Tiem Chung Mien Dich 2015

7/25/2019 Tiem Chung Mien Dich 2015

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TIM CHNG

BS Cao Vn Anh


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Cu hi


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Min dch: Immunity, bt ngun t Immunitasting La tinh c ngha l min tr.

Edward Jenner(!"# $%&' l m)t b*c +

ng-i ha ng/0i 1nh, 23 +4ng 5 lm 5i6c 7

89r9l9y, luc9+t9r+hir9, mi;n am

n/?c 1nh.

@ng l b*c + 2Au tiBn nghiBn cCu 5 +D dEng

5c Fin 2G Hhng ch4ng b6nh 2Ju mKa.

I. i cng


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II. Min dch


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Bm sinh (T nhin)

(innate immunity)ng r 5Jt lN

ng r ha hOcng r +inh hOc

(hng r t bng r thG chPt

QiBm hRng 2Sc hi6u

hu !"c

(adaptive immunity)ThU 2)ng


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&. Min dch ' nhi)n

II. Min dch


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ng r 5Jt lN: Va, niBm


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*. Min dch 'hu !"c

1daHt9d [rm illu+tratin by >ic lm9+

II. Min dch

Min dch thu 2/`c hay min dch 2Schi6u l tr-ng th*i min dch FuPt hi6nhi c thG 23 c tiH Fc 5?i h*ngnguyBn. h*ng nguyBn 2/`c 2/a 5

chU 2)ng (nh/ 5accin9 hay ngunhiBn. Min dch thu 2/`c cn c 2/`chi truy;n c*c t b c them fuy;nmin dch (min dch m/`n $ adHti59limmunity hSc truy;n h*ng thG (min

dch thE 2)ng $ Ha++i59 immunity.Min dch thu 2/`c gm ' b/?c: nhJndi6n, h-t h* 5 hi6u Cng.


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C+c c ch, c -n c/a min dch -m sinh 01

'hu !"c


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Min dch dch 'h2(umral Immunity)

T*c t b min dch tit 3h+ng 'h23h+ng'h2 t h`H 5?i c*c h*ng nguyBn t/ng Cng.


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Min dch ', -1%(T9llular Immunity

l h njng ch4ng l-i c*c t b 23 bth=m nhim 5i trKng, 5iru+, N +inhtrKng, c*c mR l- thRng fua c*c t*c2)ng trung gian cUa c*c t b

lymHhcyt9.


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Min dch dch 'h2

]*H Cng min dch dch thG 2/`c thXc hi6n thRng

fua c*c h*ng thG h tan, 2/`c +n FuPt t t b

Hla+ma (t/ng b, bi6t h* t t b lymHh 8.


15/81

45m6h%c5'e B45m6h%c5'e B

7gu8n g9c7gu8n g9c: ]/`c +n +inh t t b gan cUaHhRi thai, hng !% tuAn. kau 2 Hh*t triGn 7tUy F/ng, thnh thEc 7 2=y hSc 7 ti 8ur+a

abriciu+ cUa gia cAm.

CD34 C C

S

Khng c

g

g! g!

"# $%og&c 'inhmu

"in B(*+o,Bce--)

B '.m(/a+-y Bce--)

B mu0n(1ate Bce--)

B ch2n(!atu+e Bce--)

Qu trnh trng thnh ca B lymphocyte


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kinh ra c*c h*ng thG d/?i +X Wch thWchcUa LymHhcyt9


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Min dch trung gian t b thu)c Hh-m 5i nhi6m5E cUa t b lymHh


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45m6h%c5'e 45m6h%c5'e

7gu8n g9c

LymHhcyt9 < 2/`c +inh ra 7 tUy F/ng, diLymHhcyt9 < 2/`c +inh ra 7 tUy F/ng, dichuyGn 2n tuyn Cc (thymu+ 5 thnh thEc 7chuyGn 2n tuyn Cc (thymu+ 5 thnh thEc 72=y, +au 2 5 m*u, m)t Wt 5 h-ch lymHh.2=y, +au 2 5 m*u, m)t Wt 5 h-ch lymHh.


