Republic of the Philippines

Department of Health
 National Immunization Program (NIP)
Updates

Department of Health Center for Health Development- Bicol 2

Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Diphtheria
• caused by: Corynebacterium diphtheriae
• acute toxin mediated disease
• Greek diphthera (leather hide)

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Clinical Features
• incubation period of diphtheria is 2–5 days
(range:1–10 days)
• Disease can involve almost any mucous membrane

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Clinical Features
• anterior nasal
• pharyngeal and tonsillar
• laryngeal
• cutaneous
• ocular
• genital

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Clinical Features
• anterior nasal
• pharyngeal and tonsillar
• laryngeal
• cutaneous
• ocular
• genital

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Clinical Features
• anterior nasal
• pharyngeal and tonsillar
• laryngeal
• cutaneous
• ocular
• genital

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Complications
• Myocarditis
• present as abnormal cardiac rhythms and
• can occur early in the course of the illness or weeks later,
• and can lead to heart failure

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Complications
• Neuritis
• most often affects motor nerves and usually resolves completely.
• Paralysis of the soft palate is most frequent during the third week
of illness.
• Paralysis of eye muscles, limbs, and diaphragm can occur after
the fifth week.
• Secondary pneumonia and respiratory failure may result from
diaphragmatic paralysis.
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Case-fatality rate

• 5%–10%, with higher death rates (up to 20%) among

persons younger than 5 and older than 40 years of age.

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Medical Management:
Antibiotics
• Erythromycin
• Procaine Penicillin G
• disease is usually not contagious 48 hours after antibiotics
are instituted.

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Medical Management:
Diphtheria Antitoxin (DAT)
• Passive immunization
• does not neutralize toxin that is already fixed to tissues, but it
will neutralize circulating (unbound) toxin and prevent
progression of disease
• DAT should be administered as soon as possible after disease
onset

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Preventive Measures:
Diphtheria Toxoid
• Active Immunization
• Available as Pentavalent vaccine, Td

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Preventive Measures:
Diphtheria Toxoid
• After three doses of primary diphtheria toxoid immunization, most
children achieve antitoxin titers greater than the minimally protective
level.
• However, in the absence of ongoing exposure, immunity wanes over
time, requiring booster doses of diphtheria toxoid to maintain
protective antitoxin levels.
• In the absence of a booster doses, protection may not be maintained
throughout the school-age years.

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Preventive Measures
• For close contacts, especially household contacts, a
diphtheria booster, appropriate for age, should be given.
• Contacts should also receive antibiotics—benzathine
penicillin or oral erythromycin

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 MEASLES

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 WHAT IS MEASLES
• an acute viral respiratory illness
• highly contagious viral disease

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Transmission
• coughing and sneezing, close personal contact or direct
contact with infected nasal or throat secretions
• Droplet, direct contact and through air
• approximately 9 out of 10 susceptible persons with close
contact to a measles patient will develop measles

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
SYMPTOMS

RASH
FEVER 3C’s Koplik’s
Body Malaise Cough spot
Coryza
Conjunctivitis
5-6 days
4-7 days
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Infectious
(4 days before and 4 days after the
rash erupts)
 Complication
• Blindness
• Encephalitis
Recover
• Severe diarrhoea and
Die related dehydration
Complication
5-6 days
• Severe respiratory
4-7 days infections such as
Incubation pneumonia
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 • Death

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Sequelae
• Subacute Sclerosing PanEncephalitis (SSPE),
• a fatal disease of the central nervous system that
generally develops 7–10 years after initial measles
infection
• characterized by behavioral and intellectual
deterioration and seizures

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 “Immune Amnesia”
Measles Makes Your Immune System Forget How
to Fight Other Diseases

Measles virus can impair the body’s immune memory, causing so-called immune
amnesia.
measles virus wipes out 11 percent to 73 percent of the different antibodies
that protect against viral and bacterial strains a person was previously immune to
By protecting against measles infection, the vaccine prevents the body
from losing or “forgetting” its immune memory and preserves its resistance to
other infections
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Treatment
• No specific antiviral treatment exists
• Supportive care that ensures good nutrition, adequate fluid
intake and treatment of dehydration
• Antibiotics should be prescribed to treat eye and ear
infections, and pneumonia
• Two doses of vitamin A supplements, given 24 hours
apart (can help prevent eye damage and blindness)

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Prevention
• Routine measles vaccination for children,
combined with mass immunization campaigns
• One dose of MMR vaccine is approximately 93%
effective at preventing measles
• Two doses are approximately 97% effective at
preventing measles

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 The Disease

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
1580-1350 BC

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Poliomyelitis
1580-1350 BC
“Polio”

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Poliomyelitis
“Polio”
• very contagious (mabilis makahawa)
• virus spreads from person to person (oral-fecal route)

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
About 1 out of 4
people with
poliovirus infection
will have flu-like
symptoms:
• Sore throat
• Nausea
• Headache
• Stomach pain

usually last 2 to 5 days then go

away on their own

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Poliomyelitis
“Polio”

Paralysis is the most severe

symptom associated with polio
because it can lead to permanent
disability and death.

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Poliomyelitis
“Polio”

Paralysis is
sudden in onset, rapid
in progression,
and floppy type of
paralysis

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Iron lungs
Between 2 and 10
out of 100 people
who have paralysis
from poliovirus
infection die
because the virus
affects the muscles
that help them
breathe.

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Poliomyelitis
“Polio”

Even children who seem to fully recover can

develop new muscle pain, weakness, or
paralysis as adults, 15 to 40 years later.
This is called post-polio syndrome.

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 The Milestones

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Poliomyelitis
“Polio”

Before vaccine 1952: Documented >58,000 poliomyelitis cases in US

1990: achievement of 'universal childhood immunization' –

80% coverage in all countries
After vaccination
2000: Eradicated in the Philippines/Western Pacific Region

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Vaccines Work!
Vaccines are Effective!!!

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 The Virus

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Poliovirus
• small and simple virus
• When ingested it replicates in cells of the gastrointestinal tract
• After multiplying in the gastrointestinal tract, poliovirus may enter
the spinal cord and brain. Destruction of motor neurons (anterior
horn cells) by the virus leads to limb paralysis.

