Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin;...
-
Upload
jesse-gilmore -
Category
Documents
-
view
224 -
download
3
Transcript of Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin;...
Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo,
Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle
PEDIATRIC IMMUNIZATION
Immunization◦Deliberate provocation of an adaptive immune response by introducing antigen into the body
Vaccination◦Deliberate induction of an adaptive immune response to a pathogen by injecting a vaccine, a killed or attenuated form of the pathogen
Immunity
Active Passive
Injection of an antigen (vaccine)
Injection of preformed antibiotics
(gammaglobulins)
Protection produced by the person’s own
immune system
Protection transferred from another person or
animal
Usually permanent Temporary protection that wanes with time
ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION
Contraindications- serious allergic reaction (anaphylaxis) after a previous vaccine dose- serious allergic reaction to a vaccine component
Precautions - moderate or severe acute illness with or without fever
ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION
Contraindications to ALL LIVE VACCINES:1. immunocompromised patients2. patients given immunoglobulin and blood
products for the past 3 months3. pregnancy and possibility of getting
pregnant within 3 months4. household contacts of immunocompromised
patients* (OPV)
ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION
Simultaneous administration of Multiple Vaccines:
No contraindications for multiple vaccines routinely recommended
Immune response to one vaccine generally does not interfere with other vaccines
There should be an interval of 28 days between administration of live vaccines
Interchangeability of vaccine products is allowed for primary and booster doses
ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION
Lapsed immunizations
Intervals between vaccine doses that exceed those that are recommended do not adversely affect the immunologic response, provided immunization series is completed
EXPANDED PROGRAM ON IMMUNIZATIONEXPANDED PROGRAM ON IMMUNIZATIONVACCINE MINIMUM
AGEDOSE (NO)
ROUTE AND SITE
OF ADMINIST-
RATION
MINIMUM INTERVAL BETWEEN
DOSES
REMARKS
BCG 1 Birth; or any time after birth
0.05 ml for NB; 0.1 ml for infants (1)
Intradermal; deltoid R arm
Vaccine destroyed by heat & sunlight
DTP 6 weeks 0.5 ml (3) IM; upper outer portion of thigh
4 weeks Vaccine damaged by heat, freezing
POLIO 6 weeks 2 drops (3) PO; mouth 4 weeks Vaccine easily damaged by heat
EXPANDED PROGRAM ON IMMUNIZATIONEXPANDED PROGRAM ON IMMUNIZATION
VACCINE MINIMUM AGE
DOSE (NO) ROUTE AND SITE OF
ADMINIST-RATION
MINIMUM INTERVA
L BETWEEN DOSES
REMARKS
HEP B 6 weeks or at birth
Follow manufacturer’s instructions 0.5 ml (3) - 0,1 & 6 months
IM; anterolateral aspect of thigh
Vaccine destroyed by heat or freezing
MEASLES 9 months 0.5 ml (1) SC; outer part of the thigh
Vaccine easily damaged by heat
EXPANDED PROGRAM ON IMMUNIZATIONEXPANDED PROGRAM ON IMMUNIZATION
VACCINE
MINIMUM AGE
DOSE (NO) ROUTE AND SITE
OF ADMINIST-
RATION
MINIMUM INTERVAL BETWEEN
DOSES
REMARKS
BCG 2 At school entry, whether or not child has BCG scar
0.1 ml (1) ID; L deltoid Vaccine destroyed by heat or sunlight
TETANUS TOXOID
Women of childbrearing age
0.5 ml (5) IM; deltoid region
TT1 at 1st contact
TT2 at least 4 weeks after TT1
TT3 at least 6 wks after TT2
TT4 at least 1 year after
TT5 at least 1 year after
Vaccine easily damaged by heat & sunlight; given for those not given primary immunization in infancy and childhood
Childhood ImmunizationChildhood ImmunizationBCG Vaccine
- live attenuated bacterial vaccine- at birth or anytime after birth- booster dose given at school entry
Contraindications: immunodeficiency, progressive dermatoses
Reaction: abscess at the site; axillary lymphadenopathy
BCG Vaccine
Usual reactions induration: 2 –
4 wks pustule
formation: 5 – 7 wks
scar formation: 2 – 3 months
Accelerated Reactions:
induration: 2-3 days
pustule formation: 5-7 days
scar formation: 2-3 weeks
Hepatitis B vaccine- inactivated viral antigen- 0, 1 & 6 months- children and adolescents who have not been vaccinated with Hep B may begin series during any visit
Contraindication: anaphylactic reaction to previous dose
Reactions: pain and swelling at site, fever
Diphtheria, Tetanus & Pertussis
Usual Side Effects:◦ fever up to 72 hours (low to moderate
grade)◦ restlessness and irritability◦ local reaction: pain and swelling at
the site of injection
Contraindications:◦ encephalopathy within 7 days of
administration of previous dose◦ anaphylactic shock after a previous
dose◦ progressive neurologic disorders
Poliomyelitis Vaccine1. Oral Polio Vaccine (OPV)
- live attenuated (Sabin)Absolute contraindications:
1.altered immune states, high dose steroids, radiation, HIV/AIDS
2.pregnancy3.household contacts of
immunocompromised patientsRelative contraindications: vomiting and
diarrheaAdverse Reaction: paralysis
2. Inactivated or Killed Polio Vaccine (IPV)- recommended to decrease the incidence
of vaccine-associated paralytic polio (VAPP)
Measles Vaccine
- live attenuated - given at 9 months but may be given as early as 6 months during epidemics
Adverse reactions:1. fever with or without rashes (5-12 days
after administration)2. hypersensitivity reaction
Contraindication: immunocompromised state, pregnancy
Relative Contraindication: untreated active tuberculosis
Measles, Mumps, Rubella (MMR) Vaccine- live attenuated - given at 12-15 months; a booster dose is recommended at 4-6 years old
Reactions:1. fever with or without rashes (5-12
days after administration - measles)
2. fever, swelling of parotid gland (mumps)
3. fever, mild rash, transient arthritis or arthralgia, post-auricular lymphadenopathy (rubella)
Measles, Mumps, Rubella (MMR) Vaccine
Reasons for giving 2 doses of MMR:1. only 87-90% of children actually
receive the measles vaccine2. 5% of children who receive the first
vaccine won’t develop immunity3. children who had an immune response to
the first dose could get a “booster” effect
Contraindications: same as other live vaccines
Varicella Vaccine
- live attenuated - routinely given at age 12 months and up but can be given as early as 9 months- can be given within 5 days of exposure- varicella vaccine prevents moderate to severe cases of chickenpox
Reactions:-may develop few varicella-like
lesions about 1 month after vaccination
Hemophilus influenzae b (Hib) Vaccine
- polysaccharide protein conjugate
Reactions: low grade fever (2%)pain and swelling (10-15%)
Pneumococcal Vaccine
- PPV is given for children 2 yrs and above
Indications:1. patients undergoing splenectomy2. sickle cell disease3. asplenia4. HIV5. Routinely for children 2 months and
above
Hepatitis A Vaccine- inactivated viral antigen
Indications:1. persons traveling to areas with high
prevalence of Hepatitis A2. occupational hazards3. hemophiliacs – contacts of infected
persons
Reactions: pain and local swelling
Influenza Vaccine
- inactivated vaccine- should be administered before the start of flu season (February to June)
Indications:1. prophylaxis in children older than 6
months and adults2. over 60 years3. suffer from disease of cardiovascular
system, metabolic disease, cystic fibrosis, chronic respiratory disease, chronic renal insufficiency
THANK YOU