Measles and Tetanus Diphtheria

Mass Immunization for

Grade 1 and Grade 7 Students

Rationale:
The Philippine government through the
Department of Health and in partnership with
the Department of Education and
Department of Interior and Local
Government will conduct school-based
adolescent immunization. This is in response to
the increase threat of vaccine preventable
diseases and in compliance with the World
Health Assembly Agreement among member
countries where Philippines is a signatory.

In 2015, the Philippines has eliminated maternalneonatal tetanus. To maintain the protection
against tetanus, immunization services must be
strengthen and given as early as possible.
In 2013, school-based adolescent immunization
using Measles-Mumps-Rubella (MMR) and
Tetanus Diphtheria (Td) vaccines was conducted in
selected 19 cities and 15 provinces nationwide.

Objective:
This Order aims to guide concerned stakeholders
on the implementation of School-Based
Immunization in August to September 2015.

General Guidelines:
All public school students enrolled in Grade 1 shall be
given measles containing vaccine (MCV) and
tetanus-diphtheria (Td). Screening for measles
vaccination history at the time of school entry is necessary.
All male and female students enrolled in Grade 7 shall be
vaccinated with 1 dose each of Measles-Rubella (MR)
and Td vaccines on the same immunization session.
School-based vaccination shall be
FREE of CHARGE.

Specific Guidelines:
All teacher in-charge/clinic teachers/school nurses of
Grade 1 students shall check the status of measles
immunization of each student upon enrollment. The
immunization card of each student shall be requested
from the parents/guardians/caretakers.
There are immunization cards: Check the card for immunization
status and put mark with card category. Determine what vaccine was
given: MCV 1 and MCV 2.
If there is no card or no other record of vaccination: place
mark on the no card category

Sample eccd card #1

With MCV1 (measles @
9m)
With MCV2 (MMR)

Sample eccd card #2

With MCV1 (measles @
9m)

Sample eccd card #3

Without MCV1 and MCV2

Specific Guidelines:
Vaccination for Grade 1 Students
Vaccination with MCV After screening, students with
zero or only 1 measles-containing vaccines received
during younger days
Students with recorded 2 doses of MCV: DO NOT
VACCINATE
Students with 0 or 1 dose of MCV or no immunization
card: List the names of the students using Form 3b
Masterlist of Grade 1 students, submit to the catchment
health centers for the scheduled vaccination.

Specific Guidelines:
Vaccination for Grade 1 Students
Vaccination with MCV
After screening, students with zero or only 1 measles-containing
vaccines received during younger days
Vaccinate with Measles to complete the 2-doses per student
at 1 month interval from the last dose. Vaccination with MCV
can be done on the same immunization session for the Td
vaccine
Follow-up of Missed Students for MCV vaccines: Teacher-incharge shall follow-up the missed students for vaccination
but willing to be vaccinated and refer to Rural Health Unit
(RHU)/ Barangay Health Station (BHS) for the MCV dose.

Specific Guidelines:
Vaccination for Grade 1 Students
Vaccination with Td vaccines
All Grade 1 students shall be vaccinated with 1 dose of Td vaccine in
the designated immunization post and record in the Form 3b
Masterlist of Grade 1 Students.
Students with consent but were missed during the scheduled
immunization should be followed-up and referred to the RHU/BHS
for the needed vaccination.
Students who refused vaccination shall be
recorded in the Form 3b Masterlist of Grade 1
Students.

Vaccination Schedule for Grade 1 students:

Vaccines
Measles Vaccine
Tetanus-diphtheria
(Td)
Dosage
0.5 ml
0.5ml
Route & Site of
Subcutaneous, Right
Deep Intramuscular,
Injection
deltoid arm
Left Deltoid arm
# doses required
1 dose
Students with Zero
dose
2 doses, 28 days interval
from the last dose
Students with only 1
dose recorded
1 dose only

Specific Guidelines:
Vaccination for Grade 7 Students
Vaccination for Grade 7 students
All males and females students shall be
vaccinated with both MR and Td vaccines.
The schedule of the vaccination for these
students shall be:

Vaccination Schedule for Grade 7 students:

Dosage
Route and Site of
Injection

MR
0.5ml

Td
0.5ml

Right, deltoid arm

Left, deltoid arm

Subcutaneous

Intramuscular

Measles,
Rubella

Why get Vaccinated??