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Sabin is a live-
attenuated vaccine

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 cVDPV

>100 cycles
Poor envi condition
Other factors
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 NO cVDPV if at least
95-100% of the
population if
immunized

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 The disease burden

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 High Risk
Area

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Target: 95% coverage

5 year average

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Target: 95% coverage

5 year average

= 4/10
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
OPV Immunization Coverage:

2015 DEFAULT Missed

Projected populationEligible population OPV1 OPV2 OPV3 ER DOSES
Bicol Region 5836654 157590 120510 119100 107974 49616 125185
ALBAY 1116186 30137 21351 20583 22285 7852 26192
CAMARINES NORTE 583748 15761 13408 13296 11653 4108 8927
CAMARINES SUR 1664603 44944 34219 33996 29654 15290 36964
CATANDUANES 263659 7119 5233 5258 4679 2440 6186
MASBATE 907785 24510 20008 19686 17380 7130 16457
SORSOGON 791,134 21361 16068 16231 14112 7249 17671
Iriga City 115726 3125 2136 2011 1795 1330 3432
Legazpi City 196334 5301 4179 3835 3050 2251 4839
Naga City 197479 5332 3908 3934 3366 1966 4788

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
OPV Immunization Coverage:

2016 DEFAULT Missed

Projected population
Eligible population
OPV1 OPV2 OPV3 ER DOSES
Bicol Region 5920478 159853 95522 80991 70101 89752 232945
ALBAY 1129136 30487 16033 14611 12549 17938 48267
CAMARINES NORTE 591956 15983 1853 9203 8633 7350 28259
CAMARINES SUR 1689397 45614 26601 20989 17075 28539 72176
CATANDUANES 267140 7213 5244 4610 4079 3134 7705
MASBATE 922603 24910 15173 12813 11171 13739 35574
SORSOGON 801222 21633 13841 12292 10910 10723 27856
Iriga City 117712 3178 1670 1452 1194 1984 5219
Legazpi City 199166 5377 3515 1665 2474 2903 8478
Naga City 202146 5458 2592 1447 2046 3412 10289
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
OPV Immunization Coverage:
2017 DEFAULT Missed
Projected population
Eligible population
OPV1 OPV2 OPV3 ER DOSES
Bicol Region 6266652 169200 124121 127730 125279 43921 130469
ALBAY 1194430 32250 21958 21644 19963 12287 33184
CAMARINES NORTE 629884 17007 11221 10376 9519 7488 19905
CAMARINES SUR 1786113 48225 35911 36767 36911 11314 35086
CATANDUANES 287041 7750 5909 5924 5381 2369 6036
MASBATE 958009 25866 20991 23738 23874 1992 8996
SORSOGON 866924 23407 17241 18433 19039 4368 15508
Iriga City 121360 3277 2160 2182 2044 1233 3444
Legazpi City 210047 5671 4618 4116 3915 1756 4365
Naga City 212845 5747 4112 4550 4633 1114 3945

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
OPV Immunization Coverage:

2018 Missed
Projected population
Eligible population
OPV1 OPV2 OPV3 DEFAULTER DOSES
Bicol Region 6017003 162459 108337 111666 112338 50121 155036
ALBAY 1158523 31280 18616 21340 19779 11501 34105
CAMARINES NORTE 606997 16389 12034 13031 13740 2649 10362
CAMARINES SUR 1708933 46141 28437 28203 28492 17649 53292
CATANDUANES 269469 7276 5307 5516 5806 1470 5198
MASBATE 926118 25005 18160 18316 18540 6465 20000
SORSOGON 823469 22234 15952 15598 16232 6002 18919
Iriga City 116116 3135 1934 1966 2026 1109 3479
Legazpi City 203732 5501 4337 4194 4164 1337 3807
Naga City 203647 5498 3560 3502 3559 1939 5874

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 OPV Immunization Coverage:

2019 Missed
Projected population
Eligible population
1st sem EPOPV1 OPV2 OPV3 DEFAULTER DOSES
Bicol Region 6094462 135967 67984 28909 27900 27385 40599 119757.2
ALBAY 1172706 237825 118912 6754 6714 6781 112131 336488.2
CAMARINES NORTE 615349 14633 7316 2227 2037 1868 5448 15817.5
CAMARINES SUR 1731532 38804 19402 1537 1278 1261 18141 54129.45
CATANDUANES 272452 6059 3030 2560 2543 2561 469 1424.999
MASBATE 937990 23300 11650 8165 7744 7634 4016 11406.51
SORSOGON 834217 17986 8993 3999 3989 3840 5153 15150.58
Iriga City 117651 2637 1318 936 856 836 482 1326.838
Legazpi City 206226 4182 2091 901 880 797 1294 3695.395
Naga City 206340 4624 2312 1830 1859 1807 505 1440.119

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
OPV Defaulters:
TOTAL TOTAL Missed OPV doses
Defaulter (2015-2019)
Bicol Region 274008 763392
ALBAY 161709 478236
CAMARINES NORTE 27043 83270
CAMARINES SUR 90933 251647
CATANDUANES 9881 26551
MASBATE 33343 92432
SORSOGON 33494 95104
Iriga City 6138 16901
Legazpi City 9542 25185
Naga City 8936 26337
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 IPV Defaulters:

TOTAL
2017 2018 2019 Missed ipv
DOSES
Missed Missed Missed (2017-
Projected population
Eligible population
IPV DOSES Projected population
Eligible population
IPV DOSES Projected population
Eligible population
IPV DOSES 2019)
Bicol Region 6266652 169200 87831 81369 6017003 162459 95275 67184 6094462 67984 25972 42012 190564
ALBAY 1194430 32250 19389 12861 1158523 31280 17973 13307 1172706 118912 6774 112138 138306
CAMARINES NORTE629884 17007 6316 10691 606997 16389 11571 4818 615349 7316 1528 5788 21297
CAMARINES SUR 1786113 48225 29431 18794 1708933 46141 23471 22670 1731532 19402 1068 18334 59798
CATANDUANES 287041 7750 5234 2516 269469 7276 5913 1363 272452 3030 2561 469 4347
MASBATE 958009 25866 1452 24414 926118 25005 11554 13451 937990 11650 7032 4618 42483
SORSOGON 866924 23407 16864 6543 823469 22234 15098 7136 834217 8993 3767 5226 18904
Iriga City 121360 3277 1672 1605 116116 3135 2040 1095 117651 1318 704 614 3314
Legazpi City 210047 5671 2955 2716 203732 5501 4157 1344 206226 2091 691 1400 5460
Naga City 212845 5747 4518 1229 203647 5498 3498 2000 206340 2312 1847 465 3694

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 What should
be done?

