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Expended program for Immunization (EPI)

• Principles of EPI include:

1. Epidemiological situation

2. Mass approach

3. Basic Health Service

• The 7 immunizable diseases are:

1. Tuberculosis

2. Diptheria

3. Pertussis

4. Measles

5. Poliomyelitis

6. Tetanus

7. Hepatitis B

Administration of vaccines:

Vaccine Content Form & Dosage # of Doses Route

BCG Live attenuated Freeze dried infant- 1 ID
bacteria 0.05ml

DPT DT- weakened toxin liquid-0.5ml 3 IM

P-killed bacteria
OPV weakened virus liquid-2drops 3 Oral
Hepa B Plasma derivative Liquid-0.5ml 3 IM
Measles Weakened virus Freeze dried- 0.5ml 1 Subcutaneous

Schedule of Vaccines:

Vaccine Age at 1st dose Interval between dose Protection

BCG At birth
DPT 6 weeks 4 weeks DPT
OPV 6weeks 4weeks Poliomyelitis
Hepa B @ birth @birth,6th week,14th HepaB
Measles 9m0s.-11m0s. measles

6 months – earliest dose of measles given in case of outbreak

9months-11months- regular schedule of measles vaccine

15 months- latest dose of measles given

4-5 years old- catch up dose

Fully Immunized Child (FIC)- less than 12 months old child with complete
immunizations of DPT, OPV, BCG, Anti Hepatitis, Anti measles.

Vaccine Minimum age interval % protected Duration of Protection

TT1 As early as possible 0% 0
TT2 4 weeks later 80% 3 years
TT3 6 months later 95% 5 years
TT4 1year later/during next 99% 10 years
TT5 1 year later/third 99% Lifetime

• There is no contraindication to immunization except when the child is

immunosuppressed or is very, very ill (but not slight fever or cold). Or if the
child experienced convulsions after a DPT or measles vaccine, report such to the
doctor immediately.
• Malnutrition is not a contraindication for immunizing children rather, it is an
indication for immunization since common childhood diseases are often severe to
malnourished children.

Cold Chain under EPI:

 Cold Chain is a system used to maintain potency of a vaccine from that of

manufacture to the time it is given to child or pregnant woman.
 The allowable timeframes for the storage of vaccines at different levels are:

o 6months- Regional Level

o 3months- Provincial Level/District Level

o 1month-main health centers-with ref.

o Not more than 5days- Health centers using transport boxes.

 Most sensitive to heat: Freezer (-15 to -25 degrees C)


o Measles

 Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celcius)



o Hepa B

o TT

 Use those that will expire first, mark “X”/ exposure, 3rd- discard,

 Transport-use cold bags, let it stand in room temperature for a while before
storing DPT.

 Half life packs: 4hours-BCG, DPT, Polio, 8 hours-measles, TT, Hepa B.

FEFO (“first expiry and first out”) - vaccine is practiced to assure that all vaccines
are utilized before the expiry date.

Proper arrangement of vaccines and/or labeling of vaccines expiry date are done to
identify those near to expire vaccines.