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Republic of the Philippines

DEPARTMENT OF HEALTH
Office of the Secretary
BAGONG PILIPINAS

June 21, 2024

DEPARTMENT MEMORANDUM
No. 2024 - 0250

FOR: ALL UNDERSECRETARIES, ASSISTANT SECRETARIES,

DIRECTORS OF BUREAUS, SERVICES, AND CENTERS
FOR HEALTH DEVELOPMENT HD). MINISTER OF

HEALTH - BANGSAMORO AUTONOMOUS REGION IN

MUSLIM MINDANA MOH-BARMM ATTACHED
AGENCIES, AND OTHERS CONCERNED

SUBJECT: Interim Guidelines on the Resumption of School-Based

i
I nization (SBI r th -19 P

I. BACKGROUND

The School-based Immunization (SBI) is a program of the Department of Health

(DOH), in coordination with the Department of Education (DepEd), that aims to provide
protection against vaccine—preventable diseases (VPDs) such as measles, rubella, tetanus,
diphtheria and human papillomavirus (HPV). Since 2013, SBI has been conducted every
August nationwide in public schools until the COVID-19 pandemic. The SBI shifted from
school-based to community-based setting due to mobility restrictions and suspension of
in-person classes in schools during the peak of the COVID-19 pandemic.
With the full resumption of face-to-face classes, school learners are at high risk of
contracting VPDs. Thus, the continuity of delivering immunization services, including
school-based vaccination, proves to be critical in mitigating public health crises, such as the
recent outbreaks of measles and pertussis in certain areas of the country.

In this regard, this issuance aims to provide technical directions for the
re-implementation of School-based Immunization services at the school setting.

II. GENERAL GUIDELINES

A. All SBI services, including Measles-Rubella (MR), Tetanus-diphtheria (Td), and

Human Papillomavirus (HPV) vaccination, shall resume its implementation in
schools. It is recommended to be rolled out in public schools two (2) months from
the start of classes or as agreed upon by DOH and DepEd.
B. Grade and Grade 7 school children shall be vaccinated with MR and Td
1

vaccines while Grade 4 female school children shall be vaccinated with HPV
vaccine. These vaccinations shall follow the appropriate dosages, scheduling and
intervals.

local 1113, 1108, 1135

Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila e Trunk Line 651-7800
Direct Line: 711-9502; 711-9503 Fax: 743-1829 URL: http://www.doh.gov.ph; e-mail: dohosec@doh.gov.ph
 C. A template for informed consent (4nnex A), including information, education, and
communication (IEC) materials shall be disseminated to parents or guardians prior
to the SBI roll-out.
D. Proper microplanning, coordination, and demand generation activities shall be
undertaken by all local government units (LGUs) and local health workers
concerned, in collaboration with other stakeholders such as the Department of
Education (DepEd) and other national government agencies (NGAs), to ensure the
efficiency in managing health resources and highlight the distinction of the
MR-Td and HPV school-based immunization from other ongoing vaccination
services.

IIL. SPECIFIC GUIDELINES

A. Preparatory Activities

1. Coordination and Engagement with School Administration

a. Local health centers shall coordinate with school principals, teachers and
school nurses on the conduct of SBI activities and SBI guidelines
orientation.
Teachers-in-charge/school nurses shall issue notification letters and
consent forms (Annex A) and IEC materials of health services such as
immunization to school children upon enrollment. The template for
notification letter and informed consent may be accessed through:
https://bit.ly/SBIConsentForm.
Schools within the LGU catchment area shall endorse the list of Grade 1,
Grade 7, and female Grade 4 children enrolled for the current school year
to the local health center.
Local health center staff shall record the endorsed list of eligible school
children in the Recording Forms 1, 2, and 3 (Annexes B, C, D). The
recording forms may be accessed via: https:/tinyurl.com/SBIReporting.
2. Microplanning
a. All LGUs, assisted by the DOH Development Management Officers
(DMO) with coordination and guidance of NIP Managers, shall develop a
detailed microplan of the SBI activities. Micro-plans shall include the
following:
i. Calculation and identification of the number of children to be
vaccinated per immunization session and the vaccination teams
needed to prepare immunization schedules for the vaccination team
including the schools to be visited;
ii. Calculation of the vaccine and other logistics needed including the
cold chain equipment;
ili. Immunization session plans;
iv. Plan for high-risk and hard-to-reach population;
v. Crafting of supervisory and monitoring schedule;
vi. Follow-up schedule and mop-up plan;
vii. Human resource mapping and contingency plan;
viii. Demand generation plan;
ix. Disease surveillance and reporting;
 Xx. Adverse Events Following Immunization (AEFI) management plan;
and
xi. Waste management plan
All SBI operational resource requirements shall be consolidated at the
city/municipality, provincial and regional levels and included in the costed
SBI microplans to be submitted to the higher administrative level.
A standard microplan template which can be accessed through
https:/tinyurl.com/SBIMicroplanTemplate shall be used by all LGUs.
3. Demand Generation

a. Engagement of parents and caregivers through Parents and Teacher

Association (PTA) meetings and similar activities shall be conducted by
schools to ensure uptake among students.
Discussions on vaccination among students shall also be conducted
through platforms such as flag ceremonies,
teach-in
as part of lectures for relevant
sessions to raise awareness and
classes, and/or through dedicated
willingness among students.
Conducting social listening and feedbacking among students and parents
shall be done through different channels such as meetings and discussions
to identify mis/disinformation that need to be addressed.
LGUs and schools shall mobilize stakeholders to support demand
generation activities. This can include the provision of giveaways for
successfully vaccinated students, as well as incentives for health workers.
Other interactive community engagement activities such as contests and
kick-off/launching activities are also encouraged.

4. Setting up of Vaccination Posts

Local health centers shall coordinate with the school administrators for the use
of school facilities as temporary vaccination posts. Temporary vaccination
posts shall be well-ventilated and spacious toallow compliance with minimum
public health standards. Client flow in the vicinity shall be discussed with
school administrators, teachers-in-charge, and school nurses.

