NATIONAL

IMMUNIZATION
PROGRAM

 BENEFITS OF
IMMUNIZATION

Most cost-effective clinical preventive services
Saves lives
Protect children from VPD
Continue to give protection against more
diseases and to other age group as new
vaccines are developed
BENEFITS

Prevent the spread of diseases
Prevents virus transmission from one
generation to another by eliminating or
eradicating the disease
Source of high investment return to the
government
 CONSEQUENCES OF NON-
VACCINATION

Can develop diseases that could lead to
prolonged or long term disabilities
Unable to go to school/constrained to become
productive individuals
Families are burdened with financial toll for
medical bills and lost time for work
Daily loss of quality life


1976: 1st set of 2015: expansion of

vaccines was immunization package
introduced
Tuberculosis Tuberculosis
Poliomyelitis Poliomyelitis
Diphtheria Diphtheria
Tetanus Tetanus
Pertussis Pertussis
Measles Measles
Hepatitis B
Hib
Mumps
Rubella

1976 2015
Covered Vaccine 6 14
Preventable (Tuberculosis, Poliomyelitis, (Tuberculosis, Poliomyelitis,
Diphtheria, Tetanus, Diphtheria, Tetanus, Pertussis,
Pertussis, Measles) Measles, Hepatitis B, Hib,
Diseases Mumps, Rubella, Rota virus,
Pneumonia, HPV, Dengue,
Flu)

Beneficiaries 3 5
(infants, children, pregnant (infants, children, pregnant
women) women, adolescents, senior
citizens)

No. of vaccines 4 14
(BCG, OPV, DPT, AMV) (BCG, OPV, IPV, Pentavalent,
AMV, MR, MMR, Rota,
Dengue, HPV, PCV 13, PCV
23, Flu)

 National Immunization Program
GOAL
To reduce morbidity and mortality rates due to vaccine preventable
diseases

Objective 1
To increase coverage of
existing vaccines for
targeted population
groups across the life-
stage
Objective 2
To provide additional
protection to identified
vulnerable groups from
other VPDs through
evidenced-based new
vaccines and
technologies
Objective 3
To achieve the countrys
commitment to priority
global immunization
goals
- Measles elimination
- MNT elimination
- Sustain polio-free status
- Accelerated Hep B control

Strategy 4
Strategy 2 Build up Strategy 5
Strategy 1 supervision,
Generate clients Institute
Expand the Strategy 3 monitoring and
demand and supportive
package of quality Strengthen evaluation
multi-sectoral governance,
immunization surveillance and -program
support for financing and
services and scale response monitoring
immunization regulatory
up coverage -routine data
services collection
measures
-research/ studies

8
 HISTORY OF NIP

1976 initially covered six VPDs (TB,
POLIO,DPT,MEASLES)
PD No. 996 compulsar
y basic immunization for Infants and children below 8
yrs old
1977- BCG was first administered among
school entrants
DPT introduced in priority areas
1979- BCG and DPT nationwide; OPV and TT
for pregnant women in high risk areas
1980- OPV and TT nationwide
 HISTORY OF NIP

1982- MV among 35% of the eligible
population
1983- MV nationwide
1986- CIR was conducted showing a very low
coverage at only 23%
Presidential Proclamation No. 6 was
issued to implement EPI and to meet the
UN goal towards universal child
immunization by 1990
1989 the country achieved for the first time the
universal child immunization goal of 90%)
 HISTORY OF NIP

1989- declared support to attain 3 immunization
global goals by 1995:
1. eradication of poliomyelitis
2.elimination of NT
3. control of measles
1992- Hep B among 40% of eligible population
2000- the Phil obtained its polio - free status ;
just completed the second validation for
the declaration of NT elimination in 2014
 HISTORY OF NIP

2005 Hep B nationwide
2010 MMR in selected areas
PENTA: DTwP-HepB-Hib in 3
selected regions
2012- PENTA Nationwide
Rotavirus among NHTS HHs
Anti Influenza Vaccine and PPV for
indigent senior citizens
 HISTORY OF NIP

2013- Td and MMR in high schools in selected
high risk provinces/cities
ROTavirus in 2 regions
2014- PCV 10 introduced in CARAGA and
ARMM
PCV 13 introduced in 5 selected
regions
HPV in pilot areas in CAR and Region
7
 HISTORY OF NIP

2015 IPV in NCR, Regions 3,6,7
Td and MR in all public schools GR 1&7
HPV in 20 priority provinces
2016 - IPV nationwide
Td and MR in all public and private
schools- Gr 1& 7
 GOVERNING RULES,POLICIES AND
ISSUANCES

