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Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle PEDIATRIC IMMUNIZATION

Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

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Page 1: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo,

Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

PEDIATRIC IMMUNIZATION

Page 2: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Immunization◦Deliberate provocation of an adaptive immune response by introducing antigen into the body

Vaccination◦Deliberate induction of an adaptive immune response to a pathogen by injecting a vaccine, a killed or attenuated form of the pathogen

Page 3: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Immunity

Active Passive

Injection of an antigen (vaccine)

Injection of preformed antibiotics

(gammaglobulins)

Protection produced by the person’s own

immune system

Protection transferred from another person or

animal

Usually permanent Temporary protection that wanes with time

Page 4: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION

Contraindications- serious allergic reaction (anaphylaxis) after a previous vaccine dose- serious allergic reaction to a vaccine component

Precautions - moderate or severe acute illness with or without fever

Page 5: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION

Contraindications to ALL LIVE VACCINES:1. immunocompromised patients2. patients given immunoglobulin and blood

products for the past 3 months3. pregnancy and possibility of getting

pregnant within 3 months4. household contacts of immunocompromised

patients* (OPV)

Page 6: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION

Simultaneous administration of Multiple Vaccines:

No contraindications for multiple vaccines routinely recommended

Immune response to one vaccine generally does not interfere with other vaccines

There should be an interval of 28 days between administration of live vaccines

Interchangeability of vaccine products is allowed for primary and booster doses

Page 7: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

ACTIVE IMMUNIZATIONACTIVE IMMUNIZATION

Lapsed immunizations

Intervals between vaccine doses that exceed those that are recommended do not adversely affect the immunologic response, provided immunization series is completed

Page 8: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

EXPANDED PROGRAM ON IMMUNIZATIONEXPANDED PROGRAM ON IMMUNIZATIONVACCINE MINIMUM

AGEDOSE (NO)

ROUTE AND SITE

OF ADMINIST-

RATION

MINIMUM INTERVAL BETWEEN

DOSES

REMARKS

BCG 1 Birth; or any time after birth

0.05 ml for NB; 0.1 ml for infants (1)

Intradermal; deltoid R arm

Vaccine destroyed by heat & sunlight

DTP 6 weeks 0.5 ml (3) IM; upper outer portion of thigh

4 weeks Vaccine damaged by heat, freezing

POLIO 6 weeks 2 drops (3) PO; mouth 4 weeks Vaccine easily damaged by heat

Page 9: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

EXPANDED PROGRAM ON IMMUNIZATIONEXPANDED PROGRAM ON IMMUNIZATION

VACCINE MINIMUM AGE

DOSE (NO) ROUTE AND SITE OF

ADMINIST-RATION

MINIMUM INTERVA

L BETWEEN DOSES

REMARKS

HEP B 6 weeks or at birth

Follow manufacturer’s instructions 0.5 ml (3) - 0,1 & 6 months

IM; anterolateral aspect of thigh

Vaccine destroyed by heat or freezing

MEASLES 9 months 0.5 ml (1) SC; outer part of the thigh

Vaccine easily damaged by heat

Page 10: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

EXPANDED PROGRAM ON IMMUNIZATIONEXPANDED PROGRAM ON IMMUNIZATION

VACCINE

MINIMUM AGE

DOSE (NO) ROUTE AND SITE

OF ADMINIST-

RATION

MINIMUM INTERVAL BETWEEN

DOSES

REMARKS

BCG 2 At school entry, whether or not child has BCG scar

0.1 ml (1) ID; L deltoid Vaccine destroyed by heat or sunlight

TETANUS TOXOID

Women of childbrearing age

0.5 ml (5) IM; deltoid region

TT1 at 1st contact

TT2 at least 4 weeks after TT1

TT3 at least 6 wks after TT2

TT4 at least 1 year after

TT5 at least 1 year after

Vaccine easily damaged by heat & sunlight; given for those not given primary immunization in infancy and childhood

Page 11: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle
Page 12: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle
Page 13: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Childhood ImmunizationChildhood ImmunizationBCG Vaccine

- live attenuated bacterial vaccine- at birth or anytime after birth- booster dose given at school entry

