What is the recommended immunization schedule in the Philippines?

Immunization Schedule in the Philippines

Core Vaccination Schedule

The Philippines follows a national immunization schedule that includes hepatitis B vaccine at birth, followed by multiple vaccines at 6 weeks, 10 weeks, and 14 weeks of age, with additional doses and boosters through childhood and adolescence. 1, 2

Birth to 6 Months

At Birth

• Hepatitis B vaccine (HepB) should be administered within 24 hours of birth to prevent vertical transmission from infected mothers, which is critical for achieving up to 95% prevention of perinatally acquired infections 1
• BCG vaccine is typically given at birth in the Philippines national program 2

At 6 Weeks

• First dose of pentavalent vaccine (DTP-Hepatitis B-Hib) 3
• First dose of oral polio vaccine (OPV) 2
• First dose of pneumococcal conjugate vaccine (PCV) 2

At 10 Weeks

• Second dose of pentavalent vaccine 3
• Second dose of OPV 2
• Second dose of PCV 2

At 14 Weeks

• Third dose of pentavalent vaccine 3
• Third dose of OPV 2
• Third dose of PCV 2
• Inactivated poliovirus vaccine (IPV) was introduced at the 14-week visit, creating a three-injection visit 4

9-12 Months

• First dose of measles-containing vaccine (MCV1) is administered at 9 months of age 3

Second Year of Life (12-24 Months)

• Second dose of measles-containing vaccine (MCV2) is given in the second year of life, typically around 12-15 months, establishing the 2YL platform 3
• The 2YL platform serves as a critical catch-up opportunity - among children eligible for catch-up pentavalent vaccination at MCV visits in the Philippines, 38% received catch-up doses 3

Key Implementation Challenges

Timeliness Issues

• Only 10% of infants followed the complete national schedule as intended, with timeliness declining with successive doses: 71% for HepB1, 47% for HepB2, and 26% for HepB3 1
• The proportion completing the full hepatitis B series was 77%, but timing was frequently delayed 1

Simultaneous Administration

• Only 26% received HepB2 simultaneously with DTP1, and 34% received HepB3 simultaneously with DTP3 1
• If simultaneous administration were consistently implemented, 10% more infants could receive all hepatitis B doses 1
• Post-IPV introduction, 84% of children received all three recommended injections at the 14-week visit, though this varied by region (61-100%) 4

Critical Barriers to Coverage

Supply and Access

• Availability of routine vaccines and accessibility to vaccination sites remain major barriers in the Philippines 2
• Coverage under the National Immunization Program is well below the 95% target, with high numbers of zero-dose children 2

Vaccine Hesitancy

• Acceptability continues to be affected by previous controversies around the Dengue vaccine and the COVID-19 pandemic 2
• Perception of negative side effects and benefits of vaccines are clear drivers of vaccination decisions at the intrapersonal level 2

Social Drivers

• Influence of family members, barangay (community) health workers, and community leaders significantly affects vaccine uptake 2

Practical Recommendations for Providers

Maximize Catch-Up Opportunities

• Use every healthcare visit, especially MCV visits in the second year of life, to assess and provide catch-up vaccination for missed doses 3
• Review vaccination cards at each visit to identify immunity gaps 3

Prioritize Simultaneous Administration

• Administer all eligible vaccines at the same visit to improve coverage and reduce dropout rates 1
• Healthcare providers should be reassured that administering three injections at one visit is both safe and acceptable - 87% of providers who administered three or more injectable vaccines reported being comfortable with this practice 4

Address Vaccine Hesitancy

• Provide clear communication about vaccine benefits and address concerns about side effects through trained healthcare workers 2
• Leverage the influence of barangay health workers and community leaders to promote vaccination 2

Common Pitfalls to Avoid

• Do not delay the birth dose of hepatitis B vaccine beyond 24 hours - this significantly reduces effectiveness in preventing vertical transmission 5
• Do not miss opportunities for simultaneous vaccination - this is the single most modifiable factor to improve coverage 1
• Do not defer catch-up vaccination - the 2YL platform provides a critical second chance to close immunity gaps 3
• Do not assume card unavailability means vaccination cannot proceed - use available documentation and caregiver recall to guide catch-up strategies 3