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k4 l/`ng t b lymHh < 2/`c duy tro Zn2nh nh0 +X c=n bng gipa c*c t b m?i 2nt tus F/ng 5 t b cht d hRng tiH Fc

h*ng nguyBn.


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Phn loi t bo T

VXa 5 chCc njng chia thnh " l-i:

, -1% $5m6h%c5'e hi@u Ang(9[[9ctr


21/81

, -1% $5m6h%c5'e Ac ch,, -1% $5m6h%c5'e Ac ch,(kuHH9+r


22/81

Da 01% du n 6r%'ein m1ng CD 'ng Ang 0ichAc nFng chia 'h1nh G $%iH

45m6h% h 'r"45m6h% h 'r"(


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LymHh < 2i;u ha ng/`cLymHh < 2i;u ha ng/`c (


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C:;C 7hJn bit h*ng nguyBn 2/`c tronh

din b7i c*c Hh=n tD MT l?H II.


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ChAc nFng !Kc ', -1% c/a c+c ', -1% CDPH Th| nhJn bit h*ng nguyBn hi t h`H 5?i

c*c Hh=n tD MT l?H I. Thu tr*ch nhi6m 5; 5i6c ly gii c*c t b c

biGu l) h*ng nguyBn l- trBn b; mSt cUa chng, 2Scbi6t nh/ l h*ng nguyBn 5iru+.

ChAc nFng h%' hQa !i 'hc -1%H

}, ~ iH c*c 2-i thXc b tr7 nBn h-t 2)ng m

di6t c*c 5i +inh 5Jt th/0ng FuyBn hay nhPt th0i,ngay bBn trng c*c t b Py


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ChAc nFng !iRu h%1 6hn Ang 0i)mS '% m+uH


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III. UVCCI7EW


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&. +6 Ang min dch !9i 0i ch/ngngXa

MYc 'i)u c/a & 0accine $Z '[ngH

% s -% 0@ 'ng ' min dch \ '% !+6 Ang

-% 0@ gi9ng nh ]5 ra sau 3hi - nhim 'r^ng '

nhi)n nhng 3h_ng g5 -@nh % ra min dch $u d1i ($%ng`$as'ing immuni'5

7gFn cn s $5 $an '+c nhn 'ru5Rn nhim


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+6 Ang min dch !9i 0i 0accine $Z '[ng

Qaccin9 2/`c c*c t b tronh

di6n h*ng nguyBn thu nhJnh-t ha t b < 5 8 2G

ch ra c*c t b nh?2/a c*c


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*. #hn $%i 0accines

Min dch 'hY !Kng 1ntitFin+ 5 Immunglbulin+

Min dch ch/ !Kng Qaccin9+ +4ng

Qi +inh 5Jt b lm yu 2i 2/`c 2/a 5 c thG ng/0i

Qaccin9+ cht bPt h-t b*n 2n 5 Qi +inh 5Jt cht, tFin hSc c*c b*n 2n 5 b bPt h-t


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*.& Min dch 'hY !Kng

Immun%g$%-u$ins (IM h%bc IU '% !"c min dch ngn hn (01i'un h%bc 01i 'h+ngS cQ nga5

Ch !nh d^ng ch% c+ nhn cQ ngu5 c ca% mc -@nh nbng h%bc

-i,n chAng d% -@nh nbng Au ht 2/`c dKng ch c*c tr/0ng h`H c tiH Fc nguy c

ca hSc nhpng ng/0i b nhim IQ cn trng giai 2-n cDa +Z

fh_ng 3ch 'hch h@ min dch '% ra 3h+ng 'h2


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C+c ch, 6hm 3h+ng 'h2 T ngun g4c t ng/0i $ thu 2/`c t c*c ch Hhem m*u cUa ng/0i ch

uman >rmal Immunglbulin (>I (dnh ch nhpng ng/0itiH Fc 5?i 9H 1, +7i, +4t b-i li6t 5 rub9lla

Qaric9lla +t9r Immunglbulin (QI 9Hatiti+ 8 Immunglbulin (8I uman xabi9+ Immunglbulin (xI


