Introduction to the Immunizations

Prepared By: Miss Farah Naeem

Modified By: Miss Sadia Shahzad
 Objectives
In this unit students will be able to:

• Discuss the Expanded Program for Immunization.

• Describe the importance of childhood immunization
in the family context
• Review the types of immunization
• Enlist seven childhood communicable diseases
covered by EPI.
 objectives
• Explain the types of vaccines.
• Discuss the process of cold chain and nursing
responsibilities
• Discuss the myths and beliefs of communities
about immunization
Expanded program on Immunization (EPI) is a world health
organization program, with the goal to make vaccines
available to all children throughout the world.
• Expanding the number of diseases to be covered
• Expanding the number of children
and target population to be covered

• Expanding coverage to all corners of the country and

spreading services to reach the less privileged
sectors of the society.
 Expanded program on immunization was launched
 in Pakistan in 1978
The purpose of EPI is to initiate a collective effort to reduce the
 mortality results from the 10 EPI target disease by immunizing
children of the age 0-11 months and women of child bearing
age.
Although Pakistan has made impressive gains in increasing the

EPI coverage in the recent years ,the public awareness and thus
public support and participation in immunization derives of the
ministry of health, government of Pakistan needs to improve
further to enable us to achieve the target set under the
Millennium developmental Goals.
 Importance of childhood immunization in
family context
• Immunization prevents severe illness
• Safeguard from the vaccine preventable
diseases.
• Preventable diseases Hep B, paralysis of
limbs, amputation of legs and arms, brain
damage, hearing loss, brain malfunctions that
when left treated cause death.
 Types of immunization
active vs. passive
• Active immunization
o Antigen derived from viral or bacterial
component
o Toxoids
o Take7-10days for antibody formation
o Long lasting protection
o May be inhibited by passive immunization
 Active vs. passive
• Passive immunization
o Immune sera obtained from human donor
o Nonspecific (IGIV)
o Pathogen specific(rabies, hepatitis B, etc.)
o Immediate but temporary protection
o Usually derived from human sera
 GAVI Alliance
• Global Alliance for Vaccines and Immunization
(GAVI Alliance),
• In 2000, the GAVI Alliance was established to
revitalize immunization. The 72 poorest countries
of the world are eligible for GAVI support.
1. To achieve 100% coverage with all EPI
vaccines
 The Discovery of Vaccination

• The first systematic effort to control a disease

through immunization occurred over 200 years ago.
• Edward Jenner, a British physician

• On May 14, 1776, he performed an experiment that

would revolutionize public health.
2. Eradication of polio to maintain polio free status
3. Elimination of measles
4.Elimination of Neonatal Tetanus
5. To maintain zero level of diphtheria
6. Prevention of severe forms of TB
( TB meningitis & miliary TB)
7. To reduce the incidence of whooping cough
8. To Reduce the incidence of Bacteria Meningitis
due to Haemophilus influenza
9. To Maintain Immunization Safety
10. To prepare for introduction of new
vaccines
Types of vaccinations
EPI SCHEDULE
 Hep A and B
1.By following protocol hepatitis
B vaccine is given to infant at birth
2.Hep A given at the age of one
year and 2nd dose after 6month of
first dose.
 ROTA VIRUS
According to WHO recommendation
6th to 10th weeks is approximate time
to give Rota virus vaccine
 BCG (At birth)
 BCG vaccine is live attenuated variant of 0.05ml ID injection in
right deltoid
 It is used because it is effective in reducing the severity of TB
meningititis and miliary TB
 OPV : (Sabin)

• At birth,6 weeks,10 weeks, and14 weeks

• OPV live attenuated
• 2 drops orally
• I t prevents against paralytic polio.
• I t provides rapid immunity within 1 week.
Haemophilus influenza type b bacteria (Hib)
were the leading cause of meningitis in
children younger than 5 years old until the
Hib vaccine became available
Give all infants, including premature infants, a
primary series of Hib vaccine beginning at the
age of 2 months.
 Small child receiving Hib
vaccine into the muscles of the
thigh.

Adolescent receiving Hib vaccine

into the deltoid muscle of the arm.
 At 6 weeks, 10 weeks, 14 weeks, 18 months ,5 years, 10
years.
 Tetanus toxoid (inactivated toxin with formaldehyde).
 Dose: 0.5 ml I/M
 Two 0.5 ml doses I/M injection administered at 4-8 weeks
interval 3rd dose after 1 year.
 National Immunization Schedule
Pregnant Woman
Vaccine When to give Dose Route Site

TT - 1 Early in pregnancy 0.5ml Intra-muscular Upper arm

TT - 2 4 weeks after TT 1 0.5ml Intra-muscular Upper arm

TT – 3 6 Month to One year 0.5ml Intra-muscular Upper arm

after 2 dose

TT-4 One year after 3 dose 0.5ml Intra-muscular Upper arm

TT-5 One year after 4 dose 0.5ml Intra-muscular Upper arm

Diphtheria causes a thick covering in the back of the
throat. It can lead to breathing problems, paralysis, heart
failure, and even death. There are several combination
vaccines used to prevent diphtheria: DTaP , DT, and
Td.
 MMR
Vaccination

Live attenuated ( Three: measles,

German measles & Mumps)

(0.5 ml Subcutaneous)
 Pneumonia a bacterial infection in the lungs is a common
complication from the flu. In addition to a flu shot every fall, it's a
good idea to get a once-in-a-lifetime pneumococcal vaccine.
 Cold chain process
• Nursing responsibilities.
Maintain cold chain
Necessary precautions
Care of equipment's to maintain recommended
protocols and successful program.
BCG correct dose is 0.05ml safe temp for
vaccine is +2 to +8.
Myths and beliefs of communities about
immunization