Communicable Diseases & Vaccinations Islamic University Nursing college

Type of vaccinations Live attenuated vaccine (weak pathogen). Inactivated vaccine (dead pathogen). Toxoins (toxin of the pathogen).

Live attenuated vaccine (weak pathogen). Bacterial Live Attenuated Vaccine. BCG (Bacillus Calmette & Guerin). Viral Live Attenuated Vaccine. OPV (Oral Polio Vaccine or TOPV (Trivalent Oral Polio Vaccine). Measles. MMR (Measles, Mumps & Rubella).

Inactivated vaccine (dead pathogen). Dead Bacterial Vaccine. Pertussis vaccine. Dead Viral Vaccine. Salk vaccine.

Toxoid Vaccine Bacterial Toxoid Vaccines: Diphtheria. Tetanus. Viral Toxoid Vaccine. No vaccine for children.

Schedule of immunizations BCG Vaccine: live attenuated Bacterial vaccine . Giving at in the first week of life, preferred in the same day of delivery , only one dose. Dose: 0.05 ml using special syringe and special well trained nurse. Site of vaccine: upper part of the left shoulder.

Schedule of immunizations Hepatitis vaccine: manufactured by genetic engineering with shape like the true virus and contains the genetic material. 1st dose at birth with BCG vaccine. 2nd dose at 2 month mixed with penta vaccine. 3rd dose at 4 month mixed with penta vaccine. 4th dose at 6 month mixed with penta vaccine. Dose: o.5 ml. Site of injection: IM injection in the femoral muscle

Schedule of immunizations Salk vaccine (injectable polio vaccine IPV) killed viral vaccine. 1st dose at one month. 2nd dose at two months. Dose: 0.5 ml. Site of injection: in the forearme.

Schedule of immunizations Penta vaccine: Combination of five type of vaccines (diphtheria, Pertussis, tetanus, Haemophilus influenza type b and hepatitis). Combination of toxin, killed & conjugated polysaccharide 1st dose at 2 months of age. 2nd dose at 4 months of age. 3rd dose at 6 months of age. Dose 0.5 ml Site of injection: IM in the thigh in the outer upper part

Schedule of immunizations Polio Vaccine: (oral polio vaccine or TOPV trivalent oral polio vaccine.) Live attenuated viruses vaccine 1st dose at 2 months. 2nd dose at 4 months. 3rd dose at 6 months. 4th dose at 18 months. Dose: 2 drops Site: oral Given with Penta vaccines Given with DPT vaccine

Schedule of immunizations MMR Vaccine (Measles, Mumps & Rubella) Live attenuated viral vaccine. 1st dose at one year. 2nd dose at 18 months. Dose 0.5. Site of injection: Subcutaneous in the forearm.

Schedule of immunizations DPT or DTP or DTaP vaccines: (diphtheria, Pertussis, tetanus). Diphtheria and Tetanus are toxins, Pertussis is killed vaccine. Can be used if penta vaccine not available. Now used only one dose Used at 18 months of age as booster dose to the DPT in the penta vaccine/ Dose:0.5 ml Site: IM in the thigh in the outer upper part.

General recommendations on immunization General rules : The more similar a vaccine is to the natural disease, the better is the immune response to the vaccine. - Inactivated vaccines generally are not affected by circulating antibody to the antigen.

General recommendations on immunization Live attenuated vaccines may be affected by circulating antibody to the antigen . - Live injected vaccines that are not administered simultaneously should be separated by at least 4 weeks. - Live attenuated vaccines generally produce long lasting immunity with a single dose.

General recommendations on immunization Inactivated vaccines require multiple doses and may require periodic boosting to maintain immunity. Increasing the interval between doses of multi- dose vaccine does not diminish the effectiveness of the vaccine. - Decreasing the interval between doses of a multi- dose vaccine may interfere with antibody response and protection.

- Vaccine doses should not be given at intervals less than the minimum intervals or earlier than the minimum age. - The course of immunizations should be completed with the remaining doses administered at the recommended intervals. Young children should have completed their primary course of immunization during the second year of life.

Antibody and live vaccines : - When vaccine is given first wait 2 weeks before giving antibody. - When antibody is given first wait more than 3 months before giving the vaccine.

- In the case of B.C.G. the multiplication takes place locally in the skin. - Incase of oral polio vaccine multiplication takes place in the intestinal mucosa and is unaffected by residual maternal antibody. - Whereas with measles rubella and mumps vaccines the viruses multiply in the internal organs and are exposed to the neutralizing effect of maternal antibody.

- Patients with malignant disease as, Leukaemia, Hodgkin's disease, lymphomas etc.. should not receive live virus vaccines whilst on treatment. Live virus vaccines can be administered to these patients provided that at least 6 months has elapsed since the cessation of treatment . - Patients on medium to high corticosteroid therapy should not receive live virus vaccines (20 mg. Or more per day) or 2 mg per kg. Per day or more, live vaccines may be given when at last 3 months have elapsed since the cessation of steroid therapy.

- Aerosolized steroids such as inhaler for asthma , alternate day rapidly tapering and short ( less than 14 days ) high dose schedules topical formulations are not contraindicated to vaccination with live vaccine . - Live attenuated vaccines are contraindicated at any stage in pregnancy.

- Tetanus vaccine is strongly recommended in pregnancy to prevent neonatal tetanus. - Immunization of adults against poliomyelitis In primary immunization of adults against poliomyelitis it is preferred to use IVP and should be given as three doses at monthly intervals with a fourth dose 6-12 months later.

Low birth Weight infants or premature babies:- Should be immunized in the same way as normal weight full term infants except in Hep .B. vaccine if birth weight was less than 2kg the infant may not benefit from the vaccine and there is decreased seroconversion rates so by one month chronological age all premature infants regardless of initial birth weight or gestational age are as likely to respond as a adequately as older and larger infants.

DPT: The time interval between D P T 3 and the booster dose (D P T 4) should not be less than 6 months . There are few true contraindication and precaution to pertussis vaccine :- - Severe allergy to a vaccine component or severe allergic reaction following a prior dose of a vaccine. Encephalopathy within 7 days of pertussis vaccination.

DPT - Temperature more than 40 c. - Collapse (shock like state). - Persistent inconsolable crying lasting 3 or more hours occurring within 48 hours of a dose. - Seizures with or without fever occurring within 3 days of a dose.

O P V:- In case of diarrhea (change in consistency of stool and –or frequency) give O P V and ask mother to come back after 4weeks and repeat the dose of O P V.

- MMR can be given at any time in the 2nd year of life or after wards but the immune response is better at 15 months of age. - MMR is strongly recommended for all children at any age if they have no clear –cut history of having had measles.

Vaccination of pregnant women If the pregnant women receive T.T at preparatory school she will not receive vaccine. If she not receive, one dose only. School vaccines: dt + polio drops vaccine at registration in the 1st class. Rubllela vaccine for female student at 6th class. T.T for 9th class for both male and female students.

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