5. Establishment of Vaccination Teams

a. A vaccination team shall be composed of at least three (3) trained
personnel composed of one (1) vaccinator, one (1) recorder and one (1)
health counselor.
Vaccination teams shall be organized based on the target number of
schoolchildren to be vaccinated per immunization session and shall apply
the following strategies:
i. The LGUs shall identify available human resources for deployment
based on the calculated number of vaccination teams needed and
identify the gap for possible HR augmentation from stakeholders/
partners in order to reach the target.
ii. Schedule vaccination sessions and deployment of vaccination teams
giving priority to schools with a high number of eligible children
that are close in their respective area of jurisdiction, and/ or areas
with cases of measles-rubella. The number of target eligible
 populations shall be automatically populated in the SBI Recording
Forms.
c. Provided that remaining funds are still available, hiring additional
vaccinators and encoders for this activity may be charged under the
Locally Funded Project (LFP) funds. Appropriate remuneration through
performance-based incentives, and daily subsistence allowance (DSA),
transportation allowance, and other immunization-related activities shall
be provided to the vaccination teams and may be chargeable against Public
Health Management (PHM) funds under DO 2024-0032-B entitled
“Further Amendment to the Department Order No. 2024-0032-A dated
March 13, 2024, and February 7, 2024, entitled, Guidelines on the
Sub-Allotment and Utilization of Funds to Centers for Health Development
and Ministry of Health-Bangsamoro Autonomous Region in Muslim
Mindanao for the Conduct of CY 2024 Bivalent Oral Polio Vaccine
Catch-Up and Supplementation Immunization Activities (OPV SIA).”

6. Orientation and Training

Pre-deployment orientation and capacity—building activities on SBI guidelines
shall be conducted to all primary healthcare workers, vaccination teams,
school personnel, and other stakeholders participating in this activity.
Orientation shall be provided by the Provincial and City Health Offices with
the assistance of the National Immunization Program staff of the CHD.

B. School-Based Immunization (SBI) Roll-Out

1. Conduct of Immunization Sessions

a. Vaccination teams may request support from Barangay Local Government
Units (BLGUs) for the mobilization and transportation of vaccination teams to
the different school vaccination locations as scheduled.
Only students from the school itself can take part in the immunization sessions
held on school premises.
Consenting parents/guardians of Grade 1, Grade 7, and female Grade 4 school
children shall complete and submit the consent forms on/or before the
scheduled SBI immunization session.
School children shall bring their Routine Immunization Cards or Mother and
Child booklets on the day of immunization for confirmation of their
vaccination history.
The vaccinator shall conduct a quick health assessment prior to administration
of MR, Td, and HPV vaccines using the recommended form (4nnex G) to
ensure that the child is well enough to be vaccinated.
Antigens administered during the SBI shall be reflected as a supplemental dose
in the Routine Immunization Card, Mother and Child booklet, or SBI
vaccination card.
If the Routine Immunization Card or Mother and Child Booklet is not
available, an SBI vaccination card shall be provided by the local health center
(Annex H).
Parents and guardians must be reminded to keep the child’s immunization card
for
as it will be used as a means verification of the child’s vaccination status.
2. MR-Td and HPV Immunization Target Population, Schedules, and
Operations
a. Local health center staff shall be in charge of checking the school children’s
vaccination status and consolidating informed consents for SBI.
b. Target school children shall receive the following recommended vaccines:

Table 1. Recommended vaccines for school-based immunization.

i Vaccination ;
Schedule
Vaccine Vaccine Dosage
History
[Grade 1 Students
0.5mL SQ, Right
MR
.
Irrespective One (1) dose upper arm
(posterior triceps)
each dose

0.5mL, IM, Left

One (1) dose
.
Td Irrespective deltoid

Grade 7 Students
0.5mL SQ, Right
Irrespective One (1) dose upper arm
MR
(posterior triceps)
: .

0.5mL, IM, Left

One (1) dose
.
Td Irrespective deltoid
Grade 4 Female Students in selected HPV implementing areas only (Annex I)
0.5ml IM, left
HEV deltoid
Zerg{pdose HPV 2, at least 6
HPV months from 1st om IMlett
deltoid
dose
One (1)
= Sls
from previous year
Vaccination not
: None
: : required
implementation
c. Timing and spacing of MR, Td, or HPV vaccines with other vaccines shall
follow standard immunization rules:
i. Inactivated vaccines such as Td and HPV can be given at any interval
even if another vaccine was previously injected to the child (ie. rabies
toxoid or MR vaccine).
ii. Live, attenuated vaccines such as MR can be administered on the
following conditions:
1. If not given simultaneously/on the same day after another live
attenuated vaccine (e.g., varicella), administer following a 28-day
interval
2. If not given simultaneously/on the same day after an inactivated
vaccine (ie. Td and HPV), administer any time
 iii. Co-administration of vaccines in one session must be done using
separate syringes and different injection sites.
d. All vaccinated students shall be recorded in Recording Forms 1, 2 and 3.

~~
e. In compliance with Healthy Learning Institutions standards, private schools
who wish to participate in school-based immunization shall directly coordinate
with their respective local health centers. Eligible private school children shall
also be recorded in the Recording Forms.
f. End-of-cycle mop-up activities. To achieve maximum immunization
coverage, mop-up activities shall be provided to those students who have not
completed their recommended immunization schedule. The local health center
shall inform the teacher-in-charge or school nurse of available activities. This
catch-up may include the scheduling of an additional vaccine day, the option
for some students to receive catch-up vaccines with their peers in other classes
or accessing the immunization session from the local health center.
i. A mop-up activity may be scheduled for all eligible students who were
initially deferred for MR, Td, or HPV immunization. Parents or
caregivers of eligible students who missed the initial roll-out and
catch-up activity and express willingness to get vaccinated shall be
referred to the nearest implementing local health center. The student
shall be accompanied by their parents and/or caregivers and shall be
instructed to bring their duly accomplished consent form, provided that
there are still available vaccines.
ii. These students shall also be recorded in the Recording Forms.

