Sanitary post high school Sf.

Vasile cel Mare

Sientific Session MaY 2014
Take care of todays child!for the health of to"orro#s
ad$lt
%o# i"portant is the child
&accination'
Authors: Cristina Borcan
Roxana Fedea
Mihaela erban
Coordonator teachers : Farm. Mariana Dinu
Dr. Mihaela Vasile
Vaccines
Vaccines are (iological
preparations #ith antigenic
properties! #ich triggers the
occ$rrence of i""$ne response
)anti(odies* in organis"e
s$("ited to the &accination.
Vaccination represent an acti&
i""$ni+ation "ethod! profilactic
against so"e disease!(y
inoc$lation of a &accin.
,esearches and res$lts in the area of "aking &accines
characteri+ed the concerns of science people in the field of
"edicine! especially (iology in the last cent$ries. The Middle age
#as the period in #hich the h$"anity #as faced #ith "any
epide"ics and pande"ics . -reat res$lts #ere o(tained in the 1.
th

cent$ries /

In 1885 Louis Past performed the first rabies vaccine;

In 1896 Wright experiments the vaccine against tphoid fever;

In 188! "ictor #abe$ e%aborates the techni&ue of mi%ding do'n the fix rabies
virus(b heat;

In 189) *aff+ine prepares the first vaccine against tubercu%osis baci%%us descovered
b ,och -obert.

In 1888 in -om/nia is estab%ised the 0ntirabic Institute from #ucharest( -om/nia

being the third countr in the 'or%d that sistematica%% practices rabies vaccine.

0fter a fe' decades the antivira% vaccines are discovered( so1

In 192) 3e%%ard and Laigret prepare a vaccin for e%%o' fever;

In 195! 3abin administered for the first time the %ive reduced po%io vaccine.ora%%.

In 1968 is prepared the vaccine against rube%a;

In 19!2 is prepared the vaccine against chi+enpox;

In 19!6 'as used the vaccine against hepatittis #;

0fter 1984 'ere studied and comp%eted the preparation method of the vaccine
against vira% hepatittis 0 and #;
Vaccines can be administered in different ways:

oral: solutions!"ills!ca"sules

in nasal ca#ity: inhalations

"arenteral :in$ections%intradermal !subcutaneous!intramuscular&

Methods of obtainin' the #accines:

#accines "re"ared from (illed a'ents:bacterial or #iral

"articles are (illed by chemical methods%with
"henol!formaldehyde& or "sysical methods%cold!heat&

#accines "re"ared from attenuated li#e a'ents:are reali)ed by

'rowin' the microor'anisms or unnatural hosts or by other
ways
Tipes of &accines/
Antiviral vaccines: are divided in 2 groups1

a. li&e red$ced &iral &accines 5po%io( rube%%a(

meas%es6;

(. co"pletelly inacti&ated anti&iral

&accines5f%u(po%io6

c. anti&iral &accines inacti&e to the

antigenic fraction 5hepatitis # vaccine6.
Antibacterial vaccines 'hich are1

a. li&e red$ced anti(acterial &accines;

(. dead anti(acterial &accines5cho%era(

tphod(
tphoid fever6;

c. anato0ic anti(acterial &accines 5diphteria(

tetanus6;

d. anti(acterial polisaccharide &accines

5pneumoccocus6.
Mixed vaccine or polyvalent. Is a mix of more
vaccines ( for examp%e 78 5antitetanus(
antidiphteria6.
Autovaccines. Prepares 'ith po%va%ent germs
from the see+ person itse%f.
Vaccinations #ith general
reco"andation
0re vaccinations contained in the
nationa% vaccination programs of each
countr( 'ich are recommanded for the
'ho%e popu%ation of that countr%and
and it9s administered for free.
We 'i%% refer in this topic( to the
vaccinations recommanded b the
nationa% scheme 'hich is performed in
-om/nia.
12- V322453T465

*ecesary for the tuberculosis "rimary

"rofilaxy %+BC&

,t-s made with #accine "re"ared from

.uerin Calmette Baccil%BC.&!li#e
Mycobacterium bo#is ! reduced.

+he effciency of the #accine is

contro#ersed.

