IMMUNIZATION STATUS. Calle 128 No Calatrava, Bogotá Colombia / Teléfonos: (57) (1)

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1 IMMUNIZATION STATUS

2 OBJECTIVE Provide information and tools to pedagogical human talent, parents or caregivers to plan and eecute actions to ensure the child vaccination in order to promote the right of children to adequate vaccination scheme for their age according to the Epanded Program on Immunization PAI. REGULATIONS Decree 2287 of August 12, It regulates the authorities of educational institutions and those responsible, caregivers and liable parties for wellbeing, public or private, should ensure that all children under five years old have complete their vaccinations according to the immunization schedule established by the Ministry of Social Protection. Law 1098 of November Whereby the code of childhood and adolescence is issued. It aims to ensure that boys, girls and teenagers grow in a free a harmonious environment; in an atmosphere of happiness, love and understanding. Also aims to establish substantive and procedural rules to integral protection for boys, girls and adolescents. Article 29. It establishes the right to integral development in early childhood which is the stage of life in which is set the foundations for cognitive, emotional and social development of the human being; comprising the population group that ranges from zero (0) to si (6) years of age. From the early years, boys and girls are subject holders of the rights recognized on international treaties, in the Constitution and the code in question. They are inalienable rights to childhood, health care and nutrition, complete vaccination, protection against physical danger and early childhood education. IMMUNITY It is the body s ability to deal specifically or opposing a particular infection or disease. There are different ways to acquire immunity; one is the transmission during pregnancy passing from mother to the baby through placenta. Similarly when the mother breastfeeds their baby transferred through breast milk a series of defences against various diseases. Another way to obtain immunity is by the vaccination process in which are introduced to the body substances generating the ability to defend against a disease. Unlike the above, the same organism forms its own defences. 2

3 VACCINATION SCHEME IN BOGOTA DC Diseases that revive vaccines from the vaccination scheme in Bogota DC. Diseases, clinical manifestations and vaccines are described below including within the basic vaccination scheme in Bogota. 3

4 Disease Manifestations Vaccine TUBERCULOSIS It is a chronic disease, highly contagious. It has many clinical presentations. It is spread by droplets of saliva sick people epelled coughing, talking or spitting. Predisposing factors: Malnutrition, comorbidities, neoplasms, etreme ages. DIPHTHERIA Infectious disease caused by Corynebacterium Diphtariae. It is more common in children under 4 years. It is essential a fast treatment due to cause death by suffocation. Coughing up 2 weeks or more. Fever in the afternoons. Fatigue and weakness Weight loss It manifests with fever Malaise, pain decay. Also appear on gray plates in the pharyn. The diagnosis is confirmed through a laboratory analysis of the nasopharyngeal secretions to find the bacteria. BCG vaccine It offers crusade against leprosy action. Significantly decreases the risk of tuberculosis meningitis and disseminates tuberculosis. Its best use is in the prevention of severe forms of tuberculosis in young children. Age: New-born one dose DPT (diphtheria, pertussis and Tetanus). It is used to include protection against Diphtheria, Pertussis and Tetanus. Vaccination should be postponed if the child has a disease, has had seizures or severe previous allergies. Also if the child has a progressive brain disease. Age: 2, 4 and 6 months. A first booster at 18 months and a second one at five years. There are in total 5 doses. It is used in children under one year the vaccine presentation as that one applicator with HB and HIB vaccines. 4

5 TETANUS Its infectious agent is Clostridium tetany. It mainly affects the neonates by contaminated umbilical stump. The deaths are preventable improving hygiene before, during and after delivery. Also by vaccinating pregnant women with diphtheria tetanus tooid (Td) TOSFERlNA Its causative agent is the Bordetella Pertussis. Transmitted by contact with respiratory contaminated secretions It is more frequent and severe in children from 0 to 4 years, complicated by brain and lung injuries that can lead to death. It can cause death by suffocation. HEPATITIS B Its main form of transmission is: From mother to their child during childbirth. Transfusions, tattoos, transplants, piercings, etc. The vaccination is the best The disease is characteristic because it generates painful contractions of the muscles from the feet to the head and forces the person to adopt a position characterized by having legs etended and the arms bent with fists closed tightly. (A new born child stops nursing by spasms of the muscles chewing. Therefore the complications can lead to death of the child are fractures caused by strength of contractions and breathing problems. Catarrhal period of 1 to 2 weeks of nigh time cough. (It can be confused with mild breathing symptoms). The cough has special features: Quintus productive, incites vomiting and inspiratory stridor. It is diagnosed as growing laboratory samples of nasopharyngeal secretions. Incubation 45 to 160 days. Fever and vomiting before a yellowish skin, eyes and mouth for 1 or 2 weeks. At the end of that period, increases the size of the liver. However, the infection can present without the symptoms mentioned. His appearance HEPATITlS B VACCINE It has a 95% effective in preventing the development of chronic infection and its sequalae. [DAD: New born 2, 4 and 6 months]. 5