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V d


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a Uaccines s9ng T*c chUng 23 b lm yu 5 2/`c t*i t- trng N chU $1m 5,uj cQ nghka $1 0irus h%bc 0i 3hun !l - $1m

ch% gim !Kc $c !2 3h_ng 'h2 g5 -@nh ch% ngi3he mnh

T c*ch h-t 2)ng gi4ng nh/ nhim huen tX nhiBn

C+c 0accines s9ng r' gi9ng nh mK' nhim 'r^ng'hc s 0 05 '% !"c !+6 Ang min dch 3o% d1iSmnh mp 01 '9'

*.* Min dch ch/ !Kng


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Uaccines s9ng 4"i Li;u duy nhPt th/0ng l 2U t-

min dch l=u di `i lBn 2*H Cng min dch

m-nh m{ 959d


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Uaccines -' h%'

Qaccin9+ bPt h-t


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Sc l: uy;n dch cUa t b 5i +inh 5Jt tn HhAn bPt h-t 23

chtQW dE Qaccin9 h g, cm, d-i, QkQ 1 trOn t b

Sc: Qaccin9+ b*n 2n 5 5 m)t HhAn t b

ThCa m)t hSc m)t 5i thnh HhAn fuan trOng cUa 5i+inh c h njng b 56

QW dE Qaccin9+ m)t HhAn t b h g chCa & thnhHhAn cUa 5i huen h g trOn 5n QW dE diHhth9ria tFid QW dE ib Hly+accharid9

- Uaccines -' h%'


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4"i n 2nh *c 2nh thnh HhAn r

rng hRng thG g=y nhim

trKng

B' $"i TAn nhi;u li;u


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Vaccne !"ng g#m $%cl&c "h3y 45u (chic6enpo7)

C8m (na'a- 'p+ay)9otavi+u'


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Vi:m gan 'i:u vi BC8m (in;ection)Haemophilus influenza type $ (


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Carrier6r%'ein

#%$5saccharide $in3ed'% carrier 6r%'ein

Qaccin9 t*i tZ h`HBac'eria

#%$5saccharide(sugar c%a'ing


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T*c 5i huen nh/ Haemophilus influenzae type b,Neisseria meningitidis, Streptococcus pneumoniae c l?H5q l cPu trc 2/0ng (Hly+accharid9+

L?H Hly+accharid9 cating+ lm ch h6 min dch nn

n?t cUa m)t 2Ca b hRng nhJn bit 2/`c bBn trng cUa5i trKng 5 t- min dch thWch h`H

Qaccin9+ ly+accharid9 m t- min dch 7 tr & tuZi5 hRng Wch thWch N Cc min dch l=u di

Qaccin9+ t*i tZ h`H 2/`c +D dEng c hi6u fu giH trnga b6nh d ib, M9n T 5 Hn9umcccu+.


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Uaccines 3,' h"6 >hi;u 5accin9+ 2/`c t h`H 2G c thG tiBm cKng m)t

lc nhi;u l-i 5accin9+ Qaccin9+ t h`H lm gim +4 lAn chWch 5 +4 mi chWch


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h1nh 6hn 0accine 7g%1i 3h+ng ngu5)nS c+c 0accines cQ 'h2 chAa mK' 01i h%bc '' c c+c 'h1nh 6hn

sauH

Thnh phn L do V d

T dc Gia tng p ng min dch Mui aluminium

Cht bo qun gn ng!a "accin# b nhim "i $hu%n

ho&c "i nm

thiom#'(al

Cht ph) gia *n nh "accin#( t'ong nh+ng i,u $i-n.'om bt li nh /ng $h/ ho&c n0ng1"2n bo qun c hi-u qu c3a "accin#

g#latin#

h+ng ph4n

c5n l6i t'ongqu t'7nh (n8ut

Cc 9:u t ang bt ho6t

;hng (inh < ngn ch&n (= nhim $hu%nt'ong (ut qu t'7nh (n 8ut>'ot#in( t'ng? m@t "Ai lo6i "accin#"i'u( c nu/i t'ong t: bAo ph/i gA>'ot#in(B#a(t

.o'mald#h9d#

n#om9cin1 (t'#ptom9cin1pol9m98in in.lu#nDa1 9#lloE .#"#'