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Essential elements to a successful response
to a polio event or outbreak:

i) Fully engaged national and subnational

governments
ii) Rapid detection, notification, investigation
and risk assessment
iii) High-quality and enhanced surveillance
iv) Strong advocacy, communication and social
mobilization
v) A robust immunization response, where
indicated
vi) *good environmental sanitation
vii)*intensified infection control measures
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
i) Fully engaged national and subnational governments
What should be done?

• Review of existing local policy in support to the National

Immunization Program (NIP)
• If none yet: passing of local legislation in full support to the
NIP
• Allocation of appropriate funds (National Target: ____%)

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
i) Fully engaged national and subnational governments
• Passing of local legislation in full support to the NIP
• Outbreaks due to low immunization coverage:
• Measles
• Polio

• Reported Vaccine Preventable Diseases

• Diphtheria
• Neonatal Tetanus

• High Risk Diseases

• Pertussis, TB, Hepatitis, Cervical Cancer, Pneumonia, Flu
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Please refer to the
handout copy

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
ii) Rapid detection, notification, investigation and risk assessment
iii) High-quality and enhanced surveillance
What should be done?

• Information dissemination regarding Acute Flaccid Paralysis

• RHU Health Workers
• Hospital Health Workers

• Intensify case finding and reporting (Target 2/100,000 population)

• Designated point person for Polio response (Including AFP
Surveillance)

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Contact details:

Catanduanes
Vaccant- Disease Surveillance Officer
12 PESU Catanduanes Virac Catanduanes Daisy Flores, RN PESU Nurse 09295051460 [email protected]
Eastern Bicol Medical
13 Center (EBMC) Edna B. Tabor, RN HESU Nurse
Juan M. Alberto
Memorial District
14 Hospital (JMAMDH)

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Contact details:

Masbate
Eli Lowell A. Tusing- Disease Surveillance Officer (Mobile # 09094042123)
Old mun. Rd, Brgy.
PESU Nurse
PESU Masbate Kalipay, Masbate City, Ruben Lumontad, RN, 9981621493 [email protected]
(Nurse III)
15 Masbate
Old mun. Rd, Brgy.
Masbate Provincial HESU Nurse
Kalipay, Masbate City, Melissa Almanzor-Uy, RN 9194712076 None
Hospital (MPH) (Nurse II)
16 Masbate

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) Strong advocacy, communication and social mobilization

What should be done?

1. Whole of Society Health Education

• Inclusion of health lectures in all platforms (Schools, regular
meetings, health facility consults, etc)
• Immunization
• WASH
• Environmental hygiene
• Printing and Distribution of IEC materials

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Explore effective and feasible IEC
platform

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) Strong advocacy, communication and social mobilization

What should be done?

2. Sabayang patak at turok laban sa polio (for defaulters)

• Community organization

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) Strong advocacy, communication and social mobilization
3. Interagency support (Intensification of all prevention and control measures against VPDs)
Eg: DSWD
• Day Care Workers in all barangays to assist the Barangay Health Workers in the review of the
immunization status and catch-up immunization of all preschool children under their care
• Municipal/City Links to assist the local health workers in the review of the immunization status and
catch-immunization of all eligible children under the Pantawid Pamilyang Pilipino Program (4Ps)
• Public service announcements enjoining your patients/clients to have their children vaccinated
against polio and to update their immunization status for other vaccine preventable diseases
• Posting of tarpaulin/posters in strategic areas where your office staff and patients/clients can see
• Sharing of social media postings from the DOH CHD-Bicol Official FB page @dohbicol
• Organizing lay forum and showing of Audio Visual Presentations on the importance of immunization

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) Strong advocacy, communication and social mobilization

What should be done?

4. Other innovative social mobilization strategies*

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) A robust immunization response

What should be done?

1. Intensify Routine Immunization

2. Conduct Catch-up Immunization
for defaulters/ missed population

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
What should we do now? Complete
Oral Polio Vaccine

OPV1 OPV2 OPV3

Inactivated Polio Vaccine

IPV
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Incomplete OPV doses What should we do now?

Give OPV starting 0-59

months old to complete 3
doses (1 month a part)
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Incomplete IPV doses What should we do now?

Vaccinate with IPV starting

at 14 weeks to 3 years old
only
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Pls refer to the
handout copy

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
 Hexavalent vaccine

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 SABAYANG PATAK AT TUROK
PARA PROTEKTADO SA POLIO

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Immunization History in OPD charts and Admission Charts

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Immunization History in OPD charts and Admission Charts

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Immunization History in OPD charts and Admission Charts

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Poliomyelitis
“Polio”

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Poliomyelitis Complete
“Polio” Oral Polio Vaccine

Almost all children (99 children

OPV1 OPV2 OPV3
out of 100) who get the all
recommended doses of vaccine Inactivated Polio Vaccine

will be protected from polio.

IPV
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
OPV

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
IPV

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
OPV IPV

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 MONTHLY SCHEDULE OF ACTIVITIES FOR IMMUNIZATION
“Tara na sa barangay health center dahil BASTA WEDNESDAY, BARANGAY BAKUNA DAY”’
WEDNESDAY ACTIVITIES
WEEK NUMBER