3. Supply Chain and Logistics Management

a. Vaccine Supply and Inventory Management

i. All MR, Td, and HPV vaccines and ancillaries shall be provided by the
DOH Central Office (CO).
ii. The quantity of the vaccines and supplies to be allocated and provided
to the CHDs shall be based on the consolidated number of enrolled
students per region. Requested quantities will be reviewed and adjusted
based on inventory reports and vaccine requirements at sub-national
levels. Quantification for vaccines and ancillaries shall be done using
the microplan template (https:/tinyurl.com/SBIMicroplanTemplate).
iii. All provinces/cities are required to update inventories of MR, Td and
HPV vaccines received and issued through the electronic logistics
management information system (eLMIS). Such shall be reported
weekly.

b. Vaccine Handling and Storage

i. MR, Td, and HPV vaccines shall be maintained at +2°C to +8°C at all
times during distribution, storage, and immunization sessions.
1. MR vaccines lose their potency by 50% when exposed to over 8°C
within one (1) hour
2. Td vaccines must never be frozen
3. HPV vaccines should be protected from light
ii. Vaccine vials with vaccine vial monitors (VVMs) at discard point shall
properly be disposed of.
 iii. Vaccine vials and diluents must be placed in standard vaccine carriers.
Standard vaccine carriers should have four (4) conditioned ice packs.
Newer vaccine carriers have seven (7) conditioned ice packs.
iv. Pre-filling of syringes of vaccines is NOT allowed.
Any remaining reconstituted MR vaccine doses must be discarded after
six (6) hours or at the end of the immunization session, whichever
comes first. Unused reconstituted vaccine MUST NEVER be returned
to the refrigerator.
Vi. Open vials of Td vaccine follow the multi-dose vial policy (MDVP). As
such, these may be used in subsequent sessions (up to 28 days from
opening) provided the following conditions are met:
Ra
Expiry date has not passed
Vaccines are stored under appropriate cold chain conditions
Vaccine vial septum has not been submerged in water
ll Aseptic technique has been used to withdraw all doses
Vaccine Vial Monitor (VVM) is intact and has not reached the
discard point

vii.
6. Dateis indicated when the vial was opened.
Excess, unopened vaccine vials brought during immunization sessions
shall be marked with a check (Vv) before returning to the refrigerator for
storage. The check mark shall indicate that the vaccine vial was out of
the refrigerator and shall be prioritized for use in the next immunization
sessions.

C. Immunization Safety and Adverse Events Following Immunization (AEFI)

1. Special precautions must be instituted to ensure that blood-borne diseases will
not be transmitted during MR, Td, and HPV immunization. This shall include:
a. Use of the auto-disabled syringe (ADS) in all immunization sessions
b. Proper disposal of used syringes and needles into the safety collector box
and the safety collector boxes with used immunization wastes through the
recommended appropriate final disposal for hazardous wastes
C. Refraining from pre-filling of syringes, re-capping of needles, and use of
aspirating needles, as prohibited
Fear of injections resulting in fainting has been commonly observed in
adolescents during vaccination. Fainting is an immunization anxiety-related
reaction. To reduce its occurrence, it is recommended for vaccination sites to be
situated in areas not readily visible to the students. Further, the vaccinees shall
be:
a. Advised to eat before vaccination and be provided with comfortable room
temperature during the waiting period
b. Seated or lying down while being vaccinated
C. Carefully observed for approximately 15 minutes after administration of the
vaccine and provided with comfortable room temperature during the
observation period
The decision to administer or delay vaccination because of a current or recent
febrile illness depends largely on the severity of the symptoms and their
etiology. Mild upper respiratory infections are not generally contraindications
to vaccination.
4. Adverse events following MR-Td and HPV vaccination are generally
non-serious and of short duration. However:
a. MR vaccine should NOT be given to a child or adolescent who:
i. Has a history of a severe allergic reaction (e.g., anaphylaxis) after a
previous dose of the vaccine or vaccine component (e.g. neomycin)
ii. Has a known severe immunodeficiency (e.g., from hematologic and
solid tumors, receipt of chemotherapy, congenital immunodeficiency,
or long-term immunosuppressive therapy or patients with human
immunodeficiency virus (HIV) infection who are severely
immunocompromised)
iii. Pregnant females
b. Td vaccine should NOT be given to anyone who had a severe allergic
reaction (eg, anaphylaxis) after a previous dose.
c. HPV vaccine should NOT be given to adolescents who:
i. Had a severe allergic reaction after a previous vaccine dose, or to a
component of the vaccine.
ii. Has a history of immediate hypersensitivity to yeast.
iii. Pregnant females. Although the vaccine has not been causally
associated with adverse pregnancy outcomes or adverse events to the
developing fetus, data on vaccination in pregnancy are limited.
5. Vaccine adverse reactions from any of the vaccines can be found in Annex J of
this document. Reporting of AEFI shall follow the existing DOH Guidelines in
Surveillance and Response to Adverse Events Following Immunization using
the form in Department Circular No. 2023-0206 entitled Advisory on the
Implementation and Use of the Revised AEFI Case Investigation Form (CIF)
Version 2023.
6. All vaccination teams and sites shall have at least one (1) complete AEFI kit
with first-line treatment drugs such as epinephrine for allergic reactions and
other items for managing the clinical presentation of AEFIs. These kits shall be
replenished prior to each vaccination run. All vaccination team members shall
be trained to detect, monitor, and provide first aid for AEFI (eg. anaphylaxis)
and other health emergencies following immunization. Prompt referral to the
nearest health facility must be made in such events.

Table 2. Recommended dosage for epinephrine.

Route of Frequency of Dose
Administration Administration

Epinephrine 1:1000, IM Repeat in every 5-15 According to age:

to the midpoint of the min as needed until e 0.05 mL for less than
anterolateral aspect of there is a resolution of 1
yo.
the 3rd of the thigh the anaphylaxis e 0.15 mL for 2-6 y.o.
immediately e 0.3 mL for 6-12 y.o.
Note: Persisting or eo 0.5 mL for older
worsening cough than 12 y.o.
associated with
pulmonary edema is an
important sign of
epinephrine overdose
and toxicity
 7. The DOH-retained and other government hospitals shall not charge the patient
treated for serious AEFI with any fee. In areas where there are no existing or
accessible government hospitals/health facilities, serious AEFI cases shall be
managed in private institutions and assistance shall be provided by the LGU
with support from the DOH in accordance with Administrative Order
2023-0007 entitled Revised Omnibus Guidelines on the Surveillance and
Management of Adverse Events Following Immunization (AEFI).
D. Data Management and Monitoring

1. Recording and Reporting

a. The vaccination teams shall utilize the SBI Recording Forms as masterlists
of Grade 1, Grade 7, and female Grade 4 school children.
b. The total number of children vaccinated per immunization session shall be
recorded using the Summary Reporting Form (Annex E) and shall be
uploaded in the vaccination dashboard developed by KMITS. Submitted
reports shall be analyzed by the DPCB National Immunization Program and
submitted to the Public Health Services Cluster (PHSC) as regular updates.
The summary reporting form may be accessed via the link:
https://tinyurl.com/SBIReporting.
c. The procedure for submission of reports should adhere to the guidelines
provided in Annex F.
2 Monitoring
The Disease Prevention and Control Bureau (DPCB) together with the HPB,
EB, KMITS, SCMS and other DOH Bureaus and Offices shall convene weekly
meetings with the CHDs and MOH-BARMM every Wednesdays at 10:00 AM
until the end of the SBI roll-out period to provide regular updates, review plans
and recalibrate strategies, as needed.