F#p "accin#


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Khong cch cn thit gia cc liuvaccine To iu i!n cho p "ng #i$n d%ch tin t&i'n ( #i$n d%ch ngu)*n

pht +, thng- i-c nA9 t6o i,u $i-n cho p ng ti:p th#o th=c (= lA p ng th

pht< nhanh hHn "A m6nh hHn "Ii i l=c JgG cao hHn

T&nh cc t./ng tc #i$n d%ch :u "accin (ng $hc c ch3ng t'ong $hi h- min dch ang th=chi-n p ng min dch ngu9Kn pht1 th7 ho6t @ng c3a h- min dchb%m (inh (L t'ung h5a "accin# (ng th pht lAm gim hi-u qu c3a"accin# 7 "N9 chOng ta chP t'ong Q tu4n R t6o i,u $i-n cho h-

thng min dch hSi ph)c Jmmunoglobulin ngPi cha cc $hng thR i "Ii nhi,u lo6i nhimt'ng bao gSm b-nh (Ui h+ng $hng thR nA9 (L t'ung h5a "accin#(ng >hi chP V thng cho nSng @ $hng thR gim 8ung


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:i@u u Uaccine

Wau 3hi !"c c6 6ho6S hi@u u c/a 0accines !"cgi+m s+' 'h_ng uaH

2*nh gi* ts l6 mc b6nh F*c 2nh 5i6c tiBm chUng cUa tng c* nh=n 24i 5?i l-i

b6nh fh_ng cQ 0accine !' hi@u u & 01 hi@u u

ctng 3h+c nhau gia c+c 0accine U $Z d% n15S cn chch hn & $iRu 0accine

QW dE, hng # tr/0ng h`H chUng MMx 5accin9 +{c chuyGn 2Zi huyt thanh +au li;u 5accin9

Qo 5Jy li;u thC & 2/`c 2; ngh 2G ch nhpng ai hRng2-t 2/`c hi6u fu b 56 +au li;u thC nhPt +{ c c h)i

t- 2/`c h*ng thG +au li;u thC &


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h' -i Uaccine


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Ch9ng ch !nh 01 'hn 'rvng

Vaccine 0h1ng ch2 %nh Th3n t&4ng

Tt c "accin#W(ng "A btho6tX

Yc phn "- 89 'a U l4n tiKm ch3ngt'Ic ho&c d ng "Ii thAnh ph4n c3a"accin#

:u ngPi d= nh tiKm ch3ng $h/ng $hZ#t'ong ngA9 tiKm ch3ng th7 ho[n "i-c tiKmch3ng l6iC0 thai

\T> nh t'Kn :u c0 chng cI b-nh th4n $inh ho&c ang

c0 cc 'i lo6n th4n $inh 89 'a1 $R c $iRm(ot $h/ng tt @ng $inh1 c]ng phi ho[nch3ng ng!a

COm h t'Kn1 ngoAi 'a c5n c0^h+ng ngPi d ng "Ii t'ng

:u c0 thR1 (_ d)ng "accin# cOm $h/ng c0thiom#'(al cho thai ph) "A t'` nhZ

accin#( (ngWMM1 thu NuX

h t'Kn1 ngoAi 'a c5n c0 ^i,u t' c ch: min dchC0 thai

:u 8ut hu9:t gim tiRu c4u "/ cn 89 'a(au ch3ng MM "accin#1 th=c hi-n t#(t nhlng $hng thR:u bi:t c0 d ng "Ii t'ng1 ch3ng ng!aphi c gim (t $


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7gu5 c 6hn Ang s% 0i ngu5 c mc-@nh

9i 0i c+c -@nh cQ 'h2 ngFn ngXa !"c -ng0accineS ngu5 c mc -@nh nbng $n hn ngu5 c]5 ra 6hn Ang 3hi 'i)m ch/ng


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"n 'uDt 7Ey +a6hi mFc $nh tGnhi:n

"n 'uDt 7Ey +a'au ti:m !!9vaccine

Co g5t H I J H I H

607 -dopathcthrom(ocytopaencpurpura/

H I L H I JJL

''78-!u(9acute

!clero!ng pan9encephalt!/

H I JM

0: ;ong H I M

V d< =guy c> m?c (@nh !A ua (A ru(ellacao h>n l ta (+n 1#y ra do chng E


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hi gian ]5 ra 6hn Ang Uaccine

