Immunizations Donna Hills APN EdD Ball & Bindler.
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Transcript of Immunizations Donna Hills APN EdD Ball & Bindler.
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Immunizations
Donna Hills APN EdD Ball & Bindler
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National Goals• Reducing number of preventable
diseases is a major national goal in Healthy People 2010
• Eliminate: rubella, cong. rubella synd., diptheria, Haemophilus influenza b, measles, mumps, polio and tetanus.
• Reduce: pertussis, hepatitis b, varicella, food-borne pathogens, and HIV infection.
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Purpose of a Vaccine• to stimulate active immunity by
provoking a response from the person’s immune system
• requires B cells (and T cells) to spring into action
• create a memory within the immune system
• exposure to active disease will stimulate a specific immune response
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Vulnerability of Newborns and Infants
• Immune systems not fully mature• Passive acquired immunity from
maternal antibodies provides limited and short-term protection
• Disease protection thru immuniz is incomplete.
• Poor hygiene behaviors in young children.
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Characteristics of a Vaccine
• inactivated (killed) antigen: Flu shot, Hep. A
• live attenuated (weakened) antigen: MMR, Varicella
• synthetic (laboratory synthesized) microbial materials:Toxoids DTaP
• conjugate vaccines use outer- coats of the bacteria: Hib, PCV
• recombinant vaccines use the virus genetic material: Hep B
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Side Effects: Vaccine specific.
• low grade fever• soreness at site• body aches x 24 hrs• minor side effects are preferable to
the disease.• (U.S. Department of Health and
Human Services: NIH, 1998).
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True Contraindications to all Vaccines
• Serious allergic reaction, ie.anaphylaxis after a previous vaccine dose
• Serious allergic reaction, ie. anaphylaxis to a vaccine component
• Moderate to severe illness
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Specific Contraindications for Individual Vaccines• IPV: severe allergic reaction to neomycin,
streptomycin or polymyxin B.• DTaP: seizure, encephalopathy, fever
>105o with previous DTaP• Varicella & MMR: severe allergic reaction
to gelatin, neomycin, pregnant women, immunosuppressed individuals, treated with steroids for >2wks., have cancer or under going cancer treatment.
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• HIB: children less than 6 wks of age.
• Hep.B: severe allergic reaction to Baker;s yeast (used in bread).
Specific Contraindications (cont.)
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• High fever• Behavior changes• Seizures• Allergic reaction:diffic. Breathing,
weakness, hoarseness, wheezing, rapid heart rate, hives, dizziness, paleness, or mucus membrane swelling.
• Reported by parent and/or provider using a Vaers form from the CDC.
Adverse Reactions
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Misconceptions about Vaccines
• Diseases disappeared before vaccines were introduced
• Most people who get sick have been vaccinated
• Many vaccines cause serious adverse events
• Vaccines cause illness and deaths.• Vaccine-preventable diseases are rare• Multiple vaccinations overload the immune
sx.
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Misconceptions about Vaccines cont.
• Children with a mild illness can’t be immunized
• Concurrent multiple vaccinations shouldn’t be given
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Vaccine Truths• Vaccines are one of the most important
public health achievements• Public concern about vaccines is pervasive• Fear of vaccines can lead to public harm• Vaccines are not 100% safe• Parents want what is best for their children• The public has little understanding of the
vaccine development process
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• Risk perception is critical• There are anti-vaccine champions• Questions remain• The decision not to vaccinate is an
active decision to accept the risk of the disease.
• (Marshall, G. 2003).
Vaccine Truths continued
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Thimerisol and Autism• Ethylmercury: mercury in sufficient
doses is neurotoxic, and more toxic to the immature brain.
• Studies have failed to conclude a causative relationship between thimerisol and autism
• previously used as a preservative in the HIB, HepB, DTaP.
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• Removed as of July 1999 as prudent action to reduce mercury exposure to infants;not because a causal relationship was determined.
• Still remains in the Influenza A vaccine and meningococcal, but greatest concern is exposure in infancy.
Thimerisol and Autism (cont.)
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MMR and Autism• Likewise, results of three large
studies in Britain and the U.S. have failed to find a causal relationship between the MMR vaccine and Autism.
• MMR has never contained thimerisol• Signs of Autism often surface during
the second year of life, when the MMR is given.
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Vaccine Schedule
• Ball & Bindler top of p. 602• CDC website: www.CDC.gov
• Click on most current immuniz sched. Available.
• Print for easy reference for clinical worksheets.• Follow yellow ranges for recommended
ages