By Niguss Cherie(Assistant Prof.
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At the end of this session students are
expected to;
Define immunization
Describes EPI
Discuss vaccine preventable diseases
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Immunization- a process of inducing immunity
artificially by either vaccination(Active) OR
administration of Antibodies(Passive)
Vaccination- administration of any vaccine or toxoid
for prevention of disease.
Active Immunization-stimulating the immune system
to produce antibodies and cellular immune responses
by giving antigens
Passive Immunization- providing temporary protection
by administration of exogenously produced antibodies
OR naturally from the mother to the child
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Introduction…
Vaccines may be;
Live-attenuated; BCG, OPV, Measles, Rubella, and
mumps
Inactivated or killed; pertussis, cholera, polio,
influenzae, and rabies
Toxoids. diphtheria, tetanus
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The Expanded Program of Immunization (EPI)
• EPI was established in 1974 to ensure that all children in all
countries benefited from life-saving vaccines.
• Goals were to ensure that every child receive protection against
childhood illness
• This immunization Program started in 1980 by adopting WHO’s
immunization Program guideline. The Program has shown progress
in terms of the volume of vaccines and the number of beneficiaries
protected.
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The Five Essential Elements of Immunization
Service program
1. Immunization Service Delivery Involves: identifying target age and
schedule , administering vaccination
2. Vaccine Supply and Quality: assessing safety, managing waste, and
selecting appropriate equipment; Forecasting vaccine needs, and quality
assurance.
3. Cold Chain and logistics: Storing, handling, and distributing vaccines and
other commodities; essential equipment and procedures; and
transportation management
4. Surveillance of Vaccine Preventable Diseases and Adverse Event
following Immunization
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5. Advocacy and Communication.
Vaccine Age No of Site Route of
doses administration
BCG 1 Birth 1 Outer upper right arm or Intra-dermal
shoulder
DTP-HepB- At Weeks 3 Left mid- upper outer IM
Hib 6;10;14 thigh
PVC10 At Weeks 3 Right mid- upper outer IM
6;10;14 thigh
Rota virus At Weeks 6;10 2 oral Oral drop
Polio At birth, 6, 10, 4 oral Oral drop
14 wks
Measles At 9 mo,14 mo 2 upper arm Subcutaneous7
Vaccine Age No of doses Site Route of
administrati
on
TT (15-49 yr) 5 Upper arm Intramuscul
TT1 ar injection
TT2: After 1mo
TT3: After 6 mo
TT4: After 1 yr
TT5: After 1 yr
HPV Girls (11-12yr) 2/3 Deltoid region of IM
(0, 6–12 months) the upper arm or
(0, 1–2, 6 months) in the higher
anterolateral area
of the thigh
Vitamin A 1st dose of
Vitamin A at 9mo
Within 2 weeks of
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delivery (post
natal mothers
It includes
TB
Pneumonia
Diphteria
Hepatitis B
Measles
Pertussis
Polio
Tetanus 9
Diphtheria is caused by toxigenic strains of Corynebacterium
diphtheriae.
Though the infection involves almost any mucous membrane, the
most common sites of infection are the tonsils and pharynx.
This site of diphtheria can lead to obstructed breathing and death.
The bacterias produce an exotoxin that, if absorbed in to the
bloodstream, may damage nerves and organs such as the heart
and kidneys.
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Hepatitis B is a viral infection of the liver.
The acute infection of which can result in death or either resolves
or progresses to chronic infection, which may lead to cirrhosis or
liver cancer at a later age.
If it completely resolves, patients will have a lifelong immunity.
In developing countries, hepatitis B infection usually occurs
during infancy, at the time of birth, or in early childhood.
Symptoms usually are not apparent in young people, but the
likelihood that the child will develop lifelong chronic infection is
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higher than if the infection occurs during child or adulthood.
Measles is an acute viral infection characterized by a variety of
symptoms, including fever, rash, cough, conjunctivitis, diarrhea,
ear infections, pneumonia, and brain inflammation.
Measles is extremely infectious. The virus is transmitted
through the air by respiratory droplets expelled by infected
individuals.
Susceptible individuals in close contact with infected people are
most likely to become infected.
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Pertussis, also called whooping cough, is a highly contagious,
acute bacterial disease caused by a bacterium that is found in the
mouth, nose and throat of an infected person called Bordetella
pertussis
It affects the respiratory tract and is characterized by an
uncontrollable, violent cough lasting several weeks or even
months.
It may begin with cold-like symptoms or a dry cough that
progresses to episodes of severe coughing. 13
Pertussis is spread in droplets from the nose and throat.
Poliomyelitis is a highly contagious disease caused by three
serotypes of poliovirus.
Infection with poliovirus results in a spectrum of clinical
manifestations from apparent infection to non-specific febrile
illness, aseptic meningitis, paralytic disease, and death.
Two phases of acute poliomyelitis can be distinguished: a non-
specific febrile illness followed, in a small proportion of patients,
by aseptic meningitis and/or paralytic disease the ratio of cases of
in apparent infection to paralytic disease ranges from 100:1 to
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1000:1.
Tetanus, also known as lockjaw, is caused by a bacillus
(Clostridium tetani) that is present in the soil and in animal and
human feces.
After entering the body through a wound, the bacterium produces
a toxin that makes muscles rigid, causes spasms, and makes
breathing difficult or impossible thereby resulting in death.
It is the only vaccine-preventable disease that is not contagious.
Tetanus is a common cause of neonatal and maternal mortality
wherever maternal protection with tetanus toxoid is low and clean
umbilical cord care practices are not followed. 15
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