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Childhood Immunization & Catch Up Immunization-2
Childhood Immunization & Catch Up Immunization-2
Up Immunization
Li Faung
Nuradilah
Nurul Hassanah
Definition
• Immunization : An attempt to replace the anticipated
natural primary contact between the human body
and a hostile organism, with a safer artificial
contact, so that any subsequent natural contact
takes place in a state of heightened immunity.
Definition
• Antigen : Substances that bind to specific lymphocyte
receptors, whether or not they stimulate immune
responses.
In a high school of 1,000 students, none has ever had measles. All but five of the
students have had two doses of measles vaccine, and so are fully immunized. The entire
student body is exposed to measles, and every susceptible student becomes infected.
The five unvaccinated students will be infected, of course. But of the 995 who have been
vaccinated, we would expect several not to respond to the vaccine. The efficacy rate for
two doses of measles vaccine can be as high as >99%. In this class, seven students do
not respond, and they, too, become infected. Therefore seven of 12, or about 58%, of the
cases occur in students who have been fully vaccinated.
5. Vaccine-preventable diseases have been
virtually eliminated from my country, so there is
no need for my child to be vaccinated
6. Natural Immunity Is Better Than Vaccine-
acquired Immunity
• The risks of natural infection outweigh the risks of
immunization for every recommended vaccine.
• Wild measles infection causes encephalitis for one in
1,000 infected individuals, and, for every 1,000 reported
measles cases, two individuals die.
• The combination MMR vaccine, however, results in
encephalitis or a severe allergic reaction only one in
every million vaccinated individuals, while preventing
measles infection.
• Hib (Haemophilus Influenzae type b) and tetanus
vaccines actually provide more effective immunity than
natural infection.
7. “Overloaded Immune System”
Misconception
• studies have repeatedly demonstrated that the
recommended vaccines are no more likely to cause
adverse effects when given in combination than
when they are administered separately.
• Some parents decide to “spread out” the time
period during which their children receive
vaccinations -> delaying vaccinations puts children
at risk of contracting preventable diseases.
IMMUNISATION SCHEDULE
IMMUNISATIONS
CONTRAINDICATIONS
Contraindications:
A) Absolute Contraindications
A) For any vaccine
B) Active vaccine
C) Killed vaccine
B) Relative contraindications
C) Not Contraindications
a) Absolute contraindications:
For any vaccine severe anaphylaxis reactions to previous dose of the vaccine or to a component of
the vaccine.
Live vaccine Immunosuppressed children
malignancy, irradiation, leukaemia, lymphoma, primary immunodeficiency
syndromes (but NOT asymptomatic HIV).
On High dose steroids, i.e. Prednisolone ≥ 2 mg/kg/day for > 7 days or low dose
systemic > 2 weeks - delay vaccination for 3 months.
Pregnancy
Killed vaccine SEVERE local (induration involving > 2/3 of the limbs) or severe generalised
reactions in the previous dose.
b) Relative Contraindication
avoid a vaccine within 2 weeks of elective surgery
c) Not Contraindications
Mild illness without fever
Asthma, eczema, hay fever, impetigo, heat rash
Treatment with antibiotics or locally acting steroids.
Child’s mother is pregnant.
Breastfed child
Neonatal jaundice.
Underweight or malnourished.
Over the recommended age.
Past history of pertussis, measles or rubella (unless confirmed medically)
Non progressive, stable neurological conditions like cerebral palsy, Down syndrome,
History of heart disease, acquired or congenital.
Prematurity
Vaccines, route of administration,
indications, contraindications, side
effects
Vaccin Route of Indication/Dose Contraindication Side effects Notes
e administrati s
on
BCG Intradermal To be given at Not to be given BCG Local reaction: a papule at
birth and to be to symptomatic adenitis vaccination site may
repeated if no HIV infected occur in 2-6 weeks. This
scar is present children grows and flattens with
scaling and crusting.
Occasionally a
discharging ulcer may
occur. This heals leaving a
scar of at least 4mm in
successful vaccination
Vaccin Route of Indication/dose contraindication Side effects notes
e administrati
on
Hepatit Intramuscul All infants, Severe Local reactions. For infants of
is B ar including those hypersensitivity to Fever and flu HBsAg positive
born to HBsAg aluminium. The like symptoms mother, give with
positive mothers. vaccine is also no in first 48 hours. Hep B
All health care indicated for HBV Rarely, immunoglobulin
personnel. carrier or erythema
immuned patient multiforme or
(i.e HBsAg or Ab urticaria
positive)
Vaccine Route of Indication/dose contraindication Side effects notes
administr
ation
Diphtheria intramusc All infants should Severe Swelling, redness and -
, Tetanus ( ular receive 5 doses hypersensitivity pain. A small painless
DT) including booster to aluminium and nodule may develop at
doses at 18 months thiomersal. injection site. Transient
and standard 1 fever, headaches, malaise,
rarely anaphylaxis.
Neurological reactions rare