1ST
BARANGAY HEALTH CENTER BAKUNA DAY
• Health workers (NDP/RHMPP/LGU-DOH) will conduct vaccination in their respective barangay health center and will accommodate all residents
that will come for their scheduled immunization
• Health education program will be conducted to all patients who will avail the vaccination activity
• Health workers will update the TCL every after vaccination is done
2ND
BARANGAY SPOT MAPPING/ACTIVE MASTERLISTING/DEFAULT TRACING
• Health workers will create/update barangay spot map and profile
• Health workers will conduct a house-to-house update/inquiry about the number of individual per household, detect the presence of the
target population living in the household, clarifying the number of vaccines received by the patient/checking of the immunization
card/countercheck TCL with vaccination card, detect trans-in and trans-out
3RD
BARANGAY CATCH-UP IMMUNIZATION
• Health workers will conduct a catch-up immunization by actively locating all target patients who did not show up during the scheduled
barangay health center bakuna day (1st Wednesday)
• Health workers will encourage these patients to follow up as scheduled in barangay health center on the succeeding vaccinations
• Health workers will conduct health education
4TH
MONTHLY ACCOMPLISHMENT REPORT
• Health workers will submit completed reports
 Satisfied BOTH
 Infant ≥14 WEEKS
old
OPV 3 Immunization
(oral polio vaccine)
+ Pentavalent 3 Immunization
(DTwP-HepB-Hib) + PCV 3 Immunization
(pneumococcal conjugate vaccine)
+ IPV
(inactivated polio vaccine)
*Start
 ≥4 WEEKS after
immunization
COMPLETED SECOND ASAP Ask: Ask: Ask: Ask:
DOSE of pentavalent,  Allergy to any vaccine  Allegy to any vaccine  Allergy to any vaccine  Allergy to any vaccine
OPV, and PCV  Severe acute illness  Severe acute illness  Severe acute illness  Allergy to Streptomycin
does NOT satify  Allergy to Polymixin B
both Any of the None of the Any of the None of the Any of the None of the
above above  Low platelet count
above above above above
 Bleeding disorder
Proceed to • Defer Any of the None of the
page 5 • Defer • Defer
immunization immunization above above
immunization
• REFER •
• REFER REFER
CHECK VACCINE CONDITION: • Defer
CHECK VACCINE CONDITION: CHECK VACCINE CONDITION: immunization
 Opened within 28days  expiry date has not passed  expiry date has not passed
• REFER
 thawed less than 10 times  vaccines are stored under appropriate cold  vaccines are stored under appropriate
 expiry date has not passed chain conditions (+2°C to +8°C) cold chain conditions (+2°C to +8°C) CHECK VACCINE CONDITION:
 vaccines are stored under appropriate cold chain *freeze sensitive *freeze sensitive
 Within 28days after opening
conditions (+2°C to +8°C)  vaccine vial septum has not been submerged  vaccine vial septum has not been
 Expiry date has not passed
*for more than 1 month storage store vaccine at (-15°C in water submerged in water
 Vaccines are stored under appropriate cold chain
to -25°C)  Aseptic technique has been used  Aseptic technique has been used to
conditions (+2°C to +8°C) *freeze sensitive
 vaccine vial septum has not been submerged in water  no sign of breakage withdraw all doses
 Vaccine vial septum has not been submerged in
 Aseptic technique has been used tno sign of breakage  vaccine vial monitor (VVM) has not reached  no sign of breakage
water
 vaccine vial monitor (VVM) has not reached discard the discard point.  vaccine vial monitor (VVM), if
 Aseptic technique has been used
point. Satisfied ALL attached, has not reached the discard
Not  no sign of breakage
point.
satisfy all  Vaccine vial monitor (VVM), if attached, has not
Not satisfy all Give 0.5mL Intramuscularly reached the discard point.
Satisfied ALL Satisfied ALL Not
(IM) right outer upper thigh satisfy all
Discard Vial
Give 2 drops into the wall of the Discard Vial Give 0.5mL Satisfied ALL Not satisfy all
mouth Intramuscularly (IM)
left outer upper thigh Discard Give 0.5mL Intramuscularly left
 Health Education on possible adverse outer upper thigh 1inch away Discard vial
 Mark used/opened vial reaction:(soreness, redness or swelling from PCV3 injection site
 Store opened vial in vaccine carrier *if applicable (store in at injection site, fever) *report  Health Education on possible adverse
a refrigerator at the end of the session)  Paracetamol (10-15mkdose) PRN for reaction:(soreness, redness or
“Tara na sa barangay  Health Education on possible adverse fever (temp >37.8C) swelling at injection site) *report
health center dahil… reaction:(headache, diarrhea, muscle pain) *report  Follow up at 9 MONTHS OLD for 1ST  Health Education on possible
 Follow up at 9 MONTHS OLD for 1ST
BASTA WEDNESDAY,  Follow up at 9 MONTHS OLD for 1ST dose MMR dose MMR adverse reaction:(headache,
dose MMR
 Fill-up vaccination card for next vaccination  Fill-up vaccination card for next diarrhea, muscle pain) *report
BARANGAY BAKUNA  Fill-up vaccination card for next
schedule vaccination schedule  Vaccination card
DAY! vaccination schedule
 TCL report  TCL report  Follow up at 9 MONTHS OLD for
 TCL report
Prepared by: Mancilla, MD (DOH ROV) NIP_Flowchart_V1_2018
1ST dose MMR

ROUTINE INFANT ≥14 WEEKS OLD and ≥4 WEEKS after COMPLETED 2nd DOSE IMMUNIZATION Page 2
 Population Protection

1. Routine Immunization
2. Catch-up Immunization
3. Outbreak Response Immunization (ORI)
4. Supplemental Immunization Activity (SIA)
5. Mop-up Immunization Activity

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Outbreak Response Immunization
a

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Outbreak Response Immunization
a

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Outbreak Response Immunization
a

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Outbreak Response Immunization
a

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Outbreak Response Immunization
a

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
Outbreak Response Immunization
a

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 Vaccination (OUTBREAK RESPONSE
IMMUNIZATION)
• Schedule? DAILY or at least EVERY WEDNESDAY
BAKUNA DAY
• Fixed point? House to house?
• Selective/ non-selective?
• Vaccination Team?
• Target Vaccination per day per team?
• Urban – 50-70 vaccinations/day/team
• Rural – 30 vaccinations/day/team
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
Outbreak Response Immunization (Boarder)

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) Intensified Environmental Sanitation/ hygiene

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) Intensified Environmental Sanitation/ hygiene

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) Intensified Environmental Sanitation/ hygiene

What should be done?

• Zero Open Defecation (ZOD)

• Water testing

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
iv) intensified infection control measures

What should be done?

