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IMMUNIZATIONS, PART I. Janine Clark Adjo, M.D. 2010 IMMUNIZATION SCHEDULE. DTaP (IM). Diptheria and Tetanus components are bacterial toxoids (modified bacterial toxin that has been made nontoxic but retains ability to stimulate antibody production)

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immunizations part i

IMMUNIZATIONS, PART I

Janine Clark Adjo, M.D.

dtap im
DTaP (IM)
  • Diptheria and Tetanus components are bacterial toxoids (modified bacterial toxin that has been made nontoxic but retains ability to stimulate antibody production)
  • Acellular pertusis- inactivated acellular bacterial components
slide4
DTaP
  • DTaP- for use in children <7
  • DT- for use in children <7, in whom pertussis vaccine is contraindicated
  • Dt- Tetanus toxoid, with 1/3- 1/6 the dose of diptheria toxoid, for use >7
  • DTP- whole cell pertussis no longer marketed in US
dtap indications
DTaPINDICATIONS
  • Routine schedule- 2 mths, 4mths, 6mth, 15-18 mths, followed by Tdap at 11/12 years and then every 10 years
  • Unimmunized pregnant women
  • Tetanus prophylaxis, wound management
dtap true contraindications
DTaPTrue Contraindications
  • Anaphylaxis to vaccine or constituent of vaccine
  • Encephalopathy within 7 days of receiving vaccine, then use DT for remaining doses
dtap precautions
DTaPPRECAUTIONS
  • Moderate or severe illness regardless of fever
  • Seizure within 3 days of administration
  • Persistent crying within 48 hours of prior dose
  • Collapse or hypotonic/hyporesponsive episode within 48 hours of prior dose
  • Neurologic disorders
dtap side effects
DTaPSIDE EFFECTS
  • Erythema, swelling, pain, fever, irritability
  • Anaphylaxis
  • Seizure
  • Hyporesponsive/hypotonic episode
  • Persistent crying
  • Fever >105
dtap different formularies
DTaPDifferent Formularies
  • Daptacel- Sanofi Pasteur
  • Tripedia- Sanofi Pasteur
  • Infanrix- GlaxoSmithKline
  • DT- Sanofi Pasteur
  • Td- Decavac- Sanofi Pasteur
  • Adacel/Boostrix- Tdap- Sanofi Pasteur/GSK
dtap different formularies10
DTaPDifferent formularies
  • TriHIBit- Sanofi Pasteur
  • Pediarix- GSK
  • Pentacel- Sanofi Pasteur
  • Kinrix- GSK
haemophilus influenza type b hib im
Haemophilus Influenza Type BHib (IM)
  • Conjugate vaccine of Hib capsular polysaccharide antigen and a carrier protein to enhance immunogenicity
  • Two types

1) PRP+CRM- given at 2,4,6, and 12-15 months

2) PRP+OMP- given at 2, 4 , 12-15 months

slide12
HiB
  • Routine vaccination has led to a 99% decrease in invasive Hib disease
  • Schedule for unimmunized children

1)7-11 months: 3 doses, 2 months apart

2)12-14 months: 2 doses 2 months apart

3)15-59 months: 1 dose

4) >5 does not require immunization

hib side effects contraindications
HiBSide Effects/Contraindications
  • Local pain, erythema, swelling, fever, irritability
  • Anaphylaxis
hib different formularies
HiBDifferent Formularies
  • HiB, HbOC, conjugate, 4 dose- Hib titer, Wyeth
  • HiB, PRP-OMP, conjugate, 3 dose- pedvaxHiB, Merck
  • HiB, PRPT, conjugate, 4 dose, ActHiB, Sanofi Pasteur
  • DTaP-HiB, TriHiBit, Sanofi Pasteur
  • Hep B/Hib- Comvax, Merck
hepatitis b im
Hepatitis B (IM)
  • Inactivated viral antigen
  • Required for middle school entry in 1998
  • Routine schedule 0-2 months, 1-4 months, 6-18 months
  • Dose 3 cannot be given prior to 6 months
hepatitis b side effects contraindications
Hepatitis BSide Effects/Contraindications
  • Pain at site, fever
  • Anaphylaxis to vaccine or Baker’s yeast
hepatitis b different formularies
Hepatitis BDifferent Formularies
  • Hepatitis B, Recombivax, Merck
  • Hepatitis B, Energix- B, GSK
  • Hep B/Hib, Comvax, Merck
polio sc or im
POLIO (SC or IM)
  • IPV- trivalent vaccine of inactivated polio virus types 1, 2, and 3, grown in human diploid cells
  • Routine schedule- 2 mths, 4 mths, 6 mths, 4-6 years
polio side effects contraindications
POLIOSide effects/Contraindications
  • Pain, swelling and erythema at site
  • Anaphylaxis to vaccine, polymyxin B, neomycin, or streptomycin
polio different formularies
POLIODifferent Formularies
  • IPV, IPOL, Sanofi Pasteur
  • Pentacel, Sanofi Pasteur
  • Pediarix, GSK
pneumococcal vaccine im
Pneumococcal Vaccine (IM)
  • Prevnar 13- Pneumococcal Conjugate vaccine comprised of 13 capsular polysaccharides of Streptococcus pneumoniae
  • Routine schedule 2mths, 4 mths, 6mths, 12-15 mths
prevnar side effects contraindications
PrevnarSide effects/Contraindications
  • Pain, swelling, and erythema at site of injection
  • Fever, irritability, decreased appetite
  • Anaphylaxis to vaccine
pneumococcal vaacine different formularies
Pneumococcal vaacine Different Formularies
  • Pneumovax (IM or SC)- pneumococcal polysaccharide vaccine, 23 valent, Merck
  • Ages 2 and up
  • Immunosuppressed patients