IV. ROLES AND RESPONSIBILITIES

A. The Disease Prevention and Control Bureau (DPCB) shall:
1. Provide technical assistance and capacity building on the conduct of
school-based MR-Td-HPV vaccination, in collaboration with professional and
civil societies;
Coordinate with the Supply Chain Management Service (SCMS) to
ensure the
availability of vaccines down to the Local Government Unit (LGU) level
throughout the implementation of the conduct of school-based MR-Td-HPV
vaccination;
Coordinate with the Health Promotion Bureau with regard to increasing the
awareness on the conduct of school-based MR-Td-HPV vaccination; and
Monitor and evaluate the implementation of school-based MR-Td-HPV
vaccination services and outcome indicators.
. The Health Promotion Bureau (HPB) shall:
1. Develop social and behavior change (SBC) strategies for vaccine-preventable
diseases and school based immunization (SBI);
2. Cascade SBC plan and Communication Packages to the Centers for Health
Development (CHDs) and Ministry of Health - Bangsamoro Autonomous
Region in Muslim Mindanao (BARMM), partners, and stakeholders for
localization and dissemination;
3. Collect data on behavioral determinants of target parents and guardians for
school-based immunization;
4. Support the DepEd in monitoring the accomplishment of indicators and
standards related to vaccination in the implementation of the Oplan Kalusugan
sa DepEd-Healthy Learning Institutions (OKD-HLI) program, and propose
recommendations as appropriate; and
5. Evaluate effectiveness of SBC strategies in promoting the conduct of
school-based immunization services to guide evidence-based research and
policy making.

. The Epidemiology Bureau (EB) shall enforce the implementation of the existing
DOH Guidelines:

1. Administrative Order No. 2016-2006 entitled “Adverse Events Following

Immunization (AEFI) surveillance and response;” and
2. Administrative Order No. 2016-0025 entitled, guidelines on the Referral
System for Adverse Events.

. The Supply Chain Management Service (SCMS) shall be responsible for the
distribution and monitoring of vaccines.

. The Communication Office (COM) shall conduct media-facing activities to

increase awareness and participation for SBI.

. The Centers for Health Development (CHDs) and Ministry of

Health-Bangsamoro Autonomous Region in Muslim Mindanao
(MOH-BARMM) shall perform the following:
1. The National Immunization Program (NIP) shall:
a. Conduct orientation for concerned stakeholders regarding the policy and
promote its adoption and implementation;
b. Provide technical assistance and capacity building to LGUs and other
partners on the conduct of MR-Td and HPV school-based immunization;
c. Conduct planning with the Provincial and HUCs, DepEd, and DILG
counterparts in the implementation of the SBI;
d. Submit and analyze submitted weekly accomplishment reports by the
Local Government Units through the reporting tool indicated in Section
D.1.b;
e. Evaluate and monitor the implementation of the policy by both public and
private sectors in their respective regions; and
f. Support the LGUs in the reproduction of recording and reporting forms,
notification letter and consent forms, quick health assessment forms,
immunization cards, among others. as needed.

10
 2. The Health Education and Promotion Units (HEPUs) shall:

a. Conduct demand generation planning with the LGUs, DepEd, and DILG
counterparts in the implementation of the SBI;
b. Implement social and behavior change (SBC) strategies for
vaccine-preventable diseases and school based immunization (SBI):
i. Advocate for school administrators and teachers to become
champions of school-based immunization;
ii. Assist schools in educating, getting the consent of, and mobilizing
parents to participate in school-based immunization;
iii. Develop and reproduce communication packages and materials to
drive demand and support participation in school-based
immunization;
iv. Harmonize other stakeholders such as the private sector,
non-government or civil society organizations, development
partners and religious sector to solicit support for immunization
program;
c. Ensure intensification of health promotions regarding SBI together with
routine immunization services within their area of influence; and
d. Support LGUs in the reproduction of materials, as needed.

3. The Regional Epidemiology Surveillance Units (RESUs) shall monitor

reports of AEFI and conduct vaccine safety surveillance and conduct
investigations to reported cases of serious AEFI.

The Cold Chain Managers and/or the Supply Chain Units shall ensure
proper cold chain management at all levels and facilitate allocation and
distribution of vaccines to LGUs and monitor stock inventory for immediate
replenishment, as needed.

The Communication Management Units (CMUs) shall develop crisis

communication plans for AEFI and issue press releases and engage media to
cover the SBI activities.
G. The Department of Education (DepEd) shall:
1. Disseminate the policy to all School Division Offices (SDOs) for coordination
and planning with their respective counterpart LGUs;
2, Disseminate consent forms upon enrollment or at least two (2) weeks prior to
actual implementation;
Conduct health education and promotion activities to parents and students to
advocate for immunization in collaboration with the local health center,;
Provide the needed Master List of Learners (Grade 1, Grade 7, and Female
Grade 4) for the year of implementation to their respective counterpart LGUs
at least one (1) month prior to the actual SBI rollout; and
Inform DepEd personnel in SDOs that they may participate voluntarily in the
conduct of fixed-site approach school-based immunization. In this regard, the
school nurses may:
a. Screen immunization records of students for a missed dose, series of
doses, or all vaccines due to the learners;
b. Administer vaccines to eligible students within the school premises;
c. Provide follow-up care and additional vaccinations if required; and

11
 d. Perform the recording, data collection and validation of the number of

vb
immunized target populations during the implementation period.