Qaccin9+ bPt h-tH 'hng $1 'r%ng OP gi sau 'i)mch/ng

Qaccin9+ +4ng: ]5 ra '^5 'he% 'hi gian 0irussa%

cho6 QW dE MMx 5accin9: #hn Ang 0i 'h1nh 6hn 0accine s[i (m@'S s9'S rash ]5 ra 3h%ng

ng15 x ` && sau 'i)m ch/ng #hn Ang 0i 'h1nh 6hn 0accine ru-e$$a (!auS cAng h%bc sng 3h6

]5 ra 3h%ng 'un 'hA * sau 'i)m ch/ng #hn Ang 0i 'h1nh 6hn 0accine uai - ]5 ra 3h%ng 'un 'hA y sau

'i)m ch/ng (cQ 'h2 ]5 ra sau x 'un 'i)m ch/ng


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+c dYng 3h_ng m%ng mu9n Qaccin9+ +4ng: th/0ng tho t*c dEng hRng mng mu4n +{ gim th9 +4

li;u chUng

QW dE MMx

Qo nu h*ng thG 2/`c t- ra trng 2*H Cng cUa li;u 5accin9 +4ng

2Au tiBn, h*ng thG +{ trung ha m)t l/`ng nhq c*c 5iru+ trng5accin9 cUa bPt li;u 5accin9 +au 2

Qaccin9+ bPt h-t: th/0ng tho t*c dEng hRng mng mu4n +{ tjng th9

+4 li;u chUng

QW dE t9tanu+, h g

Qo nu h*ng thG 2/`c t- ra trng 2*H Cng cUa li;u 5accin9 2Au

tiBn, h*ng thG +{ t h`H 5?i h*ng nguyBn c trng 5accin9 t- ra

2*H Cng 5iBm (5W dE 2au ni 5t tiBm chUng.


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C+c 6hn Ang 3h_ng m%ngmu9n 'hng gb6

#hn Ang 'i ch k/ng, 2q, 2au ni tiBm chUng uPt hi6n c*c n4t nhq ni tiBm chUng

#hn Ang '%1n 'hn k4t, Wch Cng, m6t, 2au 2Au, bun nRn, nRn, tiBu lqng, jn m


54/81

fh%ng c+ch gia c+c $iRu 0accines

4iRu c/a c^ng 0accine -' h%' z sau O 'un (h%bc P 'un ch% #CU Uaccines s9ng (c^ng h%bc 3h+c $%i z sau O 'un

fh_ng cQ 3h%ng c+ch cn 'hi,' !"c uan s+' 'h5 giaH

5accin9++4ng 5 bPt h-t

T*c li;u cUa 5accin9 bPt h-t h*c nhau fh_ng cQ -ng chAng ch% 'h5 rng 0accine -' h%' 'ng '+c 0i !+6

Ang min dch c/a 0accine -' h%' 3h+c h%bc 0i 0accine s9ng.

MK' 0accine -' h%' cQ 'h2 !"c 'i)m c^ng ${c h%bc -' 3| 3hi n1% h%bc

sau 3hi 'i)m mK' $%i 0accine -' h%' 3h+c h%bc 0accine s9ng

k 9n9ral x9cmm9ndatin+ n ImmuniYatin x9cmm9ndatin+ [ th9 1d5i+ry

Tmmitt99 n ImmuniYatin ractic9+ (1TI MM}~

~ec%mmenda'i%ns and ~e6%r's Decem-er &S *x U%$. GG 7%. ~~`&G


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hi gian min dch c/a 0accines

i6u fu b 56 ch c)ng 2ngrPt t4t 2G chPm dCt l=y truy;n

24i 5?i ng/0i fu* nhq 2G cmi6n dch hSc ng/0i ch/a

di +u4t 20i # ng/0i2/`c chUng

W[i

Au nh/ fuan +*t thPy h*ngthG t- 2/`c tn t-i l=u di &njm.

& njm t ngy chWch 2U li;u:e6a'i'is B

hc l-i lc tuZi.

" njm:% g1 (hHing cugh

=hi ch{#hng !%+n 'hi gian -% 0@c/a 0accine sau 3hi ch/ng !/$iRu

B@nh

>hc l-i ch ng/0i l?n lc " tuZi.


