Measles and Tetanus DiphtheriaMass Immunization for Grade 1 and Grade 7 Students

Rationale:

•The Philippine government through the Department of Health and in partnership with the Department of Education and Department of Interior and Local Government will conduct school-based adolescent immunization. This is in response to the increase threat of vaccine preventable diseases and in compliance with the World Health Assembly Agreement among member countries where Philippines is a signatory.

●In 2015, the Philippines has eliminated maternal-neonatal tetanus. To maintain the protection against tetanus, immunization services must be strengthen and given as early as possible.

●In 2013, school-based adolescent immunization using Measles-Mumps-Rubella (MMR) and Tetanus Diphtheria (Td) vaccines was conducted in selected 19 cities and 15 provinces nationwide.

Objective:

•This Order aims to guide concerned stakeholders on the implementation of School-Based Immunization in August to September 2015.

General Guidelines:• All public school students enrolled in Grade 1 shall

be given measles containing vaccine (MCV) and tetanus-diphtheria (Td). Screening for measles vaccination history at the time of school entry is necessary.

• All male and female students enrolled in Grade 7 shall be vaccinated with 1 dose each of Measles-Rubella (MR) and Td vaccines on the same immunization session.

• School-based vaccination shall be FREE of CHARGE.

Specific Guidelines:• All teacher in-charge/clinic teachers/school

nurses of Grade 1 students shall check the status of measles immunization of each student upon enrollment. The immunization card of each student shall be requested from the parents/guardians/caretakers.

There are immunization cards: Check the card for immunization status and put mark “with card” category. Determine what vaccine was given: MCV 1 and MCV 2.

If there is no card or no other record of vaccination: place mark on the “no card” category

Sample eccd card #1

•With MCV1 (measles @ 9m)

•With MCV2 (MMR)

Sample eccd card #2•With MCV1 (measles

@ 9m)

Sample eccd card #3

•Without MCV1 and MCV2

Specific Guidelines:Vaccination for Grade 1 StudentsVaccination with MCV After screening, students with zero or only 1 measles-containing vaccines received during younger days

• Students with recorded 2 doses of MCV: DO NOT VACCINATE

• Students with 0 or 1 dose of MCV or no immunization card: List the names of the students using Form 3b Masterlist of Grade 1 students, submit to the catchment health centers for the scheduled vaccination.

Specific Guidelines:Vaccination for Grade 1 StudentsVaccination with MCV After screening, students with zero or only 1 measles-containing vaccines received during younger days

• Vaccinate with Measles to complete the 2-doses per student at 1 month interval from the last dose. Vaccination with MCV can be done on the same immunization session for the Td vaccine

• Follow-up of Missed Students for MCV vaccines: Teacher-in-charge shall follow-up the missed students for vaccination but willing to be vaccinated and refer to Rural Health Unit (RHU)/ Barangay Health Station (BHS) for the MCV dose.

Specific Guidelines:Vaccination for Grade 1 StudentsVaccination with Td vaccines

• All Grade 1 students shall be vaccinated with 1 dose of Td vaccine in the designated immunization post and record in the Form 3b Masterlist of Grade 1 Students.

• Students with consent but were missed during the scheduled immunization should be followed-up and referred to the RHU/BHS for the needed vaccination.

• Students who refused vaccination shall be recorded in the Form 3b Masterlist of Grade 1 Students.

Vaccination Schedule for Grade 1 students:  Vaccines  Measles Vaccine Tetanus-

diphtheria (Td)Dosage 0.5 ml 0.5ml

Route & Site of Injection

Subcutaneous, Right deltoid arm

Deep Intramuscular, Left Deltoid arm

# doses required   1 dose   Students with Zero

dose2 doses, 28 days

interval from the last dose

 

  Students with only 1 dose recorded

1 dose only

 

Specific Guidelines:Vaccination for Grade 7 Students

Vaccination for Grade 7 students

•All males and females students shall be vaccinated with both MR and Td vaccines.