Republic Act 101521 : Mandatory Basic
Immunization Service for infants and Children
Health Immunization Act
Administrative Order No. 2006-0015:
Implementing Guidelines on Hep B
Immunization for Infants
Administrative Order No. 39 s. 2003: Policies
on Nationwide Implementation of the
Expanded Program on Immunization
 GOVERNING RULES,POLICIES AND
ISSUANCES

Department Circular No. 2003-140: Standard
Performance Indicators for Measles
Surveillance and Additional Performance
indicator for AFP Surveillance and
Strengthening the Case Definition of EFI
Disease ( Acute Flaccid Paralysis, Neonatal
Tetanus and Measles) for Surveillance
Department Memorandum 2012-0157:
Administration of Rotavirus Vaccine for Infants
 GOVERNING RULES,POLICIES AND
ISSUANCES

Department Memorandum No. 2015-0164 :
Administration of IPV
Department Memorandum No. 2015-0155:
Administration of PCV 13
VACCINE
PREVENTABLE
DISEASES

National Immunization Program
Components

Child Maternal
Immunizatio Immunizatio
n Program n Program

School Senior
Based Citizens
Immunizatio Immunizatio
n Program n Program
 TUBERCULOSIS

Chronic disease that affects people of all ages
Caused by mycobacterium tuberculosis
Usually attacks the lungs (bones,joints and brain)
Children can contact TB any time after birth
Highly contagious
Transmission: airborne droplets
(cough,spits,sneeze)
crowded environment
poorly nourished
 TUBERCULOSIS

Symptoms include cough (2 weeks or more),
general weakness , weight loss , low grade
fever and night sweats
People who develop TB must complete a
course of drug therapy to prevent the spread
of the disease to others
The recommended method of prevention for
children who are younger than 12 months old
is to immune them as soon as possible after
birth with BCG vaccine
 BCG (Bacille
Calmette-Guerin)

Protects infants against TB
In powder form with diluents
Must be discarded after 6 hrs or at the end of
the immunization session
BCG..

TYPE OF VACCINE Live Bacteria
SCHEDULE At or ASAP after birth (delayed
to infants born of mother
+with TB )
NUMBER OF DOSES 1
DOSAGE .05ml
INJECTION SITE Outer upper Right arm or
shoulder
INJECTION TYPE intradermal
STORAGE Bet 2-8 degrees Celsius but not
the diluents
BOOSTER None
BCG..

CONTRINDICATIONS Symptomatic HIV infection
ADVERSE REACTION Local Abscess, lymphadenitis,
osteomyelitis, disseminated
disease
SPECIAL PRECAUTIONS Correct intradermal precaution
special syringe and needle
BCG..

A small raised lup appears at the injection site
(usually disappears within 30 mins)
After about 2 weeks, a red sore forms about the size of
the end of an unsharpened pencil
( the sore remains for another 2 weeks then heals)
A small scar , about 5mm across remains
Swollen glands/abscess occurs ( unsterile needle or
syringe, too much vaccine was injected, or vaccine
was injected incorrectly under the skin instead on its
top layer
 HEPATITIS B

350 millions carriers of Hep B virus worldwide
Most of them are unaware they are carriers
People who carry the virus often have no
symptoms
Hep B virus is spread through unsafe injection
practices and needle prick injuries
The younger a person gets infected , the less
likely the symptom will occur but it is more likely
that he or she will become a carrier of the
disease
 HEPATITIS B

Most infants born to mothers who are carriers
are at risk of being infected
All children should receive hep b vaccine
starting at birth or at the age of four to six
weeks, when the first visit to a clinic takes
place
A chronic carrier is more likely to develop
severe chronic liver disease or liver cancer in
later life
 HEPATITIS B

TYPE OF VACCINE Recombinant DNA or Plasma
Derived
SCHEDULE Several options
NUMBER OF DOSES 3 doses
DOSAGE 0.5 ml
INJECTION SITE Outer upper arm
INJECTION TYPE intramuscular
STORAGE Bet 2-8 Celsius . Never freeze
BOOSTER None
 HEPATITIS B

CONTRINDICATIONS Anaphylactic rxn to
previous dose
ADVERSE REACTION Mild local or systemic reactions
 POLIOMYELITIS

It is caused by any of the 3 related
polioviruses and can easily be spread by the
fecal /oral route
Many people/children who are infected with
poliovirus do not become paralyzed but may
still spread the disease to others
Less than 1 in 100 non immunized children
infected by poliovirus develop paralysis
The recommended method of prevention is
immunization with OPV/IPV
ORAL POLIO VACCINE
(OPV)

TYPE OF VACCINE Live oral polio vaccine

SCHEDULE 6, 10, 14 weeks of age

NUMBER OF DOSES NUMBER OF DOSES

DOSAGE 2 drops

STORAGE Bet -15-25 Celsius

BOOSTER Supplementary doses given

during polio eradication
activities

CONTRAINDICATIONS None
ORAL POLIO VACCINE
(OPV)