6 POLIOMICLITIS It affects the nervous central system. In an acute form causes inflammation, leading to paralysis, muscular atrophy and very often deformity affected members. The source of infection is fecal-oral. HAEMOPHILUS Influenza E TYPE B 10-20% of children under one year old carry this microorganism. 85% of infections are children under 5 years. Overcrowding, nurseries and contact with smokers are risk factors. MEASLES It is spread by breathing by contact with fluids of nose and mouth of an infected person. It is highly contagious. The risk of complications is greater in infants and is aggravated by malnutrition. MUMPS Generalized infection, acute, self-limited and contagious. Located in the salivary glands, predominantly in the parotid. It is transmitted The most common symptoms are fever, headache and pain in the etremities. Others Symptoms less frequent are vomiting and stiff neck. Associated diseases: otitis, sinusitis, pneumonia and epiglottitis, among others. The most common manifestation is the meningo-encephalitis, with a 54% in children between 4 to 24 months. Most common symptoms: Sore throat, cough and runny nose; muscle pain and fever; generalized redness; irritated eyes; frequent bouts that starts in the head and etends down to the body. It lasts from 4 to 7 days. It is characterized by swelling or inflammation of parotid glands, fever, pain, headaches and throat irritation. POLIO VACCINE The oral vaccine is best for protection in the community. It is the choice when there are epidemics. It can be given to all healthy children and their families. AGE: 2, 4 and 6 months. A first booster at 18 months of age and second booster at 5 years. Total: 5 doses. MICROORGANISMS This vaccine is one of the safes, with a minimum risk of adverse reactions. AGE: 2, 4 and 6 months. It is applied in pentavalent presentation that is a single application with vaccines from: DPT and HB. VIRAL VACCINE TRIPE The immunity is achieved after 12 to 15 months of applying the vaccine: For measles, 9 5%. For rubella, 95 to 98%. For mumps varies between 93 and 98% AGE: one year, first dose and booster at 5 years of age. Total: 2 doses. 6

7 RUBELLA Infection manifested with bouts and fever. It is very contagious. It is transmitted through sneezing, coughing or contact with contaminated surfaces. When the virus enters the organism goes to the bloodstream attacking the white cells, transmitting infection in respiratory tract, skin and other organs. 1. Low-grade fever (less than 39 degrees). 2. Headache. 3. Discomfort. 4. Nasal discharge. 5. Conjunctival infection that is, red eyes as if conjunctivitis. 6. Rash. 7. Muscle or joint pain. It can cause malformations in the fetus if it is presented in a pregnant woman. INFLUENZA It is transmitted from person to person by direct contact through secretions produced by coughing or sneezing or contaminated items. Rates of infection are higher in life etremes with higher risks of complications in patients with previous pathologies. YELLOW FEVER Most affected by yellow fever are humans and monkeys. Its transmission The classic flu is characterized by sudden fever, shaking chills, headache, malaise, and myalgia diffuse and dry cough. Later respiratory signs: sore throat, intense nasal congestion and cough. There may be conjunctival pain and infection, abdominal pain, nausea and vomiting. In small children can produce a sepsis, or croup pneumonia. The systemic symptoms and fever lasting 2 to 3 days, rarely more than 5. Fever. Sickness. VACCINE ANTINFLUENZA It aims to protect people with increased risk of complications and permanent contact with the community. It is held annually due to the constant change of the virus causing disease. It cannot be applied to people with severe allergic reaction to eggs. Age: children aged 6 to 2, 3 months. Two doses the first time and one year dose. YELLOW FEVER VACCINE It applies to children to the age of one year old and 7

8 can be through one animal to another by the bite of a mosquito. HEPATITIS A Hepatitis A is a severe liver disease caused by the hepatitis A virus (HAV). HAV is in the stools of the people with hepatitis A. Normally the spread of VUA is through contact and sometimes drinking beverages or eating food containing HAV. ROTAVIRUS (diarrhoea) Rotavirus is the most common cause on children. It is highly contagious and the majority of children get infected by the age of two years old or bellow. (Children can get infected throughout the year; however it is most common to get infected during November to April. The virus generally it acquires when the infant takes their fingers to their mouth before touching something that has being polluted through the faecal Vomiting. Abdominal pain. Jaundice. Bleeding. Hepatitis A causes variety of symptoms range from a disease 'As flu' as more severe problems, such as yellowish eyes (jaundice), severe stomach pain, and diarrhoea perhaps requiring admission to hospital. A person who has hepatitis A can easily transmit the disease to others inside the home. In some cases, hepatitis A can cause death. The child will have liquid diarrhoea, fever, nausea and vomiting. Nausea and fever usually disappear about two days; however, diarrhoea can last up to seven days. Antibiotics are not effective against the rotavirus infection. The biggest concern is to avoid dehydration resulting of the ecess fluid loss during the diarrhoea. A child can be infected more than once, even having had the rotavirus vaccine even though is less severe. people traveling to areas where the disease is frequent. It requires a booster every 20 years. Do not apply to people who are allergic to eggs and must restrict its use in pregnant women, unless risk is very high. HEPATITIS A VACCINE Vaccination is the best way to protect against hepatitis A. People with hepatitis A vaccine have lifetime protection against this virus. AGE: One year old children in a year a single dose. Outbreaks. The rotavirus vaccine is an oral vaccine that prevents diarrhoea and vomiting caused by rotavirus. 98% of children who have been vaccinated are protected against rotavirus diarrhoea and a 74% do not get rotavirus diarrhoea at all. Children vaccinated have much less chances to be hospitalized. Age. 2 and 4 months of age. 8

