To reduce the morbidity and mortality among infants and children caused by the seven childhood immunizable diseases.

Sustaining high routine FIC coverage of at least 90% in all provinces and cities. Sustaining the polio free country for global certification. Eliminating measles by 2008. Eliminating neonatal tetanus by 2008.

Target setting (main element)  Information, Education and Communication Cold chain logistic management  Assessment and Evaluation of overall performance Surveillance, Studies and Research

Tuberculosis (Primary Complex if less than 3 years old) Diphteria Pertussis Neonatal tetanus Poliomyelitis Hepatitis B Measles

- is the process by which vaccines are introduced into the body before infection sets in.

Vaccines are administered to introduce immunity thereby causing the recipients immune system to react to the vaccine that produce antibodies that fight infections. Vaccinations promote health and protect children from disease- causing agents. Infants and newborn needs to be vaccinated at an early age since they belong to vulnerable age group.

Do not give more than one dose of the same vaccine to a child in one session. Give doses of the same vaccine at the correct intervals. Strictly follow the principles of never, ever reconstituting the freeze dried vaccine in anything other than the diluents supplied with them. If you are giving more than one vaccine, do not use the same syringe and do not use the same arm or leg for more than one injection.

Anaphylaxis or severe hypersensitivity reaction to the previous dose of vaccine is an absolute contraindication to subsequent doses of vaccine Person with a known allergy to vaccine components should not be vaccinated. DPT2 and DPT3 are not given to a child who has convulsion or shock within 3 days after DPT1.Vaccines containing the whole cell pertussis component should not be given to children with an evolving neurological disease. Do no give live vaccines like BCG to individuals who are immunosuppressed due to malignant disease (child with AIDS), going therapy with immunosuppressive agents or radiation. A child with a sign or symptoms of severe dehydration. Fever of 38.5C and above

Every Wednesday is designated as immunization day and is adopted in all part of the country.

When a child receives one dose of BCG, 3 doses of OPV, 3 doses of DPT, 3 doses of Hepa B and one dose of measles before a childs first birthday.

Type of Vaccine Form of Vaccine Minimum Age at First Dose Number of Doses to Complete the Immunization Reasons

Live Bacterial Freeze Dried Birth or anytime at birth 1st dose: at birth 2nd dose: school entrance BCG given at earliest possible age protects the possibility of TB meningitis and other Tb infectious in which infants are prone. 20 (20 Children) At birth: 0.05ml At school entrance: 0.10ml Intradermal (a special syringe and needle is used for the administration of BCG vaccine ) Right deltoid region of the arm

Number of Doses per Ampule Dosage Route of Administration Site of Administration

Storage Temperature Special Precautions Side Effect

2C to 8C (in the body of refrigerator) Note: Freezing does not damage it but ampules may break. Diluents should also be kept cold before using. Correct ID administration is essential. A special syringe and needle is used for the administration of BCG vaccine A wheal formation Koch phenomenon (inflammatory reaction 2-4 days)

Indolent ulceration Abscess on the injection site Enlarged lymph nodes Note: Swollen glands or abscesses because an unsterile needle or syringe was used, too much vaccine was injected or most commonly, the vaccine was injected incorrectly under the skin instead of its top layer. Contraindication Immunosuppressed individual due to malignant disease (child with clinical AIDS); therapy with immunosuppressive agents or radiation. Undesired Effect Health Teaching Do not massage the area of injection A scar will formed 12 weeks after injection Repeat BCG vaccination if the child does not develop a scar after first injection.

Type of Vaccine

Form of Vaccine Minimum Age at First Dose Number of Doses to Complete the Immunization Interval Reasons Number of Doses per Ampule Dosage Route of Administration Site of Administration

Diphteria and Tetanus as toxiods which is a weakened toxin Pertussis as killed whole-cell bacterium Liquid Vaccine 6 weeks 3

4 weeks/ minimum of 28 days An early start with DPT reduces the chance of severe pertussis 20 or 10 0.5 ml Intramuscular Upper outer portion of the thigh (Vastus lateralis) in infant (R-L-R) Outer upper arm if older

Storage Temperature

2C to 8C (in the body of refrigerator) Note: DT components is damaged by freezing P components is damaged by heat DPT not usually given over 6 years of age Fever in the evening after receiving the injection. Soreness, children may have pain, redness or swelling at the injection site. DPT2 and DPT3 are not given to a child who has convulsion or shock within 3 days after DPT1. Vaccines containing the whole cell pertussis component should not be given to children with an evolving neurological disease. If the child has fever give paracetamol or any appropriate antipyretic at the time and at four and eight hours after immunization. Alternating cold compress for 24 hours to warm compress if there is pain and soreness.