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hi gian min dch c/a 0accines

]*H Cng +au hi tiH Fc h*ngnguyBn ch thPy hi6u fu mindch di.

njm t ngy chWch 2Uli;u

:uman#a6i$$%ma0irus

>ng 2) h*ng thG hi 2n h-n+D dEng 5n ca trng

c*c 5accin9+. i6u fu b 56c)ng 2ng 7 tr 9m.

" njm hSc hn nul 5accin9+ tZ h`H

#neum%c%cca$

i6u fu b 56 ch c)ng 2ngrPt t4t 2G chPm dCt l=y truy;n24i 5?i ng/0i fu* nhq 2G cmi6n dch hSc ng/0i ch/a2/`c chUng nga..

Auht 5accin9+ (# b56 2/`c & y9ar+

~u-e$$a

h/nghRng di nh/ 24i 5?irub9lla.

njm (#, gim dAnhi fu* h-nuai -


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MAc !K dung n6 c/a cKng !8ng

B' 3| & ngi 3h_ng cQ min dch 0i & '+cnhn g5 -@nh 'h sp dung n6 !"c

fh_ng 6hi '' c mvi ngi !Ru '% ra !"c

!+6 Ang min dch gi9ng nhaufh_ng 6hi '' c mvi ngi !Ru !"c ch

!nh ch/ng ngXa gi9ng nhauMAc !K dung n6 - nh h[ng -[i su5 gim

min dchS 0 dYH d% 'hu9c h%bc d% $Z d% n1%!Q


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Ch9ng ch !nh 'uy g#m mFn dch nguyGn pht Ho tr l@u IhJp t+ (o g"c IhJp tng

KLu tr cortco!terod ton thMn KLu tr Nc ch+ mFn dch =hFm H6V Ohc

These headings are taken from Immunisation and theImmunocompromised Child Royal College of Paediatrics andChild Health Best Practice Statement !e" #$$#%&


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4ch ch/ng ngXa"ham 6hEo 'ch


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f,' $un

VKng 5accin9+ 2G iGm +*t b6nh nhim trKngcAn Hhi c hiGu bit 5; din bin tX nhiBn cUab6nh, t*c nh=n +inh hOc cUa b6nh 5 2*H Cng

min dch cUa b6nh]4i 5?i hAu ht b6nh nhim trKng, tr 9m hRngthG 2/`c b 56 m)t c*c hi6u fu m hRng cmin dch c)ng 2ng

hi F9m Ft dXa trBn 5i6c tham h c chcUa 5accin9 l 5accin9 +4ng hay l 5accin9 gim2)c lXc


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7hPn tham *h#o thGm

, >y chuyn -@nh

, BEo RuEn v% -Nu t+ vaccine


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Cold Chain

"he Tco-d chainU i' the 'y'tem o=t+an'po+ting and 'to+ing vaccine'ithin the 'a=e tempe+atu+e+ange o= JWC to XWC

-=ayda CA Oempe RA ller = Keep it Cool: the Vaccine Cold Chain.Guidelines for Immunisation Providers on Maintaining the Cold Chain.

'econd edton CommonSealth oT Ru!trala UW/

Wh i th ld h i


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Why is the cold chainimportant?HY Vaccine' a+eZ Bologcal product! lo!e potency Sth tme 7roce!! rre;er!(le and

accelerated T proper !toragecondton! are not adhered to

Wh i th ld h i


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Why is the cold chainimportant? JY A''u+anceIcon=idence in potentp+oduct and vaccine p+og+amme'

7roTe!!onal re!pon!(lty Confident the vaccines you give will beeffective

7u(lc Health re!pon!(lty Public confidence in immunisation

programmes

Wh i th ld h i


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Why is the cold chainimportant?LY /n'u+ing ma7imum $ene=it =+om

immuni'ation' Ee!pon!(lty not to Sa!te

!carce =H' re!ource! Eeduce Sa!tage Trom error!

Wh is the cold chain


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Why is the cold chainimportant?[YComp-iance ith S*CI!anu=actu+e+ny vaccine that has not been stored

at a temperature of !"#$C as per its

licensing conditions is no longer alicensed product

%esponsibility& liability rests withimmunisation provider and PC'.