•The schedule of the vaccination for these students shall be:

Vaccination Schedule for Grade 7 students:

  MR Td

Dosage 0.5ml 0.5ml

Route and Site of Injection

Right, deltoid arm

Subcutaneous

Left, deltoid arm

Intramuscular

Measles, Rubella

Why get Vaccinated??

•Measles and rubella are serious diseases. Before vaccines they were very common, especially among children.

•Measles virus causes rash, cough, runny nose, eye irritation, and fever.

•It can lead to ear infection, pneumonia, seizures (jerking and staring) brain damage and death.

Why get Vaccinated??

•Rubella virus causes rash, arthritis (mostly in women), and mild fever.

•If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects.

How do we get these diseases?•These diseases spread from person to

person through the air. You can easily catch them by being around someone who is already infected

•Measles and rubella (MR) vaccine can protect you from all these diseases.

When not to give??•Anyone who has ever had a life-

threatening allergic reaction to the antibiotic Neomycin, or any other component of MR vaccine, should not get the vaccine. Tell your doctor if you have any severe allergies.

•Anyone who had a life-threatening allergic reaction toa previous dose of MR vaccine should not get another dose.

When not to give and wait??•Some people who are sick at the time the shot

is scheduled may be advised to wait until they recover before getting MMR vaccine.

•Pregnant women should not get MR vaccine. Pregnant women who need the vaccine should wait until after giving birth.

•Women should avoid getting pregnant for 4 weeks after vaccination with MR vaccine.

MR Adolescent Immunization

Measles-RubellaVaccine (MR)

•Contains live attenuated viruse

•1-dose efficacy varies by 95% (measles and rubella)

•Duration of immunity is lifelong

Dose and Administration

•0.5ml SC (Subcutaneous injection)

•Right upper arm

MR VaccineContraindications

•Severe allergic reaction to vaccine component or following prior dose

•Pregnancy

•Immunosuppression

MR Vaccination of Women of Childbearing Age

•Ask if pregnant or likely to become so in next 4 weeks

•Exclude those who say "yes“

•For others▫ explain theoretical risks▫ vaccinate

MR VaccinePrecautions

•Moderate or severe acute illness

•Recent receipt of a blood product

•History of thrombocytopenia or thrombycytopenic purpura

Tetanus-diphtheria (Td)

Why get vaccinated??•Tetanus and diphtheria can be very serious

diseases

•TETANUS (Lockjaw) causes painful muscle spasms and stiffness, usually all over the body.

• It can lead to tightening of muscles in the head and neck so the victim cannot open his mouth or swallow, or sometimes even breathe. Tetanus kills about 1 out of 5 people who are infected.

•Prevention of maternal and neonatal tetanus

Why get vaccinated??•DIPHTHERIA can cause a thick

membrane to cover the back of the throat.

•It can lead to breathing problems, paralysis, heart failure, and even death.

How do we get these disease?

•These two diseases are both caused by bacteria. Diphtheria is spread from person to person. Tetanus enters the body through cuts, scratches, or wounds.

When not to give and wait??

•Anyone who has had a life-threatening allergic reaction after a dose of any tetanus, diphtheria, containing vaccine should not get Td

•Anyone who has a severe allergy to any component of a vaccine should not get that vaccine.

Common Reactions after giving Td vaccine……

•Pain (up to about 8 in 10

•Redness or swelling at the injection site (up to about 1 in 3)

•Mild fever (up to about 1 in 15)

•Headache or tiredness (uncommon)

Tetanus, DiphtheriaAdolescentImmunization

Tetanus and DiphtheriaVaccines for Adults

•Tetanus and Diphtheria Toxoid (Td)

•formalin-inactivated toxins

•3 doses induces protective antibody in nearly everyone

•protection for at least 10 years

Dose and Administration

•One (1) dose

•0.5 ml IM

•Left upper arm

Td Contraindications

•Severe allergic reaction to a vaccine component or following a prior dose

•Moderate or severe illness

Td Precautions

•History of an hypersensitivity reaction following a previous dose of tetanus or diphtheria toxoid-containing vaccine

•History of Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoid-containing vaccine

•Moderate or severe acute illness

Questions and Clarifications????

Thank you!!