Philippine Guidelines for Periodic Health Examination: Pediatric Immunization

Abstract

Background. Immunization is one of the most important public health achievements of the 20th century, second only to clean water. Increased life expectancy from past decades, largely attributed to improved child survival rates and reduced child mortality from vaccine-preventable diseases, has shown that vaccines underpin disease prevention and control programs and are essential for global health security.

Objective. This clinical practice guideline (CPG) provides evidence-based recommendations and best practices on immunization for the prevention of vaccine-preventable diseases, including those outside and within the scope of routine infant immunization provided by the National Immunization Program (NIP).

Methods. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended by the Department of Health Manual, including GRADE Adolopment and the GRADE Evidence to Decision or EtD framework. This CPG contains the systematic synthesis of scientific evidence on immunization for the pre-exposure prophylaxis of rabies infection, Haemophilus influenzae B booster, rotavirus, measles, mumps, varicella, BCG, tetanus booster, hepatitis B booster, pneumococcal conjugate vaccine (PCV), and pertussis booster in the pediatric population.

Results. The CPG provides twelve (12) recommendations on prioritized questions regarding the relevant vaccines for preventing these eleven (11) disease conditions. Recommendations for rabies pre-exposure prophylaxis, Haemophilus influenzae B booster, rotavirus, measles, mumps, varicella, BCG, tetanus booster, Hepatitis B booster, pneumococcal conjugate vaccine, and pertussis booster vaccination were made.

Conclusion. This CPG can be used to assess each vaccine’s eligibility for inclusion in the NIP (rotavirus and varicella), support their continued use in existing immunization programs (Haemophilus influenzae B booster, measles, mumps, tetanus booster, PCV, and pertussis booster), and/or address controversy surrounding their use (preexposure prophylaxis for rabies and hepatitis B booster). Relevant stakeholders can use these recommendations to continuously improve the performance, reach, and efficacy of the National Immunization Program. These recommendations are intended for use in the Philippines only since vaccine access and epidemiologic conditions might vary in other countries and warrant different recommendations.