H.\g. The Local Government Units (LGUs) shall:

Tor, Conduct school-based MR-Td and HPV vaccination within their area of
influence in accordance to the guidelines set by DOH;
2. Provide localized support or counterpart (i.e. resources, collaterals, others) for
the implementation of the policy;
3. Allot funds for reproduction of SBI IEC materials and all other relevant forms
for the activity;
Develop strategies for conduct of school-based MR-Td-HPV vaccination
specific to their area of jurisdiction;
Perform data validation and generate reports regarding accomplishment during
the implementation period;
Conduct regular consultation and implementation reviews among respective
LGU personnel, immunization stakeholders, and other organizational partners
to improve service delivery efficiency and address implementation
issues/gaps; and
Submit timely reports to the DOH and DILG for monitoring and tracking of
progress of implementation.

1.6 The Local Health Centers shall:

o{*, Conduct social and behavior change strategies to support school-based
immunization;
2, Deploy trained healthcare workers to conduct immunization sessions;
3: Ensure the availability and proper storage and handling of vaccines and related
supplies;
Screen the immunization records of students for a missed dose, series of doses,
or all vaccines due to the learners;
Administer vaccines to eligible students within the school premises;
Sd
Provide follow-up care and additional vaccinations if required; and
Perform the recording, data collection and validation of the number of
immunized target populations during the implementation period.

Jw Professional medical and allied medical associations, academic institutions,

non-government organizations, development partners and the private sector
§® shall be enjoined to support the implementation of the catch-up immunization
guidelines and disseminate it to the areas of their influence.

For dissemination and strict compliance.

By Authority of the Secretary of Health:

VATEEVETaeaT0
N

GLENN Via, MSN, FPSMS, FPCHA

Undersecretary of Health
Public Health Services Cluster

12
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Annex A: Notification Letter and Consent Form Template

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NOTIFICATION LETTER

DATE:

DIVISION:
SCHOOL:
ADDRESS:

Dear Parent Guardian:

This school 2s a Public Elementary Secondary School will provide School-Based Immunization (SBI) of Measles-Rubella (MR)
and Tetanus—Diphtheria (Td) vaccines to Grade 1 and Grade 7 students in coordination with the Department of Health (DOH) and the Local

Government Unit (LGU).

This Notification is being issued to vou as information of the activity that will be conducted for SY 2024 — 2025. Should vou have
further questions clarifications on this matter, please get in touch with the Principal School Head.

Thank vou very much.

Very truly vours,

Name of School Head Principal

ACKNOWLEDGEMENT AND CONSENT

I have read and understood the information regarding the intended immunization services to be given to mychild.

Name of the Child Date of Birth (mm/dd/y¥yy)

Surname: First Name: Middle Name:

Contact Information Age Sex

Contact Number: School:

PRE-VACCINATION CHECKLIST (FOR PARENT/GUARDIAN TO COMPLETE)

Your consent is required before your child can be immunized ar school. Reguest clearance from your physician if any of the following
applies (kindly check (v) if any condition applies to your child):
[J My child had a history of severe allergy to measles-contaming or Td vaccines.
a My

[0
child has a severe illness:
Primary immune — deficiency disease
[J Suppressed immune response from medications
[J Leukemia
[J Lymphoma
[J Other generalized malignancies
[J None, mv child is
relatively healthy.

CONSENT FOR DNMUNIZATION

(Please check in the box provided)

a Yes, I

[J
will allow my child to be provided the immunization services as per DOH reccmmendation.
Grade 1
MR. Ta)
7
[O Grade (MR. Td)

[J No. Iwill not allow my child to receive the immunization service because

I understand that by opting out of the required immunizations, my child may be at a higher risk of contracting vaccme-preventable diseases. By
signing this waiver, I acknowledge that I have read and vaderstood the information provided above. I voluntarily choose to exempt my child from
the required school immunizations

Name and Signature of Parent Guardian

13
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1

= Rehivon
.

NOTIFICATION LETTER

DATE:

DIVISION:
SCHOOL:
ADDRESS:

Dear Parent Guardian:

This school as a Public Elementary Secondary School will provide School-Based Immunization (SBI) of Human Papillomavirus
(HPV) Vaccine to Grade 4 Female students in coordination with the Department of Eealth (DOH) and the Local Government Unit (LGU).

This Notification is being issued to vou as information of the activity that will be conducted for SY 2024 — 2023. Should you have
further questions clarifications on this matter, please get in touch with the Principal School Head.

Thank vou very much.

Verytruly vours,

Name of School Head Principal

ACKNOWLEDGEMENT AND CONSENT

I have read and understood the information regarding the intended immunization services to be given to my child.

Name of the Child Date of Birth (mm/dd/yyyy)

Surname: First Name: Middle Name:

Contact Information Age Sex

Contact Number: School:

PRE-VACCINATION CHECKLIST (FOR PARENT/GUARDIAN TO COMPLETE)

Your consent is required before your child can be immu d at school Request clearance from your physician if any of the foliowing
appiies (kindly check (\) if any condition appiies to your ci
[J My child had a history of severe allergy to human papillomavirus (EPV) vaccme.
O My child has a severe illness:
[J Primary immune — deficiency disease
[J Suppressed immune response from medications
O Leukemia
[J Lymphoma
[0 Other generalized malignancies
[J None, my child relatively healthy.
is

CONSENT FOR IMMUNIZATION

(Please check in the box provided)

a Yes, Iwill allow my child to be provided the immunization services as per DOH recommendatien

a Grade 1
(MR, Td)

a Grade 7
(MR, Td)

0 Ne, I will aot allow my child to recerve the immunization service because

I understand that by opting out of the required immunizations, my child may be

at a higher risk of contracting vaccine-preventable diseases. By
signing this waiver, I acknowledge that I have read and understood the information provided above. voluntarily choose to exempt my child
I from

the required school immunizations.

