School Based Immunization 2y2u3v

MR, TD & HPV VACCINE SCHOOL BASED IMMUNIZATION

Introduction To generate vaccine-mediated protection is a complex challenge. Their early protective efficacy is primarily conferred by the induction of antigen-specific antibodies.

WHY SCHOOL BASED IMMUNIZATION? • Booster doses maybe needed to ensure that high levels of protection are maintained • New vaccines such as the human papilloma virus (HPV) vaccine are more effective if delivered at a specific age.

Cervical cancer, human papillomavirus (HPV) World wide, almost 500, 000 women develop cervical cancer and 274, 000 die from the disease every year. Cervical cancer is caused by certain types of Human Papillomavirus (HPV) and is the most common cancer affecting women in developing countries (WHO 2007).

The age-standardized cervical cancer incidence rate in the Philippines is 20.9 per 100,000, which is 30% higher than the world rate (Ferlay et al., 2004).

HPV VACCINE Vaccination of HPV vaccine is one of the preventive interventions for the cervical cancer in the later life. WHO recommends that primary intervention begins with HPV vaccination of girls ages 9-13 years old, before they become sexually active.

HUMAN PAPILLOMA VIRUS VACCINE • These include two types that cause about 70% of cervical cancer and two types that cause about 90% of genital warts. HPV vaccine can prevent most genital warts and most cases of cervical cancer.

• Protection from HPV vaccine is expected to be long-lasting. But vaccinated women still need cervical cancer screening because the vaccine does not protect against all HPV types that cause cervical cancer.

SPECIFIC GUIDELINES VACCINATION FOR HPV VACCINE: •Only 9-10 years old female student shall be vaccinated with 2 doses of the quadrivalent Human Papilloma Virus (HPV) vaccine in the designated immunization post in the school.

Why is HPV vaccine given to girls at this age? • It is important for girls to get HPV vaccine before their first sexual -- because they have not been exposed to HPV. For these girls, the vaccine can prevent almost 100% of disease caused by the four types of HPV targeted by the vaccine.

TETANUS

• Potent bacterial neurotoxins originating from vegetative C. tetani may cause local muscular spasms or generalized tetanus. Untreated generalized tetanus is often fatal • It causes painful muscle tightening and stiffness, usually all over the body.

Tetanus is one of the vaccinepreventable diseases included in DOH’s Expanded Program on Immunization

DIPHTHERIA It is a potentially fatal, contagious disease that usually involves the nose, throat, and air ages, but may also infect the skin.

• It can lead to breathing problems, heart failure, paralysis, and death. • Both diphtheria and tetanus are infections caused by bacteria.

• Diphtheria spreads from person to person through secretions from coughing or sneezing. • Tetanus-causing bacteria enter the body through cuts, scratches, or wounds.

Tetanus-Diptheria (TD) VACCINE Why get vaccinated? •Tetanus and diphtheria are very serious diseases. TD vaccine is used to protect adolescents and adults from both of these diseases.

• 3 doses of

diphtheria/tetanus/pertussis vaccine in infancy • Tetanus-toxoid (TT)-containing booster at school-entry age (4 to 7 years old) • TT-containing booster in adolescence (12 to 15 years old) • TT-containing booster in early adulthood

• TD vaccine can protect adolescents and adults from tetanus and diphtheria. TD is usually given as a booster dose every 10 years but it can also be given earlier after a severe and dirty wound or burn.

MEASLES Measles is mostly a mild disease of young children, characterized by fever, cough, nasal congestion and a typical rash. Primarily by airborne respiratory droplets. The virus is highly contagious. (WHO 2012)

RUBELLA Rubella is usually a mild childhood disease characterized by moderate fever, lymphadenopathy and a rash. In adults, transient arthralgia and arthritis may occur. Rubella infection in early pregnancy often results in miscarriage, stillbirth or multiple fetal defects (WHO 2012).

Measles-Rubella Vaccines Measles is a live attenuated vaccine: available either in monovalent form (measles component only), or in fixed combinations with one or more of vaccines against mumps, rubella and varicella. Two intramuscular doses are istered at an interval of at least 4 weeks.

TARGET POPULATION GRADE 4

HUMAN PAPILLOMAVIRUS (HPV) VACCINE

GRADE 1

TETANUS-DIPHTHERIA (TD) VACCINE MEASLES-RUBELLA (MR) VACCINE

GRADE 7

TETANUS-DIPHTHERIA (TD) VACCINE MEASLES-RUBELLA (MR) VACCINE

9 - 10 years old, Female *Will undergo screening on past MCV immunization history *All will be vaccinated with TD regardless of immunization history. *All will be vaccinated with TD regardless of immunization history.

SCHEDULE FOR GRADE 1 MEASLES-RUBELLA (MR) VACCINE

TETANUSDIPHTHERIA (TD) VACCINE

DOSAGE

0.5 ml

0.5 ml

ROUTE & SITE OF INJECTION

Subcutaenous, Right Deltoid arm

Deep Intramuscular, Left Deltoid arm

#DOSES REQUIRED

1 dose

STUDENT WITH ZERO DOSE MCV

2 doses with 28 days interval

STUDENT WITH ONE DOSE MCV

1 dose only

SPECIFIC GUIDELINES • All the teacher in charge of grade 1 shall check the measles immunization of each student. The immunization card of each student shall be requested from the parents/guardians/caretakers and shall be the proof of evidence that student received the measles vaccines.

SCHEDULE FOR GRADE 7

DOSAGE ROUTE & SITE OF INJECTION

MEASLES-RUBELLA (MR) VACCINE

TETANUSDIPHTHERIA (TD) VACCINE

0.5 ml

0.5 ml

Subcutaenous, Right Deltoid arm

Deep Intramuscular, Left Deltoid arm

Some people should not get this vaccine • A person who has ever had a lifethreatening allergic reaction after a previous dose of any tetanus or diphtheria containing vaccine, OR has a severe allergy to any part of this vaccine, should not get Td vaccine. Tell the person giving the vaccine about any severe allergies.

DOH will give the tetanus-diphteria (TD) vaccine to grade 1 students starting August. In addition to this, grade 7 students will also get vaccinated against measles, rubella, tetanus, and diphtheria (MRTD).

Garin said giving TD and MRTD vaccines to students is crucial, especially in a disaster-prone country like the Philippines. On top of the 3 doses of tetanus vaccine given during the first year of life, the booster shots to be given as children reach grades 1 and 7 "will give...lifetime immunity during calamities."