Special Precautions Side Effect

Contraindication

Health Teaching

Type of Vaccine Form of Vaccine Minimum Age at 1st Dose Number of Doses to Complete the Immunization Interval Reason Number of Doses per Ampule Dosage Route of Administration Site of Administration Storage Temperature

Live attenuated vaccine Liquid vaccine 6 weeks 3

4 weeks/ minimum of 28 days The extent of protection against polio is increased the earlier the OPV is given. 20 (10 children) 2 drops Oral Mouth -15 C to -25 C (at the freezer)

Special Precautions

Side Effect

Contraindication Health Teaching

Children known to have rare congenital immune deficiency syndrome should receive IPV (injectable polio vaccine) rather OPV. Causes almost no side-effects. Less than 1 % of the people who receive the vaccine develop a headache, diarrhea or muscle pain. None y Nothing by mouth (NPO) 30 minutes before and after OPV. y Do not touch the tip dropper bottle to the tongue.

Type of Vaccine Form of Vaccine Minimum Age at 1st Dose Number of Doses to Complete the Immunization Interval Reason Number of Doses per Ampule Dosage Route of Administration Site of Administration Storage Temperature

Monovalent vaccine contain only one antigen Cloudly liquid vaccine At birth 3

6 weeks interval from 1st dose to 2nd dose 8 weeks interval from 2nd dose to 3rd dose An early start of Hep B vaccine reduces the chance of being infected and becoming a carrier. Prevent liver cirrhosis and liver cancer. 1 for single dose vial 10 for multi dose vial (10 children) 0.5 ml Intramuscular Upper outer portion of the thigh (Vastus lateralis) in infant (with DPT: L-R-L) 2C to 8 C

Special Birth dose must be given if there is a risk of Precautions perinatal transmission. Side Effect y Mild fever that lasts one to two days after injection. y Soreness, children may have pain, redness or swelling at the injection site.

Contraindic y Anaphylactic reaction such as severe rashes, ation difficulty in breathing and choking to a previous dose. Health y If the child has fever give paracetamol or any Teaching appropriate antipyretic at the time and at four and eight hours after immunization. y Alternating cold compress for 24 hours to warm compress if there is pain and soreness.

Type of Vaccine Form of Vaccine Minimum Age at 1st Dose Number of Doses to Complete the Immunization Reason

Attenuated Measles Virus Freeze dried 9 months 6 months: if there is an epidemic 1

Measles vaccine given at 9 months provide at least 85% protection against measles infection. When given at one year and older provides 95% protection. 10 (children) 0.5ml Subcutaneous Outer part of the upper arm -15 C to -25 C Birth dose must be given if there is a risk of perinatal transmission.

Number of Doses per Ampule Dosage Route of Administration Site of Administration Storage Temperature Special Precautions

Side Effect

y Fever that lasts one to two days after injection y Soreness, children may have pain, redness or swelling at the injection site within 24 hours of immunization. It usually resolves within two to three days. y About 1 in 20 children develop a mild rash five to 12 days after receiving the vaccine.The rash usual lasts about two days. y Severe reaction to previous dose. y Pregnancy y Congenital or acquired immune disorder. y If the child has fever give paracetamol or any appropriate antipyretic at the time and at four and eight hours after immunization. y Alternating cold compress for 24 hours to warm compress if there is pain and soreness. y It also prevent diarrhea.

Contraindication

Health Teaching

AGE
Birth 6 weeks 10 weeks 14 weeks 9 months

BCG
OPV DPT Hepa B Option B Option A Measles

X X X X X X X X X X X X X X