The Expanded Program on Immunization (EPI) in the Philippines began in July 1979. And, in 1986, made a response to the Universal Child Immunization goal. The four major strategies include:[1]
Every Wednesday is designated as immunization day and is adopted in all parts of the country. Immunization is done monthly in barangay health stations, quarterly in remote areas of the country.
The standard routine immunization schedule for infants in the Philippines is adopted to provide maximum immunity against the seven vaccine preventable diseases in the country before the child's first birthday. The fully immunized child must have completed BCG 1, DPT 1, DPT 2, DPT 3, OPV 1, OPV 2, OPV 3, HB 1, HB 2, HB 3 and measles vaccines before the child is 12 months of age.[2]
Vaccine | Minimum Age at 1st Dose |
Number of Doses |
Dose | Minimum Interval Between Doses | Route | Site | Reason |
---|---|---|---|---|---|---|---|
Bacillus Calmette-Guérin | Birth or anytime after birth
|
1 dose
|
0.05 mL
|
none
|
Intradermal
|
Right deltoid region of the arm | BCG given at earliest possible age protects the possibility of TB meningitis and other TB infections in which infants are prone[3] |
Diphtheria-Pertussis-Tetanus Vaccine | 6 weeks old
|
3 doses
|
0.5 mL
|
6 weeks(DPT 1), 10 weeks (DPT 2), 14 weeks (DPT 3)
|
Intramuscular
|
Upper outer portion of the thigh, Vastus Lateralis (L-R-L) | An early start with DPT reduces the chance of severe pertussis.[4] |
Oral Polio Vaccine | 6 weeks old
|
3 doses
|
2-3 drops
|
4 weeks
|
Oral
|
Mouth | The extent of protection against polio is increased the earlier the OPV is given. Keeps the Philippines polio-free.[5] |
Hepatitis B Vaccine | At birth
|
3 doses
|
0.5 mL
|
4 weeks interval
|
Intramuscular
|
Upper outer portion of the thigh, Vastus Lateralis (R-L-R) | An early start of Hepatitis B vaccine reduces the chance of being infected and becoming a carrier.[6] Prevents liver cirrhosis and liver cancer which are more likely to develop if infected with Hepatitis B early in life.[7][8] About 9,000 died of complications of Hepatitis B. 10% of Filipinos have Hepatitis B infection[9] |
Measles Vaccine (not MMR) |
9 months old
|
1 dose
|
0.5 mL
|
none
|
Subcutaneous
|
Upper outer portion of the arms, Right deltoid | At least 85% of measles can be prevented by immunization at this age.[10] |
When given to women of childbearing age, vaccines that contain tetanus toxoid (TT or Td) not only protect women against tetanus, but also prevent neonatal tetanus in their newborn infants.[17]
Vaccine | Minimum Age/Interval |
Percent Protected |
Duration of Protection |
---|---|---|---|
TT1
|
At 20th weeks AOG | 0%
|
|
TT2
|
At least 4 weeks later | 80%
|
|
TT3
|
At least 6 months later | 95%
|
|
TT4
|
At least 1 year later | 99%
|
|
TT5
|
At least 1 year later | 99%
|
|
In June 2000, the 57 countries that have not yet achieved elimination of neonatal tetanus were ranked and the Philippines was listed together with 22 other countries in Class A, a classification for countries close to maternal and neonatal tetanus elimination.[18]
To ensure the optimal potency of vaccines,a careful attention is needed in handling practices at the country level. These include storage and transport of vaccines from the primary vaccine store down to the end-user at the health facility, and further down at the outreach sites.[19] Inappropriate storage, handling and transport of vaccines won't protect patients and may lead to needless vaccine wastage.[20]
A "first expiry and first out" (FEFO) vaccine system is practiced to assure that all vaccines are utilized before its expiry date. Proper arrangement of vaccines and/or labeling of expiry dates are done to identify those close to expiring. Vaccine temperature is monitored twice a day (early in the morning and in the afternoon) in all health facilities and plotted to monitor break in the cold chain. Each level of health facilities has cold chain equipment for use in the storage vaccines which included cold room, freezer, refrigerator, transport box, vaccine carriers, thermometers, cold chain monitors, ice packs, temperature monitoring chart and safety collector boxes.[21]