Name and Signature of Parent Guardian

14
by
00
Annex B: Recording Form 1 — Masterlist of Grade 1 Students

SCHOOL-BASED IMMUNIZATION
Recording Form 1: Masterlist of Grade 1 Students

Region: Name of Schoo: Section: MPR: Td:

Numbss of vecc ine Received (in vials): Number of veccine Recewed (in vials);
Berangay: District/Municipality: Number of vaccine Used (in vialsy:, Number of Vaccine Usad (n vials);
Number of veocine Unuszd (in vials): Number of veccine Unusad (in vials):
Ciy/Provinge: Date:

i al
To be filled out Local Health Center / Vaccination Team Tobe filled out Vaccination Tsam
Date of MCV
ory sip Sick today?

oe
Complete Address Age sex Received Pamper
(Sumame, First Name, MI)
Mcvi[meval v N Y N MR1 |insc) po LetEme) pg

Name & Signature of Supervisor Name & Signature of Vaccinator 1 Name & Signature of Vaccinator 2 Name & Signature of Recorder

REASONS FOR BEING UNVACCINATED

(Select all that apply for the HH)
Code Reasons
1 Parent was absent/ away from home Code Reasons
2 Fear of vaccine Side effect 10 Lack of trust in the vaccinator
3 Vaccine safety issues (dengue vaccine experience, past adverse experience, etc.) 11 Child just recovered from illness or just dischaged from the
4 Child already has complete routine vaccination, extra vaccine dose not necessary, hospital, the parent/ caregiver refused:
so parents refused 12 Unaware of the campaign
5 Fear of COVID transmission 13 Vaccine team did not visit
6 Vaccine perceived to be not effective, of low-quality or on near-expiry 14 Child was a from a different area
7 Clientis a newborn and parents believed that her/his child is too young to be 15 Child was acutely sick or not feeling well
given vaccination 16 Do not know/ declined to respond
8 Child was already vaccinated by private MO, against advised by private MDs, thus 17 Outright refusal
parents/ caregiver refused 18 Other (specify):
9 Peculiar personal beliefs or misconceptions of the parents or caregiver on
vaccination; Against religious beliefs

15
by
Annex C: Recording Form 2 — Masterlist of Grade 7 Students

SCHOOL-BASED IMMUNIZATION
Recording Form 2: Masterlist of Grade 7 Students

Ragicn: Name of School: Saction:

MR: Td:
Barangay: Distrct/Municipality: Number of veccne Recewvad (in vas); Number of vaccine Recsivad (in vias):
Number ef vaccine Usediin vias): Number of vaccine Usediin vias;
City/Provinga: Date: Number of vecc ne Unusadin vais): Humbar of vaccine Linussdin vals):

To be filled out Loca! Health Center / Vaccination Tsam To be fillsa our Vaccination Tsam
Date of MCV Sick today?
Consent Slip
o 2
: Vaccine Given
R lame Received History of
(Sumame, First Name, MI)
CORDMAS RIESE Sex
Allergies
Deferral Refusal Reasons
MCV 1|MCV Y N Y N MR1 |oiEes| pgp op Lottie
h Na. h No

Name & Signature of Supervisor Name & Signature of Vaccinator 1 Name & Signature of Vaccinator 2 Name & Signature of Recorder

REASONS FOR BEING UNVACCINATED

(Select all that apply for the HH)
Code Reasons
1 Parent was absent/ away from home Code Reasons
2 Fear of vaccine Side effect 10 Lack of trust in the vaccinator
3 Vaccine safety issues (dengue vaccine experience, past adverse experience, etc.) 11 Child just recovered frem illness or just dischaged from the
4 Child already has complete routine vaccination, extra vaccine dose not necessary, hospital, the parent/ caregiver refused:
so parents refused 12 Unaware of the campaign
Ss Fear of COVID transmission 13 Vaccine team did not visit
6 Vaccine perceived to be not effective, of low-quality or on near-expiry 14 Child was a from a different area
7 Clientis a newborn and parents believed that her/his child is too young to be 15 Child was acutely sick or not feeling well
16 Do not know/ declined to respond
given vaccination
8 Child was already vaccinated by private MO, against advised by private MDs, thus 17 Outright refusal
parents/ caregiver refused 18 Other (specify):
9 Peculiar personal beliefs or misconceptions of the parents or caregiver on
vaccination; Against religious beliefs

16
 Annex D: Recording Form 3 — Masterlist of Grade 4 Female Students

SCHOOL-BASED IMMUNIZATION
Recording Form 3: Masterlist of Grade 4 Female Students

Regon: Name of School: Section:

HBV:

Barangay: District/Municipal ty: Number of Vaccine Received (in vials):

Number of vaccine Used|in vials):
City/Previncs: Date: Number of Vaccine Unussdin vials):

To Gs filled our by Local Hisalth Center / Vaccination Tsam To Gs filled cur by vaccination Team
Date of HPV Sick today?
" ame i
Received
Consent Sip yrictory of
Complete Address Deferral Refusal Reasons
(Sumame, First Name, MI) Allergies
HPV 1| HPV 2 Y N Y N

Name & Signature of Supervisor Name & Signature of Yaccinator 1 Name & Signature of Yaccinatar 2 Name & Signature of Recorder

REASONS FOR BEING UNVACCINATED

(Select all that apply for the HH)
Code Reasons
1 Parent was absent/ away from home Code Reasons
2 Fear of vaccine Side effect 10 Lack of trust in the vaccinator
3 Vaccine safety issues {dengue vaccine experience, past adverse experience, etc.) 11 Child just recovered from illness or just dischaged from the
4 Child already has complete routine vaccination, extra vaccine dose not necessary, hospital, the parent/ caregiver refused:
s0 parents refused 12 Unaware of the campaign
5 Fear of COVID transmission 13 Vaccine team did not visit
6
7
Vaccine percewed to be not effective, of low-quality or on near-expiry
Client is a newborn and parents believed that her/his child is too young to be
14
15
Child was
a
from a different area
Child was acutely sick or not feeling well
given vaccination 16 Do not know/ declined to respond
B Child was already vaccinated by private MD, against advised by private MDs, thus 17 Ournight refusal
parents/ caregiver refused 18 Other (specify):
9 Peculiar personal beliefs or misconceptions of the parents or caregiver on
vaccination; Against religious beliefs

17
~~
Annex E: Summary Reporting Form

School-Based Immunization
DAILY SUMMARY REPORTING Form: RHU Consolidated Accomplishment Form Report

Region:

Province/City: — [
|
Grade 1
Municipad City:

Grade 4 Female Grade 7

Owe:
—en
|
| 1

—Ta
|
Students Students
i

No. wd Students Students

|
vaccmeted wi vaccmated wi Totat mo. of deterred Tots no. of refusal Searste shuiunke of deterred of refusal

