Immunization

Immunization Definition
• Process by which an individual’s immune system becomes fortified
against an agent. Immunization can be done by various techniques.

• WHO: Process whereby a person is made immune or resistant to an

infectious disease, typically by the administration of a vaccine.
Vaccination Definition
• Administration of antigenic material (vaccine) to stimulate an
individual’s immune system to develop adaptive immunity to a
pathogen.
Human Immune System
• The human immune system can be divided into the innate and
adaptive immunity

• Human immunization and vaccination mostly affects the adaptive

immunity

• Important cells influenced/improved during this process are T-cells, B-

cells and the antibodies produced.
Passive and Active Immunization
• Immunization, as a process, can be achieved in an active or passive
manner.

• Vaccination is an Active form

 Immunization

Active Passive

Natural Artificial Natural Artificial

Person comes into Person receives

contact with a Person is injected Person is injected
with a microbe antibodies from with antibodies
microbe mother

Vaccination
 Vaccination

Whole microorganism Antigenic component of microorganism Toxoid (detoxified toxin of

microorganism)

Live Inactivated • Acellular pertussis vaccine

attenuated • Diptheria
• Tetanus
Whole cell Fractional Recombinant
Viral:
• Measles
• Mumps Viral: • PCV • Hepatitis B
• Rubella • Influenza • HiB
• Oral polio • Polio
• Rotavirus • Rabies
• Varicella • Hepatitis A
Bacterial: Bacterial:
• BCG • Pertussis
• Oral • Typhoid
typhoid • Cholera
Philippine Expanded Program on
Immunization (EPI)
• Began July 1976 (PD 996)

• Over-all goal: To reduce the morbidity and mortality among children

against the most common vaccine preventable diseases.
Specific Goals
• Immunize all infants/children against the most common vaccine
preventable diseases

• To sustain the polio free status of the Philippines (Polio free since
2000)

• To eliminate measles infection

• To eliminate maternal and neonatal tetanus

• To control diphtheria, pertussis, hepatitis B and German measles

• To prevent extra-pulmonary tuberculosis among children

Fully Immunized Child
Children who received:
• one dose of BCG,
• three doses each of OPV, DPT and Hepatitis B vaccines
• and one dose of Measles vaccine
• before reaching one (1) year of age.
Republic Act 10152
• Also known as the Mandatory Infants and Children Health
Immunization Act of 2011.

• Basic immunization for children under 5 years old

Vaccines in the 2018 National Immunization
Program
• BCG – extra-pulmonary tuberculosis
• Monovalent Hep B – Hepatitis B
• Pentavalent (DTwP-HiB,HepB) – Diptheria, Tetanus, Pertussis,
Influenza
• Bivalent OPV - Poliomyelitis
• IPV - Poliomyelitis
• PCV – Pneumonia, Meningitis, Pneumococcal diseases
• MMR Vaccince – Measles, Mumps and Rubella/German Measles
• HPV – Cervical cancer
National Immunization Program Vaccines
Bacille Calmette-Guerin (BCG)
• 1 dose
• At birth
• Intradermal (ID); right deltoid or buttocks
• <12 months: 0.05 mL
• >12 months: 0.1 mL

• For Infants >2 months suspected of TB, PPD should be done prior.
• 5 mm induration is considered positive and BCG is no longer
recommended.
Hepatitis B vaccine (HBV)
• 1 dose at birth, 3 doses primary series
• 6-10-14 weeks
• Intramuscular (IM)
• 0.5 mL

• If (+)HBsAg mother: HBV and HBIG within 12 hours. (IG not later than
7 days)
• If unknown HBsAg status: HBV within 12 hours. If later proven mother
is (+), add HBIG not later than 7 days of age
Diptheria, Tetanus toxoids and Pertussis
vaccines
• 3 doses
• 6-10-14 weeks
• Intramuscular (IM)
• 0.5 mL

• 4 or 5 doses, 4th given at 12 months (with minimum 6 month interval

from 3rd dose)
• If 4th dose is given at 4 years or older, 5th dose is not needed.
• Convulsions commonly associated (absolute contraindication)
Haemophilus Influenza type B (HiB) vaccine
• 3 doses
• 6-10-14
• Intramuscularly (IM)
• 0.5 mL

• A booster dose may be given at 12-15 months of age, with a

minimum of 6 months interval from 3rd dose.
• If 1st ever dose is given at 7-11 months of age, 2nd dose is given after 4
weeks, 3rd dose after 8 weeks.
Poliovirus Vaccine (OPV/IPV)
• 3 doses
• 6-10-14 weeks
• OPV/Sabin vaccine; oral
• IPV/Salk vaccine; intramuscular (IM)
• 0.5 mL
Pneumococcal Conjugate Vaccines (PCV)
• 3 doses
• 6-10-14 weeks
• Intramuscularly (IM)
• 0.5 mL

• Booster dose may be given 6 months after 3rd dose

Monovalent Measles Vaccine
• 1 dose
• 9 months
• Subcutaneous (SC)
• 0.5 mL

• May be given as early as 6 months in cases of outbreaks

• If not available, MMR may be given
Measles, Mumps, Rubella Vaccine
• 2 doses
• 12-15 months
• Subcutaneous (SC)
• 0.5 mL

• 2nd dose: 4-6 years old

Childhood Immunization Schedule
• The following are the recommended vaccinations on the 2018
childhood immunization schedule for ages 0-18 years old (one less
than last year since dengue was removed)

• Schedule is updated annually by the Philippine Pediatric Society (PPS),

Pediatric Infectious Disease Society of the Philippines (PIDPS), and the
Philippine Foundation for Vaccination (PFV)
Other Recommended Vaccines
• These are vaccines not included in the NIP which are recommended
by the Philippine Pediatric Society (PPS), Pediatric Infectious Disease
Society of the Philippines (PIDSP), and the Foundation for Vaccination
(PFV)
Rotavirus Vaccine
• 2 doses (monovalent) or 3 doses (pentavalent)
• 6-10 or 6-10-14
• Oral
• Rotarix: 1.0 mL
• Rotateq: 2.0 mL
Influenza Vaccine (Trivalent/Quadrivalent)
• TIV: intramuscular (IM) or subcutaneous (SC)
• QIV: intramuscular (IM)
• 6 months – 18 years old

• 6 months – 8 years old: 2 doses, 4 week interval yearly

• 9 years – 18 years old: 1 dose yearly
Japanese Encephalitis Vaccine (JEV)
• Subcutaneous (SC)
• 0.5 mL
• 9 months-17 years old

• <17 years old: booster dose 12-24 months after primary dose
• >17 years old: single dose
Varicella Vaccine
• 2 doses
• 12 months
• Subcutaneous (SC)
• 0.5 mL

• 2nd dose at 4-6 years old; (or) at least 4 weeks after 1st dose
Additional Pointers
• Vaccines do not give 100% protection

• Interruption of schedule does not interfere with the final immunity

nor does it require repeat series

• The absolute contraindications are:

1. 2nd or 3rd dose of DPT to child who had convulsion or shock within 3 days of
previous dose
2. Immunocompromised or pregnant patients should not be given live
attenuated vaccines
• Severe febrile illness may defer current immunization but it is not a
contraindication.

• Doses given a shorter interval may lessen antibody response.

• Multiple vaccines may be given simultaneously as long as they are

given at different sites

• Breastfeeding does not interfere with OPV vaccination

• Upper outer buttock injections are not recommended in ordinary
circumstances (sciatic nerve injury)

• Antibody containing products interfere with live vaccines; if live

vaccine is given first, wait at least 2 weeks before giving antibody