccine inactivated polysaccharide conjugate vaccine,It is made by joining a piece of the polysaccharide capsule that surrounds the Hib bacterium to a protein carrier. • This joining process is called conjugation.

  29. Haemophilus influenzae type b Meningitis • Accounted for approximately 50%-65% of cases in the prevaccine era • Hearing impairment or neurologic sequelae in 15%-30% • Case-fatality rate 2%-5% despite of effective antimicrobial therapy

  30. Incidence*of Invasive Hib Disease, 1990-2004 *Rate per 100,000 in children <5 years of age Year

  31. After a Hib primary series of two or three doses,95% of infants develop protective antibodies • Although Hib vaccines provide long lasting immunity the duration of immunity is not known • The recommended dose for all is 0.5 mL. • Always administer by the IM injection in the thigh. • The preferred injection site in older children and adults is the deltoid muscle in the upper arm.

  32. Small child receiving Hib vaccine into the muscles of the thigh. Adolescent receiving Hib vaccine into the deltoid muscle of the arm.

  33. Storage of the vaccine • The vaccine should not kept frozen or exposed to freezing • Store at 2° to 8°C • Shake vial vigorously before withdrawal and use. • Do not use if resuspension does not occur with vigorousshaking. • The vaccine should be administered shortly afterwithdrawal from the vial.

  34. Give all infants, including premature infants, a primary series of Hib vaccine beginning at 2 months of age. • Do not administer Hib vaccine to infants younger than 6 weeks of age because this may induce immunologic tolerance to further doses of Hib vaccine.

  35. The most common adverse reactions after Hib vaccination are • 1-local reactions: swelling, redness, or pain at the injection site.2-Fever also can occur in as many as 5% of recipients.Fever usually starts within the 1st 24 hours ofvaccination and may last for 2 to 3 days.These reactions can be treated witha non-aspirin pain reliever, if needed.

  36. local reactions: swelling, redness, or pain at the injection site.

  37. The main contraindication to Hib vaccine : • Severe allergic reaction Do not give Hib-containing vaccine to anyone who has had a prior severe allergic reaction to a dose of Hib vaccine or to a component in the vaccine. • Persons who are severely allergic to diphtheria toxoid, meningococcal vaccine, or tetanus toxoid also may be sensitive to a particular Hib vaccine because of the protein carriers used to create the conjugate vaccines.

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