— TT
Total no. Total ne. vacematea w/ vaccinated wi Total no. of deterred Tota no, of refusal
MR va

—
“A

fey
Schools |Yotatno. off Td

—
Name of Total no. of
|
students
enrated
: —] ote 00. students 1
1a in enrolea
|
2nd 2nd 1st 2nd
|
{
|

a
| |

| No. “% No. % MR “ |
Ta “ MR “ Td
|
dose “ dose LJ dose to dose |
% dose ~ dose | Na. ta No. “% MR * Ta “a MR |
4%
{
of HPV of HPV Sf HPV] of HPV. of HPV of HPV]

ee
{
|

| ee S— — 5
fe
- - 4
+ 4
- +
i
{

t
+
{ 1
- - { {
- i 1. me | ad
1 |

=
|

1 ed ee]
{ |

4 |
|
|
| | |

tees

—4
:
+ L
T
!
T

} !
4
+ + 4 4
4 4 4 4

head.
1

+ -
DY at mens 4 -.
— - Co. |—— + lice —t

1
| |
|
F
|
T

— at 1
|

er
|
|

Total
{

|
T + +

1
|

i- +

te 1

+ |
= —

Grade 1: Grade 7: Grade 4 Female:

MR: MR: HPV:
Number of Vaccine Received (in vials). Number of Vaccine Received (in vials). Number of Vaccine Received (in vials):
Number of Vaccine Used(in vials). ______ Number of Vaccine Used(in vials): Number of Vaccine Used(in vials):
Number of Vaccine Unused(in vials): Number of Vaccine Unused(in vials): Number of Vaccine Unused(in vials):

Td: Td:
Number of Vaccine Received (in vials). Number of Vaccine Received (in vials).
Number of Vaccine Used(in vials). Number of Vaccine Used(in vials).
Number of Vaccine Unused(in vials). Number of Vaccine Unused(in vials).

18
 Annex F: Flow and Submission of Reports

To be
Responsible Schedule of
g

Levels of :
Type of report Submitted
Implementation Person
0
Report

Recording Form 1:
Masterlist of Grade 1

Students

Recording Form 2: Local Health

School Masterlist of Grade 4 Center/ Vaccination RHU Daily
Students Team

Recording Form 3:
Masterlist of Grade 4
Students
Consolidated
RHU accomplishment report by |RHU Midwife PHO/CHO Weekly
Schools per Municipalities

PHO/CHO Analysis report of Provincial/City NIP RHO Weekly

municipalities Coordinator
Regional NIP CO-NIP
Bulletin report of prov/city Weekly
. .
RHO
Coordinator
CoO Bulletin report of CHDs DPCB NIP PHSCU Weekly

19
 Annex G: Quick Health Assessment Form

QUICK HEALTH ASSESSMENT FOR SCHOOL-BASED INDMUNIZATION

(MR, Td, and HPV Vaccination)

Name of the Child Date of Birth (mm/dd/vyyy)

Sumame: First Name: Middle Name:

Contact Information Age Sex

Contact Number: Name of Barangay (School): | -
School:

QUICK HEALTH ASSESSMENT

Mark all appropriate spaces/boxes with a check (N)

Questions Yes No Decision Remarks

If Yes.
DEFER
vaccination;
refer for
1. Does the child have fever medical
Temp:
{(=37.6°C)7 management;
and zeta
define date
for the
yaccination
If pregnant or
suspected to
2. Date of last menstruation, be,
if applicable: DO NOT
GIVE
AMREPV
Vaccine
Note:
o Malnutrition, low-grade fover, mild respiratory infections, diarrhea and other minor illnesses should
not be considered as contraindications.

Immunization Card Mother Baby Book available?

Assessed by:
] Yes
[] No

Sienature over printed name of the health worker/screener

Date (mm dd vvvv):

20
Annex H: School-Based Immunization Card Template

+ festing
J
Vaccination Card for Magpabakuina
sara sa Healthy Rlipnac

School-age Children
Child’s name:

Date of birth:

(Vaccination given)
Vaccine Type
.

(Measles-Rubella)

TD
(Tetanus-Diphtheria)

HPV*
(Human Papilloma Virus)

For applicable areas only

Keep this card for future reference
*

21
 Annex I: List of Provinces/Cities Implementing HPV Vaccination
CAR Region IV-B Region X
Apayao Puerto Princesa City Camiguin
De BE
Ifugao Marinduque ih Bukidnon
Abra 0 Occidental Mindoro Cagayan de Oro
hi) Baguio City dhs Oriental Mindoro Bs Iligan City
Benguet Lh Palawan Lanao del Norte
Kalinga Oy Romblon SOU
Misamis Occidental
IO
Mt. Province Misamis Oriental
Region V
Region I Masbate Region XI
Pangasinan 9 Camarines Sur =
Davao Oriental
Ilocos Norte Legazpi City Davao City
AWN

Ilocos Sur Ligao City BW

Davao del Norte
iB
La Union Tabaco City Davao Occidental
Alaminos City Syth
Davao del Sur
Candon City Region VI Davao De Oro
Dagupan City i= Iloilo
i
VHNAU

Laoag City Iloilo City Region XII

. San Carlos City 00:
Negros Occidental ee North Cotabato
10. San Fernando City Bacolod City 19 Sarangani
11. Urdaneta City (Iv
Antique General Santos City
12. Vigan City Aklan hs: South Cotabato
QOySLION

Capiz Sultan Kudarat

Region IT Guimaras
1. Batanes Region XIII
. Cagayan Region VII Agusan del Norte
Bre

. Isabela . Cebu Agusan Del Sur

2 Surigao Del Sur
nNnhWN

. Nueva Vizcaya EWN

Cebu City
. Quirino Bohol cb Surigao Del Norte
. Santiago City Dumaguete City On Butuan City
. Ilagan City Negros Oriental
BARMM
Vo

. Cauayan City Lapu-Lapu City

. Tuguegarao City
VRNAN

Mandaue City = Lanao del Sur

Siquijor (Bo
Maguindanao Del Sur
Region III Tagbilaran City bso
Maguindanao Del Norte
1. Pampanga Sulu
Zambales Region VIII Du Tawi-Tawi
WN