• WASH

Department of Health Center for Health Development- Bicol

Family Health Cluster Serbisyong Salud Bikolnon
 How vaccines are made

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 Virus/
Bacteria

Vaccine Antigen
“Tara na sa barangay health center dahil…
BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 What happens after
vaccination

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 Blood Vessel

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 Immune cells

Antibody Antibody

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
“Tara na sa barangay health center dahil…
BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 Recover
Die
Complication
5-6 days
4-7 days
Incubation

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

Mild symptoms Recover

Incubation

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

Department of Health Center for Health Development- Bicol

 Figure 1. Immunization Coverage in Bicol Region in the past 5
years

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Pool of
Susceptible

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 Batang may Polio

Batang kumpleto ang BAKUNA

Batang walang Bakuna o kulang ang bakuna

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay Ayaw Pabakuna

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay Ayaw Pabakuna

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay Ayaw Pabakuna

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay Ayaw Pabakuna

3 Polio Cases
3 possible Paralysis
3 possible Death

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay BAKUNADO

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay BAKUNADO

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay BAKUNADO

1 Polio Cases
1 possible Paralysis
1 possible Death

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay Ayaw Pabakuna Baranggay BAKUNADO

Bata edad <5yo:~700,000

3/10 na bata: 210,000 1/10 na Bata: 70,000

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay 100% BAKUNADO

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Baranggay 100% BAKUNADO

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
Department of Health, Philippines
Maraming salamat po!
 National Immunization Program (NIP)
Strategies

1
Department of Health Center for Health Development- Bicol 4
Department of Health Center for Health Development- Bicol
Family Health Cluster Serbisyong Salud Bikolnon
5
 Updated Pregnant List

Ideal System vs Reality

Active Masterlisting

100% vaccinated
population Effective Follow Up
“100% immunized” “95% Immunized”
100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up
• how service delivery
is measured
DOH ROV • how service provider • allows certain
PDO/PHO
RHU should deliver margin to account
• should target 100 for rare unforeseen
MOP
NDP/RHMP percent of the and unavoidable
system
Trainings
population because: situations that limits
Reliable Vaccine
- it is in our hands to our capacity to
100%
Supply
save a life from VPD provide the
immunized 100% effective transpo
(every life counts) expected service
system
population container
- it is in our hands to
reserve ref
save our community
thermo
Cold chain
calibration from outbreaks
ref monitoring - this is our chance to
chart
leave a legacy and to
refrigeration
make a difference
secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List
Active Masterlisting Gaps/Challenges Proposed Action
1. varried vacination schedule 1. Every wednesday is
100% vaccinated
population Effective Follow Up (some to vaccination day on barangay bakuna day
tues, some in wed some in (provide a regular
100%FIC
0%CIC Regular Vaccination thurs) in different vaccination schedule: can
launch region wide
Schedule barangay/RHU (makes it
immunization day campain:
difficult to launch region
can create a mental note to
Supplemental/Catch Up wide vaccination schedule
the general population,
campain)
DOH ROV 2. varried frequency of regardless of social status
PDO/PHO
immunization day (some that they can alway avail
RHU
once a month, some twice a vaccination on regular
month, some weekly) schedule)
MOP
NDP/RHMP 3. in areas with once a month this schedule aims to catch up
system
vaccination schedule, catch defaulters in 2 weeks time to
Trainings
up immunization is delayed decrease catch up
mininum of 1 month: more immunization time
Reliable Vaccine
Supply exposure of unvaccinated
children to VPD factors:
100% immunized 100% effective transpo
high chances to get VPD
population system container

reserve ref

thermo
calibration
Cold chain
“Tara na sa barangay health center dahil
ref monitoring
chart

BASTA WEDNESDAY, BARANGAY BAKUNA DAY”’

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 MONTHLY SCHEDULE OF ACTIVITIES FOR IMMUNIZATION
“Tara na sa barangay health center dahil BASTA WEDNESDAY, BARANGAY BAKUNA DAY”’
WEDNESDAY ACTIVITIES
WEEK NUMBER

1ST BARANGAY HEALTH CENTER BAKUNA DAY

• Health workers (NDP/RHMPP/LGU-DOH) will conduct vaccination in their respective barangay health center and will accommodate all
residents that will come for their scheduled immunization
• Health education program will be conducted to all patients who will avail the vaccination activity
• Health workers will update the TCL every after vaccination is done

2ND BARANGAY SPOT MAPPING/ACTIVE MASTERLISTING/DEFAULT TRACING

• Health workers will create/update barangay spot map and profile
• Health workers will conduct a house-to-house update/inquiry about the number of individual per household, detect the presence of the
target population living in the household, clarifying the number of vaccines received by the patient/checking of the immunization
card/countercheck TCL with vaccination card, detect trans-in and trans-out

3RD BARANGAY CATCH-UP IMMUNIZATION

• Health workers will conduct a catch-up immunization by actively locating all target patients who did not show up during the scheduled
barangay health center bakuna day (1st Wednesday)
• Health workers will encourage these patients to follow up as scheduled in barangay health center on the succeeding vaccinations
• Health workers will conduct health education

4TH MONTHLY ACCOMPLISHMENT REPORT

• Health workers will submit completed reports
 1ST WEDNESDAY OF THE MONTH
SCHEDULE OF ACTIVITIES FOR IMMUNIZATION
“Tara na sa barangay health center dahil BASTA WEDNESDAY, BARANGAY BAKUNA DAY”’
TIME ACTIVITIES

0800H Time in at Rural Health unit (have DTR signed by your immediate superior [MHO, PHN or immunization coordinator])
Check temperature of the vaccine refrigerator before opening, record the measured temperature reading on the vaccine refrigerator monitoring chart
(shall there be any discrepancy with the suggested temperature and the current refrigerator temperature REPORT to MHO, PHN, or immunization
coordinator)
Secure enough number of vaccine vials needed to vaccinate the projected number of eligible population (based on TCL) with additional vial to cover
any trans-in patient eligible for vaccination in your assigned barangay
Store vaccine vials in appropriate vaccine containers to maintain the credibility of the cold chain while in transit to your assigned barangay
Secure safety collector box
Secure TCL
0815H Travel time to assigned barangay
0830H-1100H Arrival to assigned barangay (time in will vary based on the distance of the assigned barangay from the rural health unit)
Time in at barangay health center (have your DTR signed by the midwife, barangay captain or barangay kagawad)
Prepare for vaccination
0830H-1100H to Vaccination
1500H
Record vaccination in TCL every after vaccination
Record vaccination in patient vaccination card
Health education
Specific follow up date (schedule on Wednesdays ONLY)
Like us on Facebook (if applicable)
1500H-1700H Label used and unused vaccines appropriately
Travel back to rural health unit and return used/unused and labelled vaccine vials, safety collector box, and records
Time out at Rural Health unit (have DTR signed by your immediate superior[MHO, PHN or immunization coordinator])
 2nd WEDNESDAY OF THE MONTH
SCHEDULE OF ACTIVITY FOR IMMUNIZATION

