This document summarizes vaccination programs in Pakistan, including the Expanded Program on Immunization (EPI) and non-EPI vaccines. It outlines the objectives of EPI to increase immunization coverage for children under 5 and reduce incidence of targeted diseases. The current EPI schedule in Pakistan includes vaccines for BCG, hepatitis B, oral polio, rotavirus, pneumococcal, pentavalent, IPV, typhoid, measles-rubella, and tetanus toxoid for women. Non-EPI vaccines discussed include those for COVID-19, influenza, mumps, varicella, hepatitis A, HPV, meningococcal, and dengue. The document stresses the importance of cold

1. VACCINATION:
EPI AND NON-EPI
Dr. Raheel Ahmed FCPS Pediatrics
Children Hospital, Chandka Medical College, Larkana

2. Continents
 Definitions
 EPI
 Current EPI Schedule
 Different EPI Vaccines
 Cold Chain
 Non-EPI vaccines

3. Immunization
 It is process where by a person is made
immune or resistant to an infection, typically by
administration of vaccine
 It is proven tool for controlling and elimination
life-threatening infectious.

4. Types of immunity
 Innate or natural
Immunity
 Immunity with birth
 Acquired Immunity
 Develops during life
time
 Acquired naturally or
artificially

5. Vaccine
 A vaccine is a non- pathogenic antigen that
mimics a particular pathogen in order to elicit
an immune response as if that actual pathogen
were in the body
 Types
 Live, attenuated Vaccine
 Inactive Vaccine
 Whole cell vaccine
 Protein based: Toxoid, subunit
 Polysaccharide based: Conjugate, pure

6. EPI: Extended Program of
Immunization
 EPI was established in 1974.
 Built on success of the global smallpox
eradication
 It ensures that all children in worldwide
benefited from life saving vaccines.

7. AIM
 It focuses on following items
1. Standard Immunization Schedule
2. Supplemental immunization activities
3. Disease survillance
4. Mopping up
5. Promoting safe injection techniques
6. Improving the stocking and availability of
vaccines
7. Protecting vaccines’ potency through cold chain
management
8. To prepare for introduction of new vaccines

8. Objectives
 To increase coverage of immunization for
eligible children
 To reduce incidence of immunizable diseases
among children below five years of age
 Eradication of polio, measles, neonatal
tetanus, diphtheria
 Reduce incidence of hepatitis B, whooping
cough, bacterial meningitis
 Prevention of severe forms of TB

9. Objectives

11. Current EPI Schedule In
Pakistan

12. EPI Card

13. Vaccines in
EPI Schedule
in children
and women

14. BCG
 Live attenuted variant
 0.05ml at birth
 ID injections in right forearm

15. Hepatitis B
 rDNA, bacterial
subunit
 Given in children
born to positive
Hepatitis B mothers
 Given within 24
hours
 IM 0.5ml in leg

16. OPV
 Oral polio vaccine
 Also called Sabin’
 LIVE VIRUS ATTENUATED
 Bivalent: type 1 and 3
 4 doses: birth, 6,10 and 14
weeks
 2 drops orally

17. Rotavirus Vaccine
 Rotarix®
 2-dose series at age
6 and 10 weeks
 orally

18. Pneumococcal Vaccine
 Polysaccharide
conjugated
 3 doses: 6,10,14 weeks
 IM on left leg

19. Pentavalent
 Contain:
 Diphtheria(toxoid),
 Tetanus(toxoid),
 Pertusis(whole cell/killed),
 hepatitis B (rDNA/viral
subunit),
 H. influenza type b
(polysacchrides)
 Doses 3: 6,10,14 weeks
 IM in right leg

20. IPV
 Also called Salk
 KILLED VIRUS
 2 doses at 14 weeks
and 9 months in Pak
 3 doses in
developed countries
 Contain all 3
serotypes

21. Typhoid conjugated vaccine
 Conjugated vaccine
 Single dose at 9
months
 IM
 Pakistan first time
introduce in EPI due
to XDR- typhoid
fever

22. MR
 Contain Measles
and Rubella
 LIVE VIRUS
ATTENUATED
 2 doses: 9 months
and 15 months
 SC left arm

23. Tetanus Vaccine for women
Td doses Schedule
1 At 0, or during
pregnancy
2 1 month after last dose
3 6 month after last dose
4 1 year after last dose
5 1 year after last dose

24. Td vaccine
 Diphtheria and
Tetanus
 Recommended >7y

25. Non-EPI Vaccines
Vaccine Doses Age
Covid-19 2 or 3 doses After 6m
Influenza 2 or 3 doses
Annual
After 6m
Mumps (MMR) 2 doses After 6m
Vercella 2 doses After 12m, 4-6y
Hep A 2 doses Bw 1- 40 year
HPV 2 or 3 doses 9-14years
Meningococcal 2 doses 1st: 11-12y
2nd: 16years
Dengue 3-dose 9–16 year
Ref: https://www.cdc.gov/vaccines/schedules/hcp/imz/child-
adolescent.html

26. Cold Chain
 A term used to describe the cold
temperature conditions in which
certain products need to be kept
during storage and distribution
 Vaccines may lose their
effectiveness if they become too
hot or too cold at any time.
 recommended temperature range:
+2˚C to +8˚C
 Also protected from light.
 Vaccines must never be frozen

27. Message
Thank
YOU