CHILDHOOD IMMUNIZATION s Purpose of Immunization To protect people against infectious diseases s Vaccine s Is a preparation containing whole or fractioned microorganisms.

s 2 major classes of vaccines s Killed vaccines These are composed of whole, killed microbes or isolated microbial components s Live vaccines These are composed of live microbes that have been weakened or rendered completely avirulent. Toxoid- It is a bacterial toxin that has been changed to a non toxic form. Vaccination - Production of active immunity - It is referred to any vaccine or toxoid. Immunization - Is the production of both active and passive immunity. s Active immunity s Develops response to infection or to administration of a vaccine or toxoid. s It takes weeks or months to develop, but it is long lasting. s Passive immunity s Pre-formed antibodies (immuneglobulins) s It protects immediately, but persists only as long as the antibodies remain in the body. s Specific Immune Globulin s These preparations contain a high concentration of antibodies directed against a specific antigen. s Administration provides immediate passive immunity. s Adverse Effects of immunization s Discomfort, swelling and erythema on injection site s Fever (most common) s Anaphylaxis (MMR)

s Acute encephalopathy (DPT) s Vaccine-associated paralytic poliomyelitis (OPV) s Immunization schedule Target Diseases s Measles, Mumps, Rubella (MMR) s Measles s A highly contagious viral disease characterized by rash and high fever. s Mumps s A viral disease that primarily affects the parotid gland s Usually occurs in children ages 5 to 15 s Rubella s Also known as German measles s It sometimes occurs during pregnancy MOT: It is spread by inhalation of aerosolized sputum or by direct contact with nasal or throat secretions. s Measles, Mumps, and Rubella Virus Vaccine (MMR)

MMR is marketed under the trade name of M-M-R II A combination of three live virus vaccines. Route: SC (outer aspect of the arm) Adverse Effects.

Mild. Local soreness, erythema andswelling(grandular swelling in the cheeks or neck and under the jaw), Fever.

Acetaminophen or Ibuprofen (Nonaspirinnonsteroidal antiinflammatory drugs) Precautions and Contraindications.

-Contraindicated during pregnancy. -Used with caution in children with

history of:

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--thrombocytopenia or thrombocytopenic purpura --anaphylactic-like reactions s Diptheria, Pertussis, Tetanus (DPT) s Diphtheria - Is a potentially fatal infection caused byCorynebacteriumdiphtheriae s Tetanus - Also known as lockjaw - A frequently fatal disease characterized by painful spasm of all skeletal muscles. -Caused by Clostridium tetani s Pertussis Also known as whooping cough, occurs primarily in infants and young children. - Caused by Bortedellapertussis. s Diphtheria and Tetanus Toxoids and AcellularPertusis Vaccine (DTaP) Vaccination against diphtheria, tetanus, and pertusis is usually done simultaneously using a combination of product. Two products are available: -Whole-cell pertusisDTwP; -AcellularpertusisDTaP

-low fever, fretfulness, drowsiness, anorexia, and local reactions (pain, swelling, and redness) - Acetominophen and Ibuprofen used to decrease fever and pain Moderate Persistent, inconsolable crying, fever, convulsions develop Severe. -Acute encephalopathy, sometimes leads to chronic neurologic dysfunction

Precautions and Contraindications.

Ideally, DtaP is more effective than DTwP and causes fewer and milder side effects. Preparations. - DTaP available under three trade

names: 1.) Tripedia 2.)DAPTACEL 3.)Infanrix

Adverse Effects.

-DTaP can be administered to children with mild febrile illness -DTaP is contraindicated if prior vaccination with DTaP produced: 1.) immediate anaphylactic reaction 2.) encephalophaty w/in 7 days vaccination -DTaP should be administered with caution if a prior vaccination with DTaP produced any of the following: --shock-like state --fever --persistent, inconsolable crying --convulsions Route: IM s Poliomylelitis s Also known as polio or infantile paralysis s It is a serious disease that results to skeletal muscle paralysis s Is an acute viral, infectious disease spread form person to person, primarily via fecal-oral route. s Poliovirus Vaccine

-Mild Two polio vaccines are available:

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Oral poliovirus vaccine (OPV, Sabin vaccine) Inactivated poliovirus vaccine (IPV, Salk vaccine) Adverse Effects of IPV. Local soreness may occur. Contains amounts of streptomycin, neomycin, and bacitracin. Adverse Effects of OPV. Causes vaccine-associated paralytic poliomyelitis(VAPP) can sometimes be fatal. Route: SC

Local reactions such as; swelling, erythemia, warmth and tenderness. Fever, crying, diarrhea or vomiting. Varicella (Chickenpox)

s A common, highly contagious and potencially serious disease of childhood. s Causative organism is varicella-zoster virus s Herpes zoster usually occur after chickenpox s It is the reactivation of varicella-zoster viruses that had been dormant within sensory nerve roots. s Varicella Virus Vaccine

s Haemophilusinfluenzae Type B s A gram- negative bacterium that can cause meningitis, pneumonia, and serious throat and ear infections. s Leading cause of serious illness in children under the age of 5. s HaemophilusInfluenzae Type B Conjugate Vaccine

Directed against H. Influenza type B (Hib) prepared by conjugating purified capsular polysaccharide(PRP) Diphtheria Toxoid Tetanus Toxoid Outer Membrane Protein (OMP) Route: IM Children should receive 4 doses. 1st at 2 months old 2nd at 4 months old 3rd at 6 months old 4th at between 12 to 15 months old Adverse Effect. Hib vaccine is among the safest of all vaccines.

Composed of live, attenuated varicella virus . Administration induces synthesis of antibodies against the virus. Adverse Effects. Erythema, soreness, and swelling at the injection site. Sometimes develops fever and mild local varicella-like rash Precautions and Contraindications. Contraindicated during pregnancy, for patient with cancers (leukemia, lymphomas) and with hypersensitivity to neomycin or gelatin. Vaccine should not be given to individuals who are immunocompromised. Route: SC

s s s s s s s

Hepatitis B caused by Hepatitis B virus can either be Acute or Chronic found virtually in all body fluids MOT: needle-stick accident Sexual contact

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s Maternal-child transmission s Use of IV equipment or solution s Hepatitis B Vaccine

-Fever, Malaise, Nausea, Jaundice, Anorexia, Diarrhea, Stomach pain Liver Bile Feces

Contains Hepatitis B surface antigen (HBsAg), which are the primary antigenic protein in the viral envelope. Administration of Hepa B promotes synthesis of specific antibodies direct against hepatitis B virus. Hepa B marketed under 2 trade names: Recombivax HB Available in two formulations, both containing 10ug of HBsAg/ml. Engerix-B. Available n two formulations also, both containg 20ug of HBsAg/ml. These two vaccines are made from a viral component, rather than from a live virus. Twinrix- approved for adults but not for children. Adverse effects and Contraindications. Most common reactions are soreness at the injection site, and mild to moderate fever. Aspirin should be avoided Only contraindication is a prior anaphylactic reaction either to hepa B, or to bakers yeast. Acetominophen and Ibuprofen Maybe used to relieve discomfort. Route: IM Hepatitis A caused by Hepatitis A virus. Symptoms:

MOT: Fecal-Oral

s Hepatitis A Vaccine

Two vaccine against hepatitis A are available: Havrix and VAQTA. Adverse Effect. Mild reactions are common. Soreness at the injection site Headache, loss of appetite and malaise Route: IM Two doses are required Immunization Schedule. 1st can be given 6 to 12 months of age 2nd should be given 6 to 12 months after the first.

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