ADVERSE REACTION VAPP very rarely (approx.
2-4 cases /million children
vaccinated

SPECIAL PRECAUTIONS Children known to have rare

congenital immune deficiency
syndrome
 DIPHTHERIA

Caused by Corynebacterium diphtheriae
Involve almost any mucous membrane but the
most common sites of infection are the tonsils
and pharynx
Spread from person to person in an airborne
droplets
Symptoms include sore throat, loss of
appetite, and slight fever
 DIPHTHERIA

Complications such as abnormal heartbeats
and inflammation of the heart muscle and
valves
Children with diphtheriae should be treated
with diphtheria antitoxin and antibiotics
Most effective way of preventing the diseaseis
to maintain a high level of immunization
within a community
 PERTUSSIS

Pertussis, or whooping cough
Bacterial infection spread from person to
person by sneezing and coughing
Infants and children are most likely infected,
serious complications
Most effective way to prevent is to immunize
all infants with pertussis vaccine
 TETANUS

Caused by bacteria found in the environment
Infection occurs during unclean delivery of
babies, when contaminated instruments are
used to cut the umbilical cord, or anytime
tetanus bacteria enter a puncture or cut in the
skin
NT remains aserious problem in the countries
with poor immunization coverage and unclean
practices at birth
 TETANUS

Most newborns with tetanus die
The best way to prevent tetanus is to
immunize with tetanus toxoid and to clean
wounds thoroughly and remove dead tissue
Best way to prevent NT is to immunize women
of childbearing age (or pregnat women) and to
ensure clean delivery practices
HAEMOPHILUS INFLUENZA TYPE B

Children younger than five years old are most
commonly affected by Hib
HiB bacteria are commonly present in the nose
and throat
It is transmitted from person to person in droplets
through sneezing ,coughing
Infected children may carry Hib bacteria without
showing any signs or symptoms of the disease
HiB disease can cause pneumonia and meningitis
 HAEMOPHILUS
INFLUENZA
TYPE B
HiB disease can cause pneumonia and
meningitis
Hib disease can be treated with antibiotics
HiB disease can be prevented with vaccine
given early in infancy
 PENTA VACCINE

TYPE OF VACCINE Pentavalent Vaccine
SCHEDULE 6,10,14 weeks of age
NUMBER OF DOSES 3 primary doses
DOSAGE 0.5 ml
INJECTION SITE Outer mid thigh in infant/ outer
upper arm in older children
INJECTION TYPE IM
STORAGE Bet 2-8 degrees Celsius, shoul
never be frozen
CONTRAINDICATIONS Anaphylactic reaction to
previous dose
ADVERSE RXN Local redness, warmth, edema
induration with or without
tenderness as well as urticaria
 MEASLES

Highly infectious viral disease
Kills more children than any other VPD
Spread from person to person through
sneezing,coughing,close personal contact
First sign of infection is a high grade fever
lasting 1-7days and a generalized rash
develops after onset/exposure to the virus
 MEASLES

Runny nose, cough,red and watery eyes
Small white spots inside the cheeks
Pneumonia is the most common cause of
death
Severe complications can be avoided through
proper case management, including vit A
supplementation
Can be prevented by immunization
 MUMPS

Transmitted in airborne droplets
About 1/3 of people/children infected with
mumps have no symptoms
Most common symptoms is swelling of salivary
glands
Complications can be serious but they are rare
Mumps vaccine shld be given in combination
with measles and rubella vaccine (MMR)
 RUBELLA

An infection caused by virus
Rubella is normally a mild childhood disease,
but women who get rubella during the first
trimester of pregnancy can pass the virus on
theur fetuses. This is called CRS
A rash is the prominent symptom of rubella
,especially in children
 RUBELLA

Complications are rare BUT complications of
CRS are more serious and include
deafness,cataracts,and mental retardation
 MEASLES VACCINE

TYPE OF VACCINE Live attenuated Virus
SCHEDULE 9-11 mos
NUMBER OF DOSES 1 dose
DOSAGE 0.5 ml
INJECTION SITE Upper arm
INJECTION TYPE subcutaneous
STORAGE Bet -15-25 degreesCelsius
BOOSTER 2nd opportunity(routine or
campaign)
 MEASLES VACCINE

CONTRAINDICATIONS Severe reaction to previous
dose

ADVERSE RXN Malaise, fever, rash, rarely

encephalitis, anaphylaxis

SPECIAL PRECAUTION none

 Pneumococcal Conjugate Vaccine

People sometimes call pneumococcal disease pneumonia.Pnemococcal
disease is cause by bacteria,which can lead to serious infections in the
lungs, blood ,and brain.
You can acquire the pneumococcal bacteria from people who cough or
sneeze around you.
Even if you get good medical care, pneumonia can be deadly. The disease
is hard to treat because the bacteria have become resistant to antibiotics .
Anyone can get pneumococcal disease. You are at greater risk
if you are 65 older,very young,or at have heart or lung
disease.
You can protect yourself against the serious types of blood and
brain infections by getting vaccinated.
Vaccination is the best way to prevent Pneumococcal infection
 ROTAvirus