“Tara na sa barangay health center dahil BASTA WEDNESDAY, BARANGAY BAKUNA DAY”’
TIME ACTIVITIES

0800H Time in at Rural Health unit (have DTR signed by your immediate superior [MHO, PHN or immunization coordinator])
Secure TCL
Secure previous/most recent community map/profile

0815H Travel time to assigned barangay

0830H-1100H Arrival to assigned barangay (time in will vary based on the distance of the assigned barangay from the rural health unit)
Time in at barangay health center (have your DTR signed by the midwife, barangay captain or barangay kagawad)
Prepare for community mapping/profiling

0830H-1100H to Community mapping/profiling

1500H
House to house inquiry about the following:
- Number of person living in the household (double check if there is discrepancy from the previously reported, shall there be any discrepancy, inquire for
the name of person who has recently trans-in or trans-out of the household)
- Presence of newborn, infant, child, pregnant, and elderly eligible for vaccination
- Bakuna kard for residents under 1 year old
- Reiterate schedule of next scheduled vaccination (refer to vaccination card or TCL)
- Health Education
At the end of community mapping/profiling, determine the number of vaccine doses needed to cover the missed eligible population
Determine the number of vaccine doses needed to cover the eligible population on the next scheduled vaccination day

1500H-1700H Travel back to rural health unit and return used/unused and labelled vaccine vials, safety collector box and records
Time out at Rural Health unit (have DTR signed by your immediate superior[MHO, PHN or immunization coordinator])
 3rd WEDNESDAY OF THE MONTH
SCHEDULE OF ACTIVITIES FOR IMMUNIZATION
“Tara na sa barangay health center dahil BASTA WEDNESDAY, BARANGAY BAKUNA DAY”’
TIME ACTIVITIES

0800H Time in at Rural Health unit (have DTR signed by your immediate superior [MHO, PHN or immunization coordinator])
Secure community map/profile done the previous week (with note of eligible population for catch up immunization)
Check temperature of the vaccine refrigerator before opening, record the measured temperature reading on the vaccine refrigerator monitoring chart
(shall there be any discrepancy with the suggested temperature and the current refrigerator temperature REPORT to MHO, PHN, or immunization
coordinator)
Secure enough number of vaccine vials needed to vaccinate the projected number of eligible population (based on TCL) with additional vial to cover any
trans-in patient eligible for vaccination in your assigned barangay
Store vaccine vials in appropriate vaccine containers to maintain the credibility of the cold chain while in transit to your assigned barangay
Secure safety collector box
Secure TCL
0815H Travel time to assigned barangay
0830H-1100H Arrival to assigned barangay (time in will vary based on the distance of the assigned barangay from the local health center)
Time in at barangay health center (have your DTR signed by the midwife, barangay captain or barangay kagawad)
Prepare for catch-up immunization
0830H-1100H to House to house catch-up immunization
1500H
Record vaccination in TCL every after vaccination
Record vaccination in patient vaccination card
Health education
Encourage these patients to follow up as scheduled in barangay health center on the succeeding vaccinations
Specific follow up date (schedule on Wednesdays ONLY)
1500H-1700H Label used/unused vaccines appropriately and return to vaccine carrier
Travel back to rural health unit and return used/unused and labelled vaccine vials, safety collector box and records
Time out at Rural Health unit (have DTR signed by your immediate superior [MHO, PHN or immunization coordinator])
 4th WEDNESDAY OF THE MONTH
SCHEDULE OF ACTIVITIES FOR IMMUNIZATION

“Tara na sa barangay health center dahil BASTA WEDNESDAY, BARANGAY BAKUNA DAY”’

TIME ACTIVITIES

0800H Time in at Rural Health unit (have DTR signed by your immediate superior [MHO, PHN or immunization coordinator])
Prepare the following reports:
TCL
Community map/profile

1000H NDP/RHMPP should submit report to organic midwife

Organic midwife will collate report of the group

12000H Midwife will submit report to MHO/PHN

MHO/PHN will collate report of the municipality

1400H MHO/PHN will submit report to the PDO/PHO

PDO/PHO will collate report of the province/city

16000H PDO/PHO will submit report to DOH-ROV

 Updated Pregnant List

Active Masterlisting
Proposed Action
100% vaccinated 1. conduct EPI training on all
population Effective Follow Up
deployed HRH
100%FIC
0%CIC
Regular Vaccination
Schedule
Gaps/Challenges 2. include all trained HRH in
the proposed EPI training
1. most of the NDPs/RHMPPs
Supplemental/Cat (refresher)
ch Up
deployed are not yet trained
3. will provide a standardized
on EPI (reason why in
flow chart to aid HRH
some areas HRH cannot
during immunization (this
DOH ROV conduct vaccination without
PDO/PHO will include vital updates
the presence of organic
RHU from MOP)
midwife)

NDP/RHMP
MOP MOP
2. no EPI refresher traininig to
previously trained HRH
4. equip health workers with
the knowledge required to
influence/convince the
system 3. HRH knowledge/pratice
community to avail the
challenges
service/to correct myths
4. insufficient knowledge of
and false beliefs of the
Reliable Vaccine
Supply Trainings health workers to influence
the community towards
community (can provide
FAQs by the community
health programs
100% immunized 100% effective transpo and provide standardized
population system container
5. some health workers are
answers)
not 100% convinced about
5. provide trainings and
reserve ref the efficacy of the service
provide references/studies
thermo
calibration
to support the departmet of
Cold chain health and partners claims
ref monitoring
chart

refrigeration

“basta DOH HEALTH WORKER, bakuna trained”

