IMMUNIZATION(Vaccination)

Transcription

1 IMMUNIZATION(Vaccination) 1 st week of age BCG OPV zero dose HBV 1 st dose 2 nd month of age 1 st dose DPT OPV HBV 2 nd ROTA Hib 1 st dose dose 1 st dose 1 st dose 4 th month of age DPT 2 nd dose OPV 2 nd dose ROTA 2 nd dose Hib 2 nd dose 6 th month of age DPT 3rd dose OPV 3 rd dose HBV 3 rd dose ROTA 3 rd dose Hib 3 rd dose 9 th month of age Measles single vaccine 15 th month of age MMR 18 th month of age 1 st booster DPT 1 st booster OPV booster Hib 4-6 y 2 nd booster 2 nd booster MMR DPT OPV Vit A IU Vit A IU Rubella Vaccine for unmarried female (14-45 y) When we give Tetanus Vaccine for pregnant woman : start as 1 st dose at the end of the 1 st trimester 2 nd dose after one month 3 rd dose after six months 4rth dose after one year 5 th dose after one year THE EXPANDED PROGRAM OF IMMUNIZATION (EPI) During the early 1980s the EPI was introduced in most of the contries Determination of the high immunization coverage rate:- 1.Inntegrity of the health services.( Vaccine availablity on regular bases,functional cold chain system) 2. Awarness of the parent of the availablity of the vaccine & the programme & their motivation to vaccinate their child. 3.Motivation & detection of the health workers. * Contraindication to killed vaccine & toxoid 1-diphtheria: full doses to children over 6 years of age 2.Pertusis: -Any abnormality of thecns.e.g. spinabifida 1

2 - Acute febril illness. -Sever local general reaction to a previous dose (give dt). -History of convulsions in the child. - family history of convulsion. Contraindications to live vaccine: 1- General :- -Within 3 weeks of given another live vaccine ( not absolute) -Pregnancy. -Acute febrile illness. -Immunological dysfunctuon. -Malignant diseases e.g. Leakaemia &Hodgkins disease. - Steroid therapy,immunosupressant & radiotherapy. 2. Specific: -Oral polimylitis:diarrhea & vomiting. -Measles : Active TB, allergy to polymyxine & neomycine,familly history of convalsion. -BCG: local specific condition,premature & LBW baby,chronic skin Disease. -Rubella : pregnancy, allergy to neomycine, thrombocytopenia. *Charectaristics of vaccines 1.BCG: -efficasy of 60-90%. -BCG prevents the forms of TB developing.(tb maningitis & miliary TB). -Protection may last for 20 years. Side-effects:- a-a small red papule at the site of the injection which appears 6-8 weeks after vaccination,scar after 12 weeks. b-if givevn S.C instead of I.D route it will lead to abscess formation & regional lymphadenopathy. c-if the child tuberclin +ve it will lead to sever reaction. 2

3 *Storage : Sensitive to light ( sunlight) & heat,should be stored at refrigerator tempreatuer (4-6C ) for up to 2 years. Physiological neonatal jaundice is not a contraindication of BCG vaccine. 2.DPT efficasy is 90% ( after 3 doses). Side effects : swelling,tenderness,redness & fever for 24hr.with increasing the age adverse effects increase. So we give TD( full dose of tetanus & reduced dose of diphtheria toxiod) after age of 6 years. 1. Sever side effects : convulsions,collaps & brain damage.the incidence of such complications is about 1/180,000 doses. Storage : refrigerator temperature 4-8C. *Pliomylitis vaccine:- There are 2 types of poliomylitis vaccine : salk & sabin. 1. Salk: -Inactivated (killed). -Injectable. - In developed countries. -Prevent spread of child polio viruse to the nervous system through blood. -No shedding of vaccine viruses in the stool. -Expensive. -No side effect 2. Sabine -Live attenuated. -Oral. -In developing contries. -Limits multiplication of wild polioviruse in the intestine & reduce fecal Transmission. -Sheding of the vaccine leading to passive immunity of close contacts. -Cheep & easy. -side effect vaccine associated paralysis(1/3,000,000 dose). * Storage:- -20C (up to 2 years). OPV 0-8C ( up to 1year)in 37 C for 1day. 3

4 IPV : 0-8C (18 months),in 37C for 4 weeks. *Measles Maternal antidody will disappear at age of 6 months of the infant & cases start to appear at age of 1 year.95% effective.when giving the vaccine in the age of 9 month it will provide long lasting immunity. S/E :- mild fever,rash after 8-12 days last for 1-3 days about 15% of children. Encephalitis 1/1,000,000. S/E of measles ; diarrhea, bronchitis pneumonia conjactivites ; these decreases by vaccination & measles encephalitis decrease by 1000 times. *Storage : Live attenuated viruse kept in deep,freeze at temperature of -20C. In powder form we store it at room temperature for 4 weeks. HB vaccine Three doses are effective...s/e : local reaction with no contrainndications. It should be stored at refrigerator temperature. Cold chain : Vaccines are effective only if maintained at the recommended temperature throughout their journy from the manifacturer to the consumer.expossuer to high temp. will lead to the damage of the vaccine. To keep them cold we need equipments(freezer,refrigerators,cool boxes vaccine,thermometers & cold rooms). Methods used for detecting heat exposure: 1-Cold Chain Monitor (CCM) There is acolor index with the vaccine that change its color when expossed to higher temp. than recommended. 4

5 2-Vaccine Vial Monitor (VVM) Used only in polio vaccine vials, where each one has a sticker ( A squer & a circle in it ) one is Perpil & one is white,and when exposed to high temp. both the circle & the box become pink. Destruction of unused vaccines: This is done by incineration. 5