Vaccine StabilityVaccine Stability


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Vaccine StabilityVaccine Stability

Sen'itivity to


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Light SensitiveLight Sensitive

Sen'itive to 't+ong -ight 'un-ightu-t+avio-et =-uo+e'cent' (neon)

BCIEVarcella

enngococcal C Con.ugateo!t D0a7 contanng ;accne!

accin#( (houldalEa9( b# (to'#din th#i' o'iginal

pac$aging until

point o. u(# top'ot#ct th#m .'omlight

V i S


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Vaccine Storage 'se a dedicated (accine

fridge

Safeguard electricitysupply

)o more than *$+ full

Place (accines in clearlyla"elled plastic mesh"askets

,roup (accines "y typePaediatric- .dult-.dolescent%

/efrost0cali"rate fridgeregularly

1nsure "ack up facilitiesare a(aila"le in the e(entof fridge failing

No food or mdical!"cimn!

# $o not "lac fridg indirct !unlight or nar hat!ourc

# $o not rmo% %accin!from original bo&! untilrad' to u!

# $o not !tor %accin! infridg door! or in !olid

"la!tic tra'!(containr!ithin th fridg

# *" %accin! aa' fromfridg all! and cold air%nt!

Picture taken from www.medisave.co.uk


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Temperature Monitoring 'se ma20min

thermometer Pro"e should "e placed

in the centre of fridge Temperature should "e

recorded at least once aday

Reset daily Cali"rate as

recommended Take immediate action if

temperature is outsiderecommended range

Sample refrigerator


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Sample refrigeratortemperature record

chart

+%ailabl at, htt",((-.cdc.go%(ni"(i!d(immtoolit(contnt(%ac!torag(log!.htm


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Storage temperature

)e(er e2ceed 34C or fall "elo5#4C

Aim =o+ M]CAim to maintain vaccine =+idge a'c-o'e a' po''i$-e to MWC a' thi' give'

a 'a=ety ma+gin o= ^ o+ _ LWc

O d i d


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Ordering and

Delivery Pamed t+ained de'ignated pe+'on and deputyho haveove+a-- +e'pon'i$i-ity =o+ o+de+ing+eceipt and ca+e o= vaccine'Y

9e'pon'i$i-itie' inc-udeZ 1nsuring cold chain has "een maintained during

transport and managing receipt of (accines directly intorefrigeration

Checking deli(ery for leakage- damage anddiscrepancies

Rotation of stock 6aintaining stock information system to keep track of

orders- e2piry dates and running total of (accines 1nsuring ade7uate supply0 6inimising o(er ordering or

stockpiling

Risks of excess


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59rac9dridg9

r 1irl

r ktrag9xtatin

Incr9a+9d xi+[ u+ing ut [

dat9 ktcr99Ying

Incr9a+9da+t9

Incr9a+9d T+t


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Cool Boxes andransporting vaccines [!e a ;aldated cool (o1 and ce pac*! Trom

recogn!ed medcal !upply company ontor ma1mum)mnmum temperatureA

recordng at regular nter;al!

` Vaccine' 'hou-d $e +apped in $u$$-e +ap o+ 'imi-a+in'u-ation mate+ia- to p+event di+ect contact ith icepac6'

` 'e in'u-ating mate+ia- to =i-- any 'pace' ithin the coo-$o7

` \n-y ta6e enough vaccine =o+ pa+ticu-a+ 'e''ion andminimi'e e7po'u+e o= the vaccine' to +oom tempe+atu+e'

!hat to do if there has


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!hat to do if there hasbeen a

Cold Chain failurePrior to administration.ny (accine that has not "een stored at a

temperature of #834C as per its licensingconditions is no longer a licensed product

9here there is any dou"t that cold chain has not "eenmaintained- (accines should not "e used until further

ad(ice has "een sought from the (accine

manufacturer

b+itten p+ocedu+e =o+ the di'po'a- o= vaccine'$y incine+ation 'hou-d $e avai-a$-e -oca--y

Tiem Chung Mien Dich 2015

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Transcript of Tiem Chung Mien Dich 2015