Angeles City Eastern Samar

Cabanatuan City BLD
Northern Leyte NCR
Gapan City Northern Samar = Caloocan City
Mabalacat City Ormoc City Mandaluyong
Marikina City
VENUE

Palayan City Guth

Tacloban City LEAD

Muiioz City Borongan City Pasay City

Nueva Ecija
.
(IN
Quezon City
10. Olongapo City Region IX RON
Taguig City
11. San Jose City 1. Zamboanga del Sur Valenzuela City
12. San Fernando City 2. Pagadian City NOT00)
Las Pinas City
3. Zamboanga City Makati City
Region IV-A Malabon City
1. Quezon Manila City
2. Batangas Muntinlupa City
3. Cavite . Navotas City
4. Laguna Paranaque City
5. Rizal Pasig City
6. Antipolo City Pateros
7. Lucena City San Juan City

22
 Annex J: List of Immediately Notifiable AEFIs
(AO 2023-0007: Revised Omnibus Guidelines on the Surveillance and Management of
Adverse Events Following Immunization)
Adverse event Case definition Vaccine
Acute flaccid paralysis Acute onset of flaccid paralysis within 4 to 30 days OPV
(Vaccine associated paralytic of receipt of oral poliovirus vaccine (OPV), or
poliomyelitis) within 4 to 75 days after contact with a vaccine
recipient and neurological deficits remaining 60
days after onset, or death.

Notifiable if the onset is within 3 months after

immunization
Anaphylactoid reaction (acute Exaggerated acute allergic reaction, occurring within All
hypersensitivity reaction) 2 hours after immunization, characterized by one or
more of the following:
eo Wheezing and shortness of breath due to
bronchospasm
e One or more skin manifestations, e.g. hives,
facial oedema, or generalized oedema. Less
severe allergic reactions do not need to be
reported.
e Laryngospasm/laryngeal oedema

Notifiable if the onset is within 24 to 48 hours after

immunization
Anaphylaxis Severe immediate (within 1 hour) allergic reaction All
leading to circulatory failure with or without
bronchospasm and/or laryngospasm/laryngeal
oedema.

Notifiable if the onset is within 24 to 48 hours after

immunization
Arthralgia Joint pain usually including the small peripheral Rubella, MMR
joints. Persistent if lasting longer than 10 days,
transient: if lasting up to 10 days

Notifiable if the onset is within 1 month after

immunization
Brachial neuritis Dysfunction of nerves supplying the arm/shoulder Tetanus
without other involvement of the nervous system. A
deep steady, often severe aching pain in the shoulder
and upper arm followed in days or weakness by
weakness and wasting in arm/shoulder muscles.
Sensory loss may be present, but is
less prominent.
May present on the same or the opposite side to the
injection and sometimes affects both arms.

Notifiable if the onset is within 3 months after

immunization
Disseminated BCG infections Widespread infection occurring within 1 to 12 BCG
months after BCG vaccination and confirmed by
isolation of Mycobacterium bovis BCG strain.
Usually in immunocompromised individuals.
Encephalopathy Acute onset of major illness characterized by any Measles- containing,
two of the following three conditions: seizures, Pertussis- containing
severe alteration in level of consciousness lasting for

23
 one day or more distinct change in behavior lasting
one day or more. Needs to occur within 48 hours of
DTP vaccine or from 7 to 12 days after measles or
MMR vaccine, to be related to immunization.
Hypotonic, hyporesponsive Event of sudden onset occurring within 48 [usually Mainly DTP, rarely
episode (HHE or less than 12] hours of vaccination and lasting from others
shock-collapse) one minute to several hours, in children younger
than 10 years of age. All of the following must be
present:
eo
Limpness (hypotonic)
e Reduced responsiveness (hyporesponsive)
e Pallor or cyanosis — or failure to observe/
recall
Injection site abscess Fluctuant or draining fluid filled lesion at the site of All
injection. Bacterial if evidence of infection (e.g.
purulent, inflammatory signs, fever, culture), sterile
abscess if not.

Notifiable if the onset is within 7 days after

immunization
Lymphadenitis (includes Either at least one lymph node enlarged to >1.0 cm BCG
simple and suppurative in size (one adult finger width) or a draining sinus
lymphadenitis) over a lymph node. Almost exclusively caused by
BCG and then occurring within 2 to 6 months after
receipt of BCG vaccine, on the same side as
inoculation (mostly axillary). May develop as early
as two weeks after vaccination, most cases appear
within six months, and almost all cases occur within
24 months.
Osteitis/ Osteomyelitis Inflammation of the bone with isolation of BCG
(Mycobacterium bovis BCG strain.

Notifiable if the onset is between 1 and 12 months

after immunization
Persistent inconsolable Inconsolable continuous crying lasting 3 hours or DTP, Pertussis
screaming longer accompanied by high-pitched screaming.

Notifiable if the onset is within 24 to 48 hours after

immunization
Seizures Occurrence of generalized convulsions that are not All, especially DTP,
accompanied by focal neurological signs or MMR Measles
symptoms. Febrile seizures: if temperature elevated
>38°C (rectal) Afebrile seizures: if temperature
normal

Notifiable if the onset is within 14 days after

immunization
Sepsis Acute onset of severe generalized illness due to All
bacterial infection and confirmed (if possible) by
positive blood culture. Needs to be reported as a
possible indicator of program error.

Notifiable if the onset is within 7 days after

immunization
Severe local reaction Redness and/or swelling centered at the site of All
injection and one or more of the following:
eo Swelling beyond the nearest joint

24
 e Pain, redness, and swelling of more than 3
days duration
e Requires hospitalization.

Notifiable if the onset is within 7 days after

immunization.
Local reactions of lesser intensity occur
commonly and are trivial and do not need to be
reported.
Thrombocytopenia Serum platelet count of less than 150,000/ml leading MMR
to bruising and/or bleeding

Notifiable if the onset is within 3 months after

immunization
Toxic shock syndrome (TSS) Abrupt onset of fever, vomiting and watery diarrhea All
within a few hours of immunization. Often leading
to death within 24 to 48 hours. Needs be reportedto
as a possible indicator of program error.

Notifiable if the onset is within 24 to 48 hours after

immunization

*Brighton collaboration has developed case definitions for many

vaccines reactions
2014
and
is available at: www.brighton collaboration.org.

Reference: Manual of Procedures for Surveillance and Response to AEFI,

25