+he rate of "rotection in different

countries! #aries from / to 0/2!
de"endin' of the disease "re#alence and
the effecti#eness of the #accination.

It9s administered in a sing%e dose( intraderma%%( in

de%toid region.

:irst dose in ne'borns 'ith the birth 'eight

bigger than )544 grams bet'een the age of );!
das and ) months.

3econd vaccination ; in 8
th
grade 5at the age 12;
1<6 on% if the I7- testing for tubercu%osis is
negativ 5under 9 mm6.

8he in=ection is ver painfu%.

8he postvaccination reaction can be prett

unp%easant( and the time to hea% of %esion can
reach up to 6 month( in case of u%ceration and
abscess.

8he intensit of the reaction after vaccination

increases 'ith age( therefore in the %ast ears the
vaccination from the 8
th
to 1)
th
grade 'as given
up.
7iTe8er Vaccination
)against diphteria! tetan$s and pert$ssis*

,t-s recommanded at a'e 3! 4! 5

monts! then

Ra""el 6 at the a'e of 63 months

and

Ra""el 3 between 7/75 months.

8erocon#ersion is hi'h after

minimum 7 doses of #accine! and
the ris( of disease decreases with
959:2 between 6 and 4 years.

Deli#ered #accine in side of

immuni)ation na;ional "ro'ram
is a tri#accin which contain
"lurified
di"hteria anatoxin!"urified
tetanus anatoxin and inacti#ated
Bortella "ertusis %celular "ertusis
#accine&.

8ei)ures ocuur at about

<:=6//./// celular "ertusis
#accine doses! ris( bein' hi'her
at children with family history of
sei)ures.

Acute ence"halo"athy is
si'naled at 5!0 = 6 milion doses of
celular "ertusis #accine! with
maximal ris( of death in the first
: days.
7T &accination
)against diphteria and tetan$s*

It9s done 'ith biva%ent vaccine 'hich contain

purified diphteria anatoxin and purified tetanus
anatoxin.

78 vaccine is administered either as rappe%

dose at big chi%d( after 7i8ePer prime
vaccination from the ear% ears of %ife( or as
prime vaccination to big chi%dren and
unvaccinated adu%ts and 'ith uncertain
vaccination histor.

:or the rappe%s at adu%ts previous% prper%

vaccinated 78 vaccines are used('hich contain
a &uantit of diphteria anatoxin %o'er then 78
vaccine(enough for mentaining immunit
ac&uired b previous vaccination.

8o the big chi%d previous% proper% immuni>ed(

is given one 78 dose in 1
st
grade 5at age 6;!
ears6 and in 8
th
5at age 12;1< ears6.
8o pregnant 'omen( is administered a dose of
78 vaccine in the 8
th
month of pregnanc.
"accination is done in order to ensure one
measure of materna% antibodies to confer
passive immunit for the ne'born and sma%%
infant( ti%% the age in 'hich can be vaccinated
5) months6.
It9s not necesar revaccination in further
pregnancies( but according to the adu%t
scheme 5 d8 rappe%s ever14 ears6.
3ntihepatitis 1 &accine

In -om/nia ?7? 0t%anta considers

that the infection 'ith hepatitis # virus
is practica% endemic( being present in
a%% groups of age.

@an studies have demonstrated that

anti;*# vaccine( administered to
chi%dren 'ith positive 0g*#s mothers(
has an effectiveness of 6);9)A
depending on the dose( dosing interva%
( vaccine tpe and state of materna%
antigen.

8he effectiveness of immuni>ation

using combined vaccine 'ith anti;*#
immunog%obu%in is higher then the one
from the simp%e vaccine.

8he effectiveness of vaccine is +ept for

a period 'hich varies bet'een 2 and
11;1) ears( despite of antibodies
%eve% decreasing.

In -om/nia( anti;*# vaccine is

administered at ) hours after birth( at )
and 6 month( fo%%o'ed b one rappe% at
the age of 9 52th grade6
,6, &accination
)against "easles!"$"ps and
r$(ella*

Was introdused in immuni>ation scheme from

-om/nia since )44< (rep%acing the simp%e
meas%es vaccination.

It9s administered one first dose at age of 1);15

months( fo%%o'ed b a rappe% at age of 6;! 51
st

grade6.

8here are used trivaccines 'ith %ive reduced

viruses.

