18 Questions
What is the recommended route of administration for the BCG vaccine?
Intradermal
When should the first dose of the Hepatitis B vaccine be administered to newborns weighing more than 2 kg?
Within the first 24 hours of life
What should be done if a baby less than 7 years old receives the Hepatitis B vaccine and Td is not available?
A single dose of Tdap can replace Td
What is the accelerated reaction to the BCG vaccine indicative of?
Recent tuberculosis infection
How soon after birth should the first dose of Hepatitis B vaccine be given to newborns with a birth weight above 2 kg?
Within the first 24 hours of life
What is the recommended timing for administering Tdap vaccine to pregnant adolescents?
During the third trimester (27-36 weeks gestation)
What is the minimum age requirement for administering the Human Papillomavirus (HPV) vaccine in females?
9 years old
What is the recommended dosing schedule for the HPV vaccine if the interval between the 1st and 2nd dose is less than 6 months?
A 3rd dose is needed
Which age group requires a 3-dose series of the HPV vaccine?
Individuals aged 15 years or older
For males aged 9-18 years, which types of HPVs are recommended for the prevention of anogenital warts and anal cancer?
Quadrivalent (4vHPV)
What is important to note about the use of HPV vaccines in females?
Prevents cervical carcinoma
What is the significant difference in dosing schedules between females under 15 years old and those aged 15 or older for the HPV vaccine?
The time interval between the 1st and 2nd dose
What does BCG stand for in the context of vaccines?
Bacillus Calmette-Guerin
Which of the following diseases is NOT initially included in the Expanded Program on Immunization (EPI)?
Mumps
When is the BCG vaccine preferably given?
Within the first 2 months of life
Which organization recommends vaccines not included in the National Immunization Program but still important for children?
Philippine Pediatric Society (PPS)
What is the correct route of administration for the BCG vaccine?
Intradermal (ID)
Which condition indicates that a PPD test is recommended prior to BCG vaccination?
Congenital tuberculosis
Study Notes
National Immunization Program (NIP)
- Established in 1976, originally called Expanded Program on Immunization (EPI)
- Initially included six vaccine-preventable diseases:
- Tuberculosis
- Poliomyelitis
- Diphtheria
- Tetanus
- Pertussis
- Measles
Vaccines in the National Immunization Program (NIP)
- Vaccines included in the 2023 NIP:
- BCG
- Monovalent Hepatitis B
- Pentavalent vaccine (DTwP/Hib/HepB)
- Bivalent OPV
- IPV
- PCV
- MR/ MMR
- Td
Bacille Calmette-Guérin (BCG)
- Vaccine type: Live Attenuated Vaccine
- Route: Intradermal (ID)
- Given at the right deltoid muscle (right upper arm)
- When: Earliest possible after birth and preferably within the first 2 months of life
- Dose:
- 0.05 ml (infants < 12 months)
- 0.1 ml (children > 12 months)
- Contraindications:
- Immunodeficiency
- Progressive dermatoses near the site of injection
- Abscess at the site of infection
- Regional lymphadenopathy
- Rare: osteitis affecting epiphysis of long bones can occur several years after BCG
- Special Remarks:
- PPD is recommended prior to BCG vaccination if any of the following is present:
- Congenital TB
- History of close contact to known or suspected infectious TB case
- Clinical findings suggestive of TB and/or chest x-ray suggestive of TB
- In the presence of any of these conditions, an induration of ≥ 5 mm is considered positive, and BCG is no longer recommended
- PPD is recommended prior to BCG vaccination if any of the following is present:
Hepatitis B Vaccine
- Vaccine type: Inactivated Vaccine
- Route: Intramuscular (IM)
- When:
- 1st dose: Soon after birth (for newborns BW >2 kg)
- Subsequent doses are given as per schedule
- Dose: Depends on the company:
Response to BCG Vaccine
- Accelerated Reaction:
- Occurs when a child is given the BCG vaccine when they already have tuberculosis
- Happens earlier than the usual reaction
- Has the same range but differs in days, weeks, or months
- Usual Reaction:
- Induration: 2-4 weeks
- Pustule: 5-7 weeks
- Formation of Scar: 2-3 months
Human Papillomavirus (HPV) Vaccine
- Vaccine type: Inactivated vaccine
- Route: Intramuscular (IM)
- When:
- Minimum age of 9 years
- Best given before sexual intercourse
- Dose:
- Bivalent (2vHPV)
- Quadrivalent (4vHPV)
- Nonavalent (9vHPV)
- For females: used to prevent cervical carcinoma
- For males: recommended for the prevention of anogenital warts and anal cancer
Test your knowledge on the history and vaccines included in the National Immunization Program (NIP) which was established in 1976 as the Expanded Program on Immunization (EPI). Learn about the six initial vaccine-preventable diseases and the current vaccines included in the program.
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