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Chapter 68

Childhood Immunization

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Immunizations

Purpose is to protect against infectious diseases

Most effective method is to create a highly immune population

Universal vaccine is the goal Vaccines carry risk, but risks of disease are

much greater

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General Considerations

Definitions Vaccine Killed vaccines vs. live vaccines Toxoid Vaccination Immunization; active vs. passive Specific immune globulins

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General Considerations

Reporting vaccine-preventable disease Determine whether an outbreak is occurring Evaluate prevention and control strategies Evaluate the impact of national immunization

policies and practices

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General Considerations

Immunization records National Childhood Vaccine Act of 1986 requires a

permanent record of each mandated vaccination• Date of vaccination• Route and site of vaccination• Vaccine type, manufacturer, lot number, expiration date• Name, address, title of person administering the vaccine

Reason for record• To ensure appropriate vaccination• To avoid overvaccination

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General Considerations

Adverse effects of immunization Immunocompromised children are at special risk

from live vaccines• Congenital immunodeficiency• HIV infection• Leukemia• Lymphoma• Generalized malignancy• Therapy with radiation• Cytotoxic anticancer drugs• High-dose glucocorticoids

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Target Diseases

Measles Mumps Rubella Diphtheria Tetanus (lockjaw) Pertussis (whooping cough) Poliomyelitis (polio or infantile paralysis)

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Target Diseases

Haemophilus influenzae type b Varicella (chickenpox) Hepatitis B Hepatitis A Pneumococcal infection Meningococcal infection Influenza Rotavirus gastroenteritis Genital human papillomavirus infection

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Specific Vaccines and Toxoids

Measles, mumps, and rubella virus vaccine (MMR)

Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP)

Poliovirus vaccine H. influenzae type b conjugate vaccine

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Specific Vaccines and Toxoids

Varicella virus vaccine Hepatitis B vaccine Hepatitis A vaccine Pneumococcal conjugate vaccine Meningococcal conjugate vaccine Influenza vaccine Rotavirus vaccine Human papillomavirus vaccine