0 sing%e dose of vaccine is ver effective against

meas%es(mumps and rube%%a( its use %eading to
significant decrease of this 2 disease incidence.

Immuni>ation fai%s appear in approximate% 5A of

the cases('hen the prime vaccination is being
administered after the age of 15 months.

-evaccination prevents the appearance of

meas%es( even to those 'hom the seroconversion
'as not done at the first vaccination.

3ecundar effects are in genera% mi%d(at hea%th

persons.

-are% can appear thromboctopenia( hives or

anaph%axis 54(1;5 per 144.444 in cases6.

0t chi%dren 'ith compromise immunitar sistem

5immunodeficienc sindroms6( using vaccines 'ith
%ive reduced viruses presents a ris+ of death
caused b vira% infection 'ith the virus from the
vaccine.
8olio &accination

+he first #accination is done at the a'e of 3!4!5

months ! followed by ra""el 6 at the a'e of 63
months and the second ra""el at a'e of 9 %7
th

'rade&.

For the national "ro'ram of immuni)ation it-s

used VPO %oral "olio #accine!with li#e reduced
"olio #iruses &! V>?+ mixture.

+hree doses of V>? offers a "rotection of 9<

6//2 a'ainst the three ty"es of "olio #irus.

Because the #accination it-s administered orally!

it-s not administered to children with im"ortant
di'esti#e disorders %diarrhea&! then after their
remission.
,isks associated #ith orally
ad"inistered polio &accine #ith
li&e red$ced &ir$ses

8he ris+ of post immuni>ation po%io para%sis

after administration of "PB is estimated at
1C)(5 mi%ion doses 5aproximate% 15
casesCear in -om/nia6.

#eside the after immuni>ation po%io para%tic (

"PB can be responsab%e even for the
apparience of Dui%%ain#arrE sndrome.

In persons 'ith immunodeficiencies 5for

examp%e 0I736( the virus from "PB can cause
invasive infections and death.

"PB presents a ris+ of environment

contamination 'ith po%iovirus(
because of excretion in environment
and circu%ation of po%ivirus derived
from the vaccine.

8here 'ere cases reported of po%io

'ith po%iovirus derived from the
vaccine in immuni>ed sub=ects.

#ecause of that chi%dren recent%

vaccinated 'ith "PB must be
contained in separate rooms in case
of hospita% admision.
3ct$al trends in polio
&accination

In deve%oped countries ora%% vaccination 'ith

"PB 'hich contain reduced %ive viruses 'as
rep%aced b in=ectab%e vaccination 'ith VPI 'hich
contain inactivated po%io viruses( 'ith simi%ar
immunogenicit and minima% side effects.

In case of "PI( administered b in=ection( it9s

avoided digestive passage of viruses from vaccine
and their excretion in environment b feces. In this
'a it9s decrease the ris+ of environment
contamination 'ith po%ioviruses derived from
vaccine( %imiting transmition of 'i%d po%ioviruses
partia%% inactivated 5derived from "PB6 to
susceptib%e persons.

Wor%d 'ide there is a trend to rep%ace "PB vaccine

'ith "PI( in the nationa% scheme.

In -om/nia( "PI is being used in naFiona% program

of immuni>ation on% for instituFiona%i>ed chi%dren
5from maternit( hospita%s and foster care6.

:or chi%dren raised in fami% there is the posibi%it to

choose for variants vaccines 'ith "PI component.

8hese vaccines can be obtain('ith mone(from

pharmac.

It9s administered according to the nationa% vaccine

ca%endar(after the same scheme as "PB.

"accination b in=ection 'ith VPI it9s administered

intramuscu%ar or subcutaneous.

It9s not administered if there is an a%ergic reaction the

active substance( excipients( neomcin(
streptomcin( po%mxin #( or if there is a
fever(infectious disease or evo%utive chronic disease

0s adverse reactions can appear %oca% reactions at

the administration p%ace1 pain( redness( edema 'hich
can appear in the first <8 hours after vaccination and
can persist up to 1;) das.

Incidence and severit of %oca% reactions can be

inf%uenced b the p%ace('a of administration and the
number of previous administrations.

@a appear as sistematic reaction moderate fever.

141946-,3:4;