Rotaviral gastroenteritis is associated with a substancial
clinical and economic burden in both developed and
developing countries.
The disease burden is particiularly considerable in
infants and young children,producing infections that
range from mild diarrhea to severe diarrhea ,vomiting
and fever that result in hospitalization and death.
The prevalence of the disease may be under-reported
because laboratory confirmation is not typically
performed. Because there are currently no specific
treatments for rotaviral infection ,vaccination is the
primary public health intervention
 Human papillomavirus(HPV)

HPV is a common virus that infects the skin and mucous membrane.
There are about 100 types of HPV. Approximately 30 of those are
spread through genetal contact(typically sexual intercourse). Around
12-called low risktypes of HPV- can cause genital warts. In
addition ,there are approximately 15high-risk types of HPV that
can cause cervical cancer.
It is estimated that 80% of all women and 50 % of men and women
combined-will get one or more types of genital HPV at some point
in thheir lives.
Although risk factors like smoking can contribute to your chance of
developing cervical disease,HPV must first be present.
Fortunately ,in most people,the bodys immune system fights off or
suppresses the HPV virus before it causes problems.It is only when
the infection persists that it canm cause cells to becaome abnormal.
 Influenza

Influenza is an infectious disease with mostly
respiratory symptoms caused by influenza
viruses.The most significant impacts of
influenza viruses on human are those arising
from the influenza A strains. Seasonal
Influenza is a disease that anually affects
Europe and the rest of northern hemisphere
during the winter season with larger opr
smaller epidemics. The southern hemisphere
has a similar epidemic in its winter.(June to
OCTOBER).
Child Immunization Program

 Child Immunization
Program
Antigen Recipient
1st Dose 2nd Dose 3rd Dose
Rotavirus Infants (6 15 w) (10 32 NA
w)
SITE OF
ADMINISTRATION

OPV &
ROTA
by
mouth
IPV
LEFT
THIGH
-IM PENTA /Hepa
B
Upper, outer
thigh
Intramuscula
r
 Maternal
Immunization
Program
 Maternal Immunization
Program

Target Population
2.7% of the total population
Target Accomplishment
95% coverage
Tetanus Toxoid/ Tetanus Diptheria

Type Toxoid as DT, TT or TD

No. of doses At least 2 primary doses

Schedule See next table

Booster TT/TD every 10 yrs or during

pregnancy. DT 18 mos-6 yrs.

Contraindications Anaphylactic rxn

Adverse Rxn Mild local or systemic reactions

Dosage .5 ml

Injection site Outer upper arm

Injection type Intramascular

Storage Store between 2-8 C. Never Freeze

 Maternal Immunization
Program
2015 Regional Accomplishment

Vaccination Schedule of TT
School Based
Immunization
Program

 School Based Immunization
2015 RegionalProgram
Accomplishment

Tetanus-
Measles-
Diphther Dengue HPV
Rubella
ia
Grade 4
Female
Students
Grade 4
Grade 1 Grade 1 in
(9-45
and 7 and 7 Quezon
y/o)
Province
(9-10
y/o)
 School Based Immunization
Program

Antigen Recipient 1st Dose 2nd Dose 3rd Dose
MR Grade I NA
Grade 7 NA NA
Td Grade I NA NA
Vaccination
Grade 7 Schedule
NA NA
HPV Grade 4 Female
Students in
Quezon NA
Province
(9-10 y.o)
Dengue Grade 4
Students (9-45
y.o)
Senior Citizen
Immunization
Program

 Senior Citizen Immunization
2015 RegionalProgram
Accomplishment

Target Population
Old guidelines
17% (NHTS-PR) of the 7% of the total population
<60 years old
New guidelines:
7% of the total population
60 and 65 years old
Actual master list of senior citizens aged 60 and
65
 Senior Citizen Immunization
Program
Old Guideline
Vaccination Schedule:
Vaccine >60 yrs old
Pneumococcal
Polysaccharide Vaccine (one dose throughout
(PPV23) his/her lifetime)
Polyvalent Influenza

Vaccine
(every year)

 Senior Citizen Immunization
Program
New Guideline
Vaccination Schedule:
Vaccine 60 yrs 61-64 yrs 65 yrs
old old old
Pneumococcal
Polysaccharide
Vaccine (PPV23)
Polyvalent Influenza
Vaccine

Thank you