Measles and rubella are serious diseases. Before
vaccines they were very common, especially
among children.
Measles virus causes rash, cough, runny nose,
eye irritation, and fever.
It can lead to ear infection, pneumonia, seizures
(jerking and staring) brain damage and death.

Why get Vaccinated??

Rubella virus causes rash, arthritis (mostly in
women), and mild fever.
If a woman gets rubella while she is pregnant,
she could have a miscarriage or her baby could
be born with serious birth defects.

How do we get these

diseases?

These diseases spread from person to person

through the air. You can easily catch them by
being around someone who is already infected
Measles and rubella (MR) vaccine can protect
you from all these diseases.

When not to give??

Anyone who has ever had a life-threatening
allergic reaction to the antibiotic Neomycin, or
any other component of MR vaccine, should not
get the vaccine. Tell your doctor if you have any
severe allergies.
Anyone who had a life-threatening allergic
reaction toa previous dose of MR vaccine should
not get another dose.

When not to give and

wait??

Some people who are sick at the time the shot is

scheduled may be advised to wait until they recover
before getting MMR vaccine.
Pregnant women should not get MR vaccine.
Pregnant women who need the vaccine should wait
until after giving birth.
Women should avoid getting pregnant for 4 weeks
after vaccination with MR vaccine.

MR
Adolescent
Immunization

Measles-Rubella
Vaccine (MR)
Contains live attenuated viruse
1-dose efficacy varies by 95% (measles and
rubella)
Duration of immunity is lifelong

Dose and Administration

0.5ml SC (Subcutaneous injection)
Right upper arm

MR Vaccine
Contraindications

Severe allergic reaction to vaccine

component or following prior dose
Pregnancy
Immunosuppression

MR Vaccination of Women of
Childbearing Age
Ask if pregnant or likely to become so in next 4
weeks
Exclude those who say "yes
For others
explain theoretical risks
vaccinate

MR Vaccine
Precautions

Moderate or severe acute illness

Recent receipt of a blood product
History of thrombocytopenia or
thrombycytopenic purpura

Tetanus-diphtheria (Td)

Why get vaccinated??

Tetanus and diphtheria can be very serious diseases
TETANUS (Lockjaw) causes painful muscle spasms
and stiffness, usually all over the body.
It can lead to tightening of muscles in the head and
neck so the victim cannot open his mouth or swallow,
or sometimes even breathe. Tetanus kills about 1 out of
5 people who are infected.
Prevention of maternal and neonatal
tetanus

Why get vaccinated??

DIPHTHERIA can cause a thick membrane to
cover the back of the throat.
It can lead to breathing problems, paralysis,
heart failure, and even death.

How do we get these

disease?
These two diseases are both caused by bacteria.
Diphtheria is spread from person to person.
Tetanus enters the body through cuts, scratches,
or wounds.

When not to give and

wait??
Anyone who has had a life-threatening allergic
reaction after a dose of any tetanus, diphtheria,
containing vaccine should not get Td
Anyone who has a severe allergy to any
component of a vaccine should not get that
vaccine.

Common Reactions after giving Td

vaccine
Pain (up to about 8 in 10
Redness or swelling at the injection site (up to
about 1 in 3)
Mild fever (up to about 1 in 15)
Headache or tiredness (uncommon)

Tetanus,
Diphtheria
Adolescent
Immunizati
on

Tetanus and Diphtheria

Vaccines for Adults
Tetanus and Diphtheria Toxoid (Td)
formalin-inactivated toxins
3 doses induces protective antibody in nearly
everyone
protection for at least 10 years

Dose and Administration

One (1) dose
0.5 ml IM
Left upper arm

Td Contraindications
Severe allergic reaction to a vaccine
component or following a prior dose
Moderate or severe illness

Td Precautions
History of an hypersensitivity reaction following
a previous dose of tetanus or diphtheria toxoidcontaining vaccine
History of Guillain-Barr syndrome (GBS)
within 6 weeks after a previous dose of tetanus
toxoid-containing vaccine
Moderate or severe acute illness

Questions and
Clarifications?
???

Thank you!!