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List

Active Masterlisting

100% vaccinated
population Effective Follow Up

100%FIC Regular Vaccination

0%CIC Schedule

Supplemental/Cat
ch Up

Proposed Action
DOH ROV 1. store only the necessary
PDO/PHO
RHU amount of vaccine enough
to deliver for 3 months
MOP
Gaps/Challenges 2. estimate the max number of
NDP/RHMP 1. not enough ref/storage to refrigerator that may be
system accomodate large amount supplied by the power
trainings
of vaccines source
2. power limitations/overload 3. regular accounting of
Reliable Vaccine concerns vaccine and replenishing
3. irregular vaccine the number of vaccine
100% immunized 100% effective
Supply request/timming of vaccine necessary to immunize the
transpo
population system container requests/per demand basis target population for a
4. inacurate estimation of certain time frame
reserve ref
allocation/computed 4. provide a system to
thermo 5. delivery challenges/long accurately estimate eligible
calibration
Cold chain delivery time population and allocate
ref monitoring enough number of vaccine
chart for immunization
5. requestt necessary number
refrigeration
of vaccine 3 months prior

secondary school
health education

brgy based
RHU lectures
lectures
“Bakuna mo, SIGURADO” TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List

Active Masterlisting

100% vaccinated
population Effective Follow Up

100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings
Proposed Action
1. will provide vaccine container
Reliable Vaccine
Supply
1:1:1 barangay:HRH:vaccine
container ratio
status:
100% immunized
population
100% effective
system
Vaccine - already requested for 5000 pcs of
Carrier small vaccine carriers from central
reserve ref office
thermo - already followed up for the delivery
Cold chain
calibration - allocation to diffirent provinces is
ref monitoring prepared in anticipation of the
chart delivery from central office
refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List

Active Masterlisting

100% vaccinated

“Kaalamang pangkalusugan para sa mga studyante sa Bicol”

population
100%FIC
Effective Follow Up

Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

Proposed Action
DOH ROV
PDO/PHO “tayo na BESH” 1. will provide health education
(immunization) in grade 8 studets
RHU
b- rationale:
MOP
NDP/RHMP
system
bikolano/bikolanonang Grade 8 includes the topic immunization in
their MAPEH subject: DOH health worker will
e - estudyante
Trainings
tie up with the grade 8 teacher: they will
conduct a standardized and pre-approved
Reliable Vaccine
Supply
s - sararo sa (ka-isa sa) lecture material and outline about
immunization
100% immunized 100% effective
h - health
transpo
population system container goal:
-increase awareness of grade 8 students to
reserve ref
the programs of DOH/immunization:
thermo -increase tie up with DepEd:
calibration -health experts will conduct lecture to assure
Cold chain
ref monitoring that questions will be clarified immediately:
chart -indirectly increasing awareness and
knowledge of guardians (using
refrigeration
homeworks/assignments) (in some areas,
parents not able to go to school but able to
send their child in school: the child can teach
secondary school the parents about immunization services
brgy based available)
health education
lectures
RHU lectures
-increase involvement of students to
TV interviews community health organization (influence the
Effective health about programs
100% KAP of organization of health clubs: can tie up with
population education FB regular
social media adolesent health)
updates
-increase health volunteer
community based
activity

HP material payong :) leaflets

 Updated Pregnant List

Active Masterlisting

100% vaccinated
population Effective Follow Up

100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

Effective health
TV interviews about immunization
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

“Tara na sa barangay health center dahil…
BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 Updated Pregnant List

Active Masterlisting

100% vaccinated
population Effective Follow Up

100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
“Health education para sa Bicol”
Trainings

Reliable Vaccine
Supply

100% immunized
population
100% effective
system
“DOH, like mo”
transpo
container
Proposed Action
reserve ref 1. will provide regular FB
thermo
posts about immunization
Cold chain
calibration goal:
-increase awareness of those
ref monitoring
chart population reachable by social
media platform
refrigeration (adolescent/youngadult/adult/e
lderly)
secondary school -decrease HP material costs (if
health education we utilize social media: no
brgy based funds needed as compared to
RHU lectures
lectures printing hardcopy HP
TV interviews materials)
Effective health about programs -if there are issues about the
100% KAP of
population education
social media
FB regular post, this will provide
opportunity for us to correct
community based
updates misconceptions about
activity vaccines/immunization
HP material payong :) leaflets
 Updated Pregnant List

Active Masterlisting

100% vaccinated
population Effective Follow Up

100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based activity

HP material payong :) leaflets
 Updated Pregnant List

Active Masterlisting

100% vaccinated
population Effective Follow Up

100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration Proposed Action

1. will give 1 unit of umbrella
secondary school to the first 1000 mothers
health education whos child completed
brgy based
RHU lectures
immunization at 12 months
lectures (FIC)
TV interviews the umbrella with serve as HP
about programs
100% KAP of Effective health material
population education
social media
FB regular payong: used by mothers
updates

community based
payong ng regularly: more exposure of
the HP material: increase
activity
awareness of other mothers
HP material
nanay ni FIC leaflets
about FIC
 Updated Pregnant List
What else have we done?
Active Masterlisting

100% vaccinated
population Effective Follow Up
• 1. every wednesday brgy
100%FIC
Regular Vaccination
0%CIC
Schedule bakuna day jingle
Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List
What else have we done?
Active Masterlisting

100% vaccinated
population Effective Follow Up
• 2. Routine immunization flow
100%FIC
Regular Vaccination
0%CIC
Schedule chart
Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List
What else?
Active Masterlisting

100% vaccinated
population Effective Follow Up
• 3. Bakuna kard
100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List
What else?
Active Masterlisting

100% vaccinated
population Effective Follow Up
• 3. Immunization Monitoring
100%FIC
Regular Vaccination
0%CIC
Schedule chart
Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List
What else?
Active Masterlisting

100% vaccinated
population Effective Follow Up
• 4. Every Wednesday Barangay
100%FIC
Regular Vaccination
0%CIC
Schedule Bakuna Day Tarp
Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 Updated Pregnant List
What else?
Active Masterlisting

100% vaccinated
population Effective Follow Up
• 5. Ref Cold Chain Sticker
100%FIC
Regular Vaccination
0%CIC
Schedule

Supplemental/Cat
ch Up

DOH ROV
PDO/PHO
RHU

MOP
NDP/RHMP
system
Trainings

Reliable Vaccine
Supply

100% immunized 100% effective transpo

population system container

reserve ref

thermo
calibration
Cold chain
ref monitoring
chart

refrigeration

secondary school
health education

brgy based
RHU lectures
lectures

TV interviews
Effective health about programs
100% KAP of
population education FB regular
social media
updates

community based
activity

HP material payong :) leaflets

 More Sensitive
HEAT LIGHT FREEZE
OPV BCG Hep B
BCG MCV IPV
JE JE Penta
IPV HPV
PCV Flu
HPV PCV
Flu Rota
Rota Td
Penta TT
HepB
Td
Less Sensitive

