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EXPANDED PROGRAM ON
IMMUNIZATION (EPI)PAKISTAN
By
Dr. Syed Sanowar AliAssociate Professor
Department of Community Health Sciences United Medical Dental College
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IMMUNITYIt is the Defense mechanism of the body. Protection from an infectious disease. If you are immune to a disease, you can be exposed to it without becoming infected Vaccine: A product that stimulates a person’s immune system to produce immunity to a specific disease, protecting the person from that disease.
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Immunization: A process by which a person becomes protected against a disease through vaccination. Active Immunity: When dead or live attenuated antigen is given to body to produce antibodies.Passive Immunity: When already prepared antibodies are given to body
Vaccination: The act of introducing a vaccine into the body to produce immunity to a specific disease.
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Active ImmunityImmunity developed after contacting pathogens inside the body
Artificial Immunity
Passive Immunity
Natural Immunitye.g. Injection of attenuated live / killed organism or toxoide.g. Infection
Natural Immunity Artificial Immunitye.g. Injection of antibodies or antitoxin
e.g. Antibodies from mother
Immunity provided by antibodies or antitoxins provided from outside the body
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PASSIVE IMMUNIZATIONACTIVE IMMUNIZATION
IMMUNIZATIONOR
VACCINATIONVaccination: The act of introducing a vaccine into the body to produce immunity to a specific disease.
Immunization: A process by which a person becomes protected against a disease through vaccination.
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In EPI program ONLY
ACTIVE IMMUNIZATION
is done
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EPI Global EPI Launched By WHO in MAY 1974. With Objective Of Reducing to a negligible level morbidity &
Mortality from Diphtheria, Pertusis, Tetanus, Poliomyelitis, TB & Measles to make immunization against these disease available to every child in the world by 1997.
Pakistan Started Its EPI programme in June-July 1978 with help of WHO & UNICEF.
Hep B Was also Inducted In Pakistan EPI in August 2002. Then HiB & Pneumococcal Vaccines
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1. LIVE VACCINES2. DEAD VACCINES3. TOXOIDS4. Others
VACCINES
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Route of Administration - Vaccines
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Intra-Muscular(90°angle)
Sub-Cutaneous(45°angle)
Intra-Dermal(15 -20°angle)
Oral
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2. Female Immunization
EPI program has two parts1. Child Immunization
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1. CHILD IMMUNIZATION
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EPI Vaccination Schedule Age Vaccines to
be givenDose Form Site Route of
AdministrationAt Birth BCG
OPV00.05 ml Powdered Deltoid
(Rt. Arm)Intra-Dermal
OralAt 6
WeeksPENTA1 (DPT1 + HBV1 + HiB1)
OPV10.5 ml Liquid Ant. Lat.
Lt. ThighIntra-Muscular
OralPCV1 0.5 ml Liquid Rt. Thigh Intra-Muscular
At 10 Weeks
PENTA2 (DPT2 + HBV2 + HiB2)
OPV20.5 ml Liquid Ant. Lat.
Lt. ThighIntra-Muscular
Oral
PCV2 0.5 ml Liquid Rt. Thigh Intra-Muscular
At 14 Weeks
PENTA3 (DPT3 + HBV3 + HiB3)
OPV30.5 ml Liquid Ant. Lat.
Lt. ThighIntra-Muscular
Oral
PCV3 0.5 ml Liquid Rt. Thigh Intra-Muscular
At 9 Months
Measles 0.5 ml Powdered Deltoid(Lt. Arm)
Sub- Cutaneous
At 15 Months
(Booster)
Measles 0.5 ml Powdered Deltoid(Lt. Arm)
Sub- Cutaneous
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EPI Vaccination Schedule Vaccine BCG - (Live vaccine)BCG Bacillus Calmette –Guérin
Against Disease Tuberculosis
Ideal age(only one dose)
At Birth(within 1 week)
Dose 0.05 mlForm Powdered
Site Deltoid muscle (Rt. Arm)
Route of Administration
Intra-Dermal
Side Effect Rare – Scar after 3-6 months Immunity Achieved 80% against Pulmonary TB
100% against Tuberculous Meningitis (TBM)
Important : Instruction to mother about Scar
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EPI Vaccination Schedule Vaccine OPV - (Live vaccine)OPV Oral Polio Vaccine
Against Disease Poliomyelitis
Ideal age (four doses) At Birth OPV0(within 1 week), 6 (OPV1),10 (OPV2) & 14 (OPV3) weeks
Dose Two drops
Form Liquid
Site Mouth
Route of Administration Orally
Side Effect No
Immunity Achieved 70% in Developing countries100% in Developed countries
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EPI Vaccination Schedule Vaccine PENTA PENTA D + P+ T + HBV + HiB
(Toxoid-D&T, Dead-P& others HBV & HiB)
Against Disease Diphtheria, Pertussis, Tetanus, Hepatitis B & Haemophilus Influenza type B
Ideal age (three doses)
6 (Penta1),10 (Penta2) & 14 (Penta3) weeks
Dose 0.5 ml
Form Powdered
Site Anterio-Lateral site – Mid Left Thigh
Route of Administration
Intra-Muscular
Side Effect Fever, tenderness injection site & Rarely fits
Immunity Achieved 95 – 98 %
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EPI Vaccination Schedule Vaccine PCV
(other method)PCV Pneumococcal Vaccine
Against Disease Due to Pneumococcal bacteria (Pneumonia, Meningitis etc.)
Ideal age (three doses)
6 (PCV1),10 (PCV2) & 14 (PCV3) weeks
Dose 0.5 ml
Form LiquidSite Anterio-Lateral site – Mid Right Thigh
Route of Administration
Intra-Muscular
Side Effect Generally No
Immunity Achieved 95 - 98%
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EPI Vaccination Schedule Vaccine Measles (Live Vaccine)Against Disease Measles
Ideal age (two doses) At 9 months & 15 months (Booster)
Dose 0.5 ml
Form Powdered
Site Deltoid muscle (Lt. Arm)
Route of Administration
Sub- Cutaneous
Side Effect Generally No
Immunity Achieved 95 - 98%
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2. FEMALE IMMUNIZATION
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EPI Vaccination Schedule
Vaccine TTTT Tetanus Toxoid
Against Disease Tetanus
Ideal age (five doses) According to schedule
Dose 0.5 ml
Form Liquid
Site Deltoid muscle – Left Arm
Route of Administration
Intra-Muscular
Side Effect Generally No
Immunity Achieved 100%
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Vaccination Schedule for Females 15- 45 years (Child Bearing Age - CBA)
Tetanus Toxoid
TT1 TT2 TT3TT4 TT5
Intra-Muscular
At 1st Contact as early as possible
OR during 7th months of Pregnancy
At least 4 Weeks
after TT1
At least 6-12 Months after TT2
At least 1 year after
TT3
At least 1 year after
TT4
Immunity Achieved
No 3 years 5 years 10 years 20 years OR Live long
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Contraindications General Contraindications
Acute Illness esp. High grade fever Individual Vaccines
Whooping Cough (Pertussis) Appearance of Neurological Symptoms
But generally there is No absolute Contraindications
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THANK YOU!!!!!!!