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Childhood Immunization. Lucy Dirie. Objectives. Types of immunity Immunization schedule Types of vaccine Contraindications. Curriculum statements. Statement 5: Healthy people; promoting health and preventing disease Statement 8: Care of children and young people.

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Presentation Transcript
objectives
Objectives
  • Types of immunity
  • Immunization schedule
  • Types of vaccine
  • Contraindications
curriculum statements
Curriculum statements
  • Statement 5: Healthy people; promoting health and preventing disease
  • Statement 8: Care of children and young people
slide4
“It is every child’s right to be protected against infectious diseases. No child should be denied immunization without serious thought as to the consequences, both for the individual child and for the community”

Department of Health Immunization against infectious disease, 1996

immunity
Immunity
  • Active
    • Inactivated/attenuated live organisms or products
    • Induces cell-mediated immunity & serum abs
    • Long lasting
  • Passive
    • Transfer of abs /Injection of human Ig
    • Immediate protection
    • Lasts few weeks
herd immunity
Herd immunity
  • Vaccination of specific proportion of population confers protection to the unvaccinated
  • ↓likelihood of coming into contact with infected individual
slide10

When to immunise Diseases protected against Vaccine given

Two months Diphtheria, tetanus, pertussis, polio DTaP/IPV/Hib Haemophilus influenzae type b (Hib) +PCV Pneumococcal infection

Three months Diphtheria, tetanus, pertussis, polio DTaP/IPV/HibHaemophilus influenzae type b (Hib) +Men C Meningitis C

Four months Diphtheria, tetanus, pertussis, polio DTaP/IPV/HibHaemophilus influenzae type b (Hib) + MenC + PCV Meningitis C + Pneumococcal infection

slide11
Around 12 monthsHaemophilus influenza type b Hib/MenC Meningitis C

Around 13 months Measles, mumps & rubella MMR+ PCV

Pneumococcal infection

Three years & four Diphtheria, tetanus, pertussis & polio DTaP/IPV

Months/soon Measles, mumps and rubella dTaP/IPV after +MMR

Girls aged 12 to 13 years Cervical cancer types 16,18 HPV

13to 18years old Diphtheria, tetanus, polio Td/IPV

non routine
Non routine

At birth Tuberculosis BCG (to babies who aremore likely to come intocontact with TB thanthe general population)

At birth Hepatitis B Hep B (to babies whose mothers

are hepatitis B positive)

premature babies
Premature babies
  • Corrected age?
slide14
No
  • At greater risk of infection, should be immunized according to the recommended schedule from 2 months after birth regardless of gestation at birth.
slide17
Live attenuated organism
    • MMR, BCG
  • Inactivated organism
    • Pertussis
    • Inactivated poliomyelitis virus
  • Inactivated toxin
    • Tetanus, Diptheria
  • Conjugated
    • Hib, MenC
contraindications to vaccination
Contraindications to vaccination
  • None
  • Egg allergy
  • Acute febrile illness
  • Local erythema post previous dose
contraindications to vaccination1
Contraindications to vaccination
  • None
  • Egg allergy
  • Acute febrile illness
  • Local erythema post previous dose
contraindications
Contraindications
  • Acute febrile illness
  • Evolving neurological condition
  • Severe local reaction to preceding dose
  • Generalized reaction to preceding dose
contraindications to live vaccines
Contraindications to live vaccines
  • Immunocompromised
    • High-dose steroids for >1/52
    • Haematological malignancy
    • Radio/chemotherapy in last 6/12
    • Another immunodeficiency syndrome
  • <3/52 after another live vaccine
  • With immunoglobulin
slide23
Important to be familiar with immunization schedule
  • Few true contraindications
  • Easy marks in AKT!!
references
References
  • Simon, C., Everitt, H., Kendrick, T. Oxford Handbook of General Practice. 2nd edition Oxford: Oxford Univeristy Press 2006
  • The Green Book www.dh.gov.uk/greenbook
  • NHS Immunisation Information www.immunisation.nhs.uk
  • Mehrani, T. Childhood immunization. Innovait (Feb 2009) 2: p86-90
  • Dawson, H., Trigell, A. EMQs for the MRCGP paper 2. Master Pass 2005