Contraindications: immunodeficiency, progressive dermatoses

Reaction: abscess at the site; axillary lymphadenopathy

Page 14: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

BCG Vaccine

Usual reactions induration: 2 –

4 wks pustule

formation: 5 – 7 wks

scar formation: 2 – 3 months

Accelerated Reactions:

induration: 2-3 days

pustule formation: 5-7 days

scar formation: 2-3 weeks

Page 15: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Hepatitis B vaccine- inactivated viral antigen- 0, 1 & 6 months- children and adolescents who have not been vaccinated with Hep B may begin series during any visit

Contraindication: anaphylactic reaction to previous dose

Reactions: pain and swelling at site, fever

Page 16: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Diphtheria, Tetanus & Pertussis

Usual Side Effects:◦ fever up to 72 hours (low to moderate

grade)◦ restlessness and irritability◦ local reaction: pain and swelling at

the site of injection

Contraindications:◦ encephalopathy within 7 days of

administration of previous dose◦ anaphylactic shock after a previous

dose◦ progressive neurologic disorders

Page 17: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Poliomyelitis Vaccine1. Oral Polio Vaccine (OPV)

- live attenuated (Sabin)Absolute contraindications:

1.altered immune states, high dose steroids, radiation, HIV/AIDS

2.pregnancy3.household contacts of

immunocompromised patientsRelative contraindications: vomiting and

diarrheaAdverse Reaction: paralysis

2. Inactivated or Killed Polio Vaccine (IPV)- recommended to decrease the incidence

of vaccine-associated paralytic polio (VAPP)

Page 18: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Measles Vaccine

- live attenuated - given at 9 months but may be given as early as 6 months during epidemics

Adverse reactions:1. fever with or without rashes (5-12 days

after administration)2. hypersensitivity reaction

Contraindication: immunocompromised state, pregnancy

Relative Contraindication: untreated active tuberculosis

Page 19: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Measles, Mumps, Rubella (MMR) Vaccine- live attenuated - given at 12-15 months; a booster dose is recommended at 4-6 years old

Reactions:1. fever with or without rashes (5-12

days after administration - measles)

2. fever, swelling of parotid gland (mumps)

3. fever, mild rash, transient arthritis or arthralgia, post-auricular lymphadenopathy (rubella)

Page 20: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Measles, Mumps, Rubella (MMR) Vaccine

Reasons for giving 2 doses of MMR:1. only 87-90% of children actually

receive the measles vaccine2. 5% of children who receive the first

vaccine won’t develop immunity3. children who had an immune response to

the first dose could get a “booster” effect

Contraindications: same as other live vaccines

Page 21: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Varicella Vaccine

- live attenuated - routinely given at age 12 months and up but can be given as early as 9 months- can be given within 5 days of exposure- varicella vaccine prevents moderate to severe cases of chickenpox

Reactions:-may develop few varicella-like

lesions about 1 month after vaccination

Page 22: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Hemophilus influenzae b (Hib) Vaccine

- polysaccharide protein conjugate

Reactions: low grade fever (2%)pain and swelling (10-15%)

Page 23: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Pneumococcal Vaccine

- PPV is given for children 2 yrs and above

Indications:1. patients undergoing splenectomy2. sickle cell disease3. asplenia4. HIV5. Routinely for children 2 months and

above

Page 24: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Hepatitis A Vaccine- inactivated viral antigen

Indications:1. persons traveling to areas with high

prevalence of Hepatitis A2. occupational hazards3. hemophiliacs – contacts of infected

persons

Reactions: pain and local swelling

Page 25: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

Influenza Vaccine

- inactivated vaccine- should be administered before the start of flu season (February to June)

Indications:1. prophylaxis in children older than 6

months and adults2. over 60 years3. suffer from disease of cardiovascular

system, metabolic disease, cystic fibrosis, chronic respiratory disease, chronic renal insufficiency

Page 26: Medenilla, Judy; Medina, Kristianne; Medina, Sakura; Mejino, Carla; Melgarejo, Ivy; Mendoza, Alvin; Mendoza, Diana; Mendoza, Donne; Mendoza, Gracielle

THANK YOU