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Innate immunity resistance (immunity) of epithelial surfaces to invasion, is a characteristic which is present from birth prevents entry of microorganisms into tissues or, once they have gained entry, eliminates them prior to the occurrence of disease. Non-specific - acts on many organisms and does not show specificity. Does not become more efficient on subsequent exposure to same organisms Biochemical (complement, lysozyme, interferons) Cellular components (neutrophils, monocytes, macrophages, natural killer cells)
Acquired immunity Not present during fetal development Require exposure to antigen for antibody production Respond to a variety of antigens, each in specific manner. Discriminate between foreign antigen and self antigen of the host. Respond to a previously encountered antigen by initiating memory response. Active induction of immunity by infection or with a vaccine naturally Develop primary immune response due to exposure of antigen with the production of the immunological memory (B-cell) artificially Induce by vaccine which contain antigen Stimulate primary response against antigen without cause any symptom of disease tetanus toxoid (against tetanus). Passive the transfer of antibody from one individual to another, naturally happens when a mother transfer antibodies to her offspring via placental route during pregnancy and via colostrum during brea stfeeding artificially injecting antibodies or se nsitized lymphocytes to an organism via a vaccination. measles, hepatitis, rubella, mumps, diphtheria, snake venom
After genuine attack from the pathogen. eg : chickenpox, mumps, measles A long lasting immunity It takes time (usually several weeks) to develop
immediate protection lasts only for a few weeks or months
Vaccine A vaccine is any preparation intended to produce immunity to a disease by stimulating the production of antibodies. Eg: suspensions of killed or attenuated microorganisms, or products or derivatives of microorganisms. 3 main substances used for production of vaccines are: o LIVE microorganisms, (eg : weaken measles, polio virus/ tuberculosis bacteria) o KILLED microorganisms (eg : pertussis microorganism used in DPT o TOXOIDS (eg: inactivated toxins such as tetanus toxoid and diphtheria toxoid vaccines stored in the clinic? -using 2-door refrigerator/ top loading with temperature within 2-8 °c -monitored twice a day ( early morning and before closing premise) using the minimax and dial thermometer. -readings are recorded on a chart (to ensure a safe temperature is maintained). 1
Disclaimer: NOT INTENDED FOR PROFIT. FOR PERSONAL USE ONLY. Plagiarism not intended. I do not own any of the materials. I only compile various resources. Credits goes to the textbook authors, lecturers and friends. Peer reviews and corrections are encouraged. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. USE AT YOU OWN RISK. ISAAC 2013
those who cannot be vaccinated for medical reasons (eg leukemia). 8. lecturers and friends. I only compile various resources. 6. 2. Killed Purified extracts fromn live organisms which are incapable at replication and therefore non-infectious Polio Hepatitis A Advantage Disadvantage Influenza 1. Definition Description Vaccine Any suspesnsion of antigen which is intended to induce protective immunity in the host after administration Adjuvant or Haemophilus Compound linked to a vaccine to increase the immunity conjugate influenza type This vaccines develop by linking the bacterial capsular polysaccharide to carrier protein to enhance immunogenicity. To slow down or prevent the disease outbreak. antiseptic and others The temperature is outside the range between 2˚C and 8˚C the importance of immunity 1. Once scientists do that.3 4-6 BCG Hepatitis B DTaP Hib Age (year) 7 If no 13 15 DTB B TB 2 Disclaimer: NOT INTENDED FOR PROFIT. Protection against illness 1. 3. the immunogenicity will increase and the immune system able to recognize it and immune response develop Live Live suspension of microorganisms which have been rendered non-virulent but retain their infectivity and immunogenicity in Measles attenuated the host. Herd immunity Also known as community