9 material of an infected person. PNEUMOCOCCUS Pneumococcal disease is not an invasive disease. It presents when the pneumococcus have met pneumococcus previously colonized in the nasopharyn and etends to other sites of the respiratory tract upper and lower. This organism may cause the following types of disease: a) disseminated invasive infections, including bacteremia and meningitis: b) pneumonia and other infections from the lower respiratory tract. c) tract upper respiratory infections including sinusitis and otitis media. Symptoms range from sinusitis, pharyngitis, otitis media, pneumonia and disseminated disease as sepsis. In Bogota the mortality rate old in 2005 was 19.3 X 100,000 children under five; which 50% were viral and 50% were bacterial. Taking into consideration the latter, the percentage of deaths caused by Streptococcus pneumoniae is approimately 30%. STREPTOCOCCUS VACCINE NEUMONIE It is a vaccine that protects children under two years old against seven varieties of bacterium, the most frequent associated with respiratory disease. Generates high effectiveness protection against future eposure to infectious agent. Additionally it has a protector effect decreasing the status of the pneumococcal carrier. Therefore it prevents population not being vaccinated (herd effect. The agreement 3.35 / 2006, 366/07 and 406/09 of the National Council of Welfare and the Ministry of Social Protection, established resource allocation to fund vaccine among children up to 2 years 11 months 29 days at high risk, as children are underweight birth (less than 2,500 grams) and children with serious diseases as sons or daughters of mothers for HIV AIDS, lower cancer treatment, failure renal, congenital failure renal, congenital heart disease, cerebrospinal fluid and chronic pulmonary disease. In addition to, the Health Plan District provided resources. 9

10 ADDITIONAL DISEASES THAT PREVENT COMPLEMENTARY VACCINES The additional vaccines are not free and are not included in the national scheme of pneumococcal vaccine immunization; ecept that it applies to children of high clinical risk according to regulations (agreement 366/2007). In Bogota according to resources by District Health Plan, all children born from October 2008/ will be supplied, independent of the health system affiliation. DISEASE EVENTS VACCINE CHICKENPOX Chickenpo is a common disease during. Generally it is mild but can be serious, especially in infants and Adults. The chickenpo virus can be spread through air, or by contact with the fluid in blisters chickenpo. It is highly contagious and can appear in many cases sites where they are children like kindergarten or schools. Cause a rash, itch, fever, tiredness. May cause severe skin infections, scars, pneumonia, brain damage or death. People who become ill of chickenpo may have years later a painful rash called herpes. VARICELLA VACCINE Most people who have been vaccinated against chickenpo do not contract the illness. But if someone who was vaccinated contracts the illness the effect is very slight: They have fewer spots and less likely to have fever; also the recovery process is faster. Age from 1 year of age. If the child is vaccinated within a year or 2 requires one dose. After 3 years old, there are two doses range of 4 to 8 weeks. Although there is a specific management scheme for each laboratory. For all children and people with poor immunity requires two doses. ADVERSE EFFECTS OF VACCINES Approimately from 5% to 15% of children vaccinated may present fever and at least 5% have a generalized rash lasting 1-3 days, begins a second week (between 1 and 14 days) after vaccination. The reactions are generally mild, well tolerated and without complications. 10

11 VACCINE LOCAL REACTION FEVER IRRITABILITY, DISCOMFORT, NO SPECIFIC SYMPTOMS HIB (Haemophilus 5-15% 2-10% - influenza type B) Hepatitis B Up to 30% in adults up to 5% in children 1-6% - Measles / MMR Up to 10% Up to 5% Up to 5% Oral Antipoliomehtica Any Less than 1% Less than 1% (a) (VOP) IT / DT Up to 10% (b) Up to 10% Up to 25% DPT (c) To 50% To 50% To 60% BCG (d) Common - - FALSE CONTRAINDICACIONCS FOR VACCINATION Although the contraindications to perform the immunization are rare in many, sometimes False contraindications occurs due to ignorance of health staff or beliefs of the population. Frequent false contraindications are: Upper respiratory tract infection with mild fever Diarrhea Allergies, asthma or other atopic manifestations Premature birth Malnutrition Breastfeeding Family history of seizure Antibiotic therapy, low-dose corticosteroids or local action Dermatitis: eczema or localized skin infections Chronic diseases No progressive neurological conditions (cerebral palsy, Down syndrome) History of jaundice at birth BIBLIOGRAPHY Guidelines and technical standards Initial Education -Ministry of Social Integration. Bogota. May