“Tara na sa barangay health center dahil…

BASTA WEDNESDAY, BARANGAY BAKUNA DAY!”
 2w January
A F
37w AOG 22w AOG

B G
35w AOG 20w AOG

C H
30w AOG 17w AOG

D
27w AOG

E
25w AOG
 2w January 2w February
A F F
37w AOG 22w AOG
A 26w AOG

B G B G
35w AOG 20w AOG 24w AOG

C H C H
30w AOG 17w AOG 34w AOG 21w AOG

D D I
27w AOG 31w AOG 20w AOG

E E J
25w AOG 29w AOG 17w AOG
 2w January 2w February 2w March
A F F F
37w AOG 22w AOG
A 26w AOG 30w AOG

B G G G
35w AOG
B 28w AOG
20w AOG 24w AOG

C H C H H
30w AOG 17w AOG 34w AOG 21w AOG C 25w AOG

D D I D I
27w AOG 31w AOG 35w AOG 20w AOG
20w AOG

E E J E J
25w AOG 17w AOG 33w AOG 17w AOG
29w AOG
 2w January 2w February 2w March 2w April
A F F F F
37w AOG 22w AOG
A 26w AOG 30w AOG
34w AOG

B G G G G
35w AOG
B 28w AOG
20w AOG 24w AOG 32w AOG

C H C H H H
30w AOG 17w AOG 34w AOG 21w AOG C 25w AOG
29w AOG

D D I D I
35w AOG I
27w AOG 31w AOG 20w AOG 20w AOG D 24w AOG

E E J E J J
25w AOG 29w AOG 17w AOG 33w AOG 17w AOG E 21w AOG
2w February 2w March 2w April 2w May
F F F
A 26w AOG 30w AOG
34w AOG F

G G G
B 28w AOG
G
24w AOG 32w AOG 36w AOG

C H H H
C 25w AOG
H
34w AOG 21w AOG 29w AOG 33w AOG

D I D I
35w AOG I I
31w AOG 20w AOG 20w AOG D 24w AOG 28w AOG

E J E J J J
29w AOG 17w AOG 33w AOG 17w AOG E 21w AOG 25w AOG
 2w January 2w February 2w March 2w April
A F F F F
37w AOG 22w AOG
A 26w AOG 30w AOG
34w AOG

Number of pregnant Number of BCG Number of BCG to be Number of Hep B Number of Hep B to
B G Women
G
currently in cold requested G
currently in cold be requested
G
35w AOG
B
(25-37weeks AOG) storage storage
28w AOG
20w AOG 2nd trim pregnant 24w AOG 32w AOG

C H number of expected
C
newborn eligible for H H H
30w AOG 17w AOG BCG and
34wHep B
AOG 21w AOG C 25w AOG
29w AOG
vaccination for next
3 month

should be equal the

number vaccine in
D D
storage for large
I D I
storage facilities
35w AOG I
27w AOG 31w AOG 20w AOG 20w AOG D 24w AOG

5 3 2 1 4
E E J E J J
25w AOG 29w AOG 17w AOG 33w AOG 17w AOG E 21w AOG
2w February 2w March 2w April 2w May
F F F
A 26w AOG 30w AOG
34w AOG F

G Number of pregnant G Number of BCG Number of BCG to be

G
Number of Hep B Number of Hep B to
B Women currently in cold requested currently in cold G
be requested
24w AOG (25-37weeks AOG)28w AOG storage storage
32w AOG 36w AOG
2nd trim pregnant

C H H H
number of expected
C 25w AOG
newborn eligible for
H
34w AOG 21w AOG 29w AOG
BCG and Hep B 33w AOG
vaccination for next
3 month

should be equal the

D I Dnumber vaccine in
I
storage for large
35wstorage
AOG facilities20w AOG I I
31w AOG 20w AOG D 24w AOG 28w AOG

E J E 4 J 3 1
J
3 1
J
29w AOG 17w AOG 33w AOG 17w AOG E 21w AOG 25w AOG
 12 PHO

3 4 5 RHU

HRH

2nd trim Pregnant

women in barangay
• Penta, OPV, PCV, IPV
Number of Number of Number of Number of Number of OPV Number of Number of PCV Number of IPV Number of IPV to
Penta in Penta to be OPV in to be Requested PCV in to be Requested in Storage be Requested
Live storage Requested Storage (multiplied by 3) Storage (multiplied by 3) (multiplied by 1)
Births (multiplied by 3)

equal to the multiplied by 3

number of since these
population vaccines are
eligible to given in 3 doses
receive OPV,
PCV and penta
after 6 weeks
(1.5 months)

can also use

number of 3rd
trim pegnant
to estimate the
number of
eligible
population in
the next 3
months
• MMR

Number of Number of patients Total Number of Number of MMR in Number of MMR to

Patients given 3rd given MMR1 in the population eligible Storage be Requested
dose of current month for MMR vaccination
OPV/IPV/Penta in the next 3 months
(which ever is higher)

equal to the number equal to the number

of population eligible of population eligible
to receive MMR1 to receive MMR2
after 3 months after 3 months
• PPV

Number of Number of PPPV in Storage Number of PPV to be Requested

Patients aged 60yo without PPV
immunization in the last 5 years
 Vaccine Request Form for _________,20__
(Month)

Name of HRH: Name of Barangay: Name of Municipality:

Number of pregnant Women Number of BCG currently in cold Number of Hep B currently in cold
(25-37weeks AOG) storage Number of BCG to be storage Number of Hep B to be
requested requested
2nd trim pregnant

Number of Number of Number of Number of Number of Number of IPV in

Penta in OPV in Storage Number of OPV PCV in Number of PCV to Storage Number of IPV to
Live storage Penta to be to be Requested Storage be Requested be Requested
Requested ( = Live Birth)
Births

* for Penta, OPV, PCV number of dose needed is equal to the number of Live births multiplied by 3
Number of Patients given Number of patients given Total Number of population Number of MMR in Storage
3rd dose OPV/IPV/Penta MMR1 in the current month eligible for MMR vaccination Number of MMR to
be Requested
(which ever is higher)

Number of Number of PPV in Storage

Patients aged 60yo
without PPV immunization
Number of PPV to be Requested
in the last 5 years

mancilla/NIP/dohrov.v1
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Thank you!
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