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

Vaccine

Content

Form &

# of

Age at

Interval between

Protection

Route

Dosage

Doses

1 dose

At birth

6 weeks

4 weeks

DPT

IM

6weeks

4weeks

Poliomyelitis

Oral

@ birth

HepaB

IM

st

dose

Freeze
dried

BCG

Live

infant-

attenuated

0.05ml

ID

bacteria
Preschool0.1ml
DTweakened
DPT

toxin

liquid-0.5ml

P-killed
bacteria
OPV

Hepa B

weakened

liquid-

virus

2drops

Plasma

Liquid-

derivative

0.5ml

@birth,6 week,14
th

week

th

Measles

Weakened

Freeze

virus

dried- 0.5ml

9m0s.11m0s.

measles

Subcutaneo
us

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 withcomplete immunizations of DPT, OPV,
BCG, Anti Hepatitis, Anti measles.

Vaccine

TT1

Minimum age
interval
As early as
possible

% protected

Duration of
Protection

0%

TT2

4 weeks later

80%

3 years

TT3

6 months later

95%

5 years

TT4

1year

99%

10 years

later/during

next pregnany
1 year
TT5

later/third

99%

Lifetime

pregnancy

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 OPV
o Measles
Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celcius)
o BCG
o DPT
o Hepa B
o TT
Use those that will expire first, mark X/ exposure, 3 discard,
rd

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.