12.2  Vaccines covered under EPI and their schedule of administration

Currently, the EPI delivers eight vaccines to protect children against the following serious childhood illnesses: tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus, Haemophilus influenzae-B (Hib) infections, hepatitis B disease and measles.

• Haemophilus influenzae type B and the hepatitis B vaccines are new vaccines introduced into the EPI programme in Ethiopia in 2007.
• Haemophilus influenzae type B vaccine prevents meningitis, pneumonia, epiglottitis and other serious infections caused by Haemophilus influenzae type B bacteria. The vaccine will not protect against these conditions if they are caused by other infectious agents such as viruses.
• Hepatitis B vaccine protects against liver disease. Hepatitis B infection in young children is usually asymptomatic (they don’t develop symptoms). However, a larger proportion of children than adults may become chronic carriers who can transmit the hepatitis B virus to others for many years without showing symptoms themselves. Chronic carriers are more likely to develop severe chronic liver disease or liver cancer in later life.

Table 12.1 shows the recommended immunization schedule and the mode of administration of the eight childhood vaccines. The recommended vaccine should be given when the child reaches the appropriate age for each dose. If the vaccination is given too early, protection may not be adequate. If there is any delay in giving the appropriate vaccine, this will increase the risk of the child getting the disease. If you see a child who has not been immunized at the recommended age, you should give the necessary immunizations as soon as possible. Most vaccines (except BCG and measles) require administration of repeated doses, usually three times. For these vaccines, after the first dose, give the remaining doses at least four weeks apart.

• BCG vaccine protects against tuberculosis (TB) and is given once only.
• OPV is the oral polio vaccine, given in four doses numbered 0 to 3.
• DPT is the diphtheria, pertussis, tetanus vaccine, combined in a single preparation with the Hepatitis B vaccine and the Haemophilus influenzae type B vaccine. Together, these five vaccines are known as the pentavalent vaccine (‘penta’ means five). Children get three doses.
• Measles vaccine is given only once.

You should not give OPV0 (the first dose of oral polio vaccine) to an infant who is more than 14 days old. Therefore, if an infant has not received OPV0 by the time he or she is 15 days old, you should wait until the child is four weeks old to give OPV-1. Then also give DPT1-HepB1-Hib1 at four weeks.

Children with diarrhoea who are due for OPV (any dose) should still receive the prescribed dose. However, you should not count this as it may be passed through the body. You should tell the mother to return with the child in four weeks’ time so that you can give the child an extra dose of OPV.