General Notes

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The terms Immunisation and Vaccination will be used interchangeably in this section. Further information on immunisation may be found in the Manual for the Zimbabwe Expanded Programme on Immunisation (ZEPI). Information relating to rabies can be found in the chapter on tropical diseases

Diseases Preventable by Immunization 

  • Diphtheria
  • Measles
  • Rubella
  • Hepatitis B
  • Pertussis (whooping cough)
  • Poliomyelitis
  • Rotavirus Diarrhoea
  • Rabies (see Tropical disease section)
  • Tetanus
  • Tuberculosis
  • Typhoid
  • Some pneumonias, septicaemia and meningitis (caused by Haemophilus Influenza type Band Streptococcus pneumoniae)
  • Diarrhoea, vomiting and systematic upset due to Rotavirus infection.
  • Cancer caused by Human Papilloma Virus

There are other vaccine preventable diseases, for example, Anthrax that are not yet provided under the national immunization programme.

Cold Chain

All vaccines should be kept at temperatures of +2°C to +8°C.

Management of Open Vials

  • Open vials of DTP, DTP-Hep B-Hib (Pentavalent), DT, Td, OPV,IPV, HPV and Hep B may be used in subsequent sessions for a maximum of 28 days (ZEPI Policy) provided the vaccine has not expired, the vaccine vial monitor (VVM) has not reached the discard point, the vial has not been contaminated, the vaccine has been kept in appropriate cold chain condition.
  • Any vaccine that contains an ingredient that has not yet been approved by WHO for Multi-dose vial policy (e.g Typhoid vaccine-Typbar-TCV 5-dose vial), once opened should be discarded after 6 hours of opening.
  • Reconstituted vials of measles-rubella and BCG vaccines must be discarded after 6 hours or as per manufacturer's instructions, whichever comes first.

Effectiveness of Vaccines in HIV Infected Individuals

EPI recommended vaccines have shown satisfactory sero-conversion rates in early stages of HIV infection. However, the proportion of responders decreases with progression from HIV infection to AIDS.

  • Children with known or asymptomatic HIV infection should receive all EPI vaccines according to the schedule
  • BCG vaccine should not be given to children with clinical symptoms of HIV

Contraindications to Vaccination 

There are very few absolute contraindications to vaccines. Fever, diarrhoea, mild respiratory infection and malnutrition are not contraindications to vaccines.

  • BCG vaccine should not be given to a child with symptomatic HIV infection but polio and measles/rubella vaccines should be given to children with HIV and AIDS together with other vaccines
  • The current DTP contains whole cell pertussis, some children are sensitive to whole cell pertussis and a second or third dose of Pentavalent and DTP at 18 months should not be given to a child who severely reacted to a previous dose of Pentavalent. DT should be given instead (Note: DTP in Pentavalent contains whole cell Pertussis which may cause severe anaphylaxis, collapse, or convulsions).
  • A child with an evolving neurological disease such as uncontrolled epilepsy or progressive encephalopathy should not be given Pentavalent or DTP. Give DT instead.

Adverse Events

All adverse events following immunisation should be reported using the 'Adverse Events Following Immunisation' (AEFI) form. Health workers should refer to the ZEPI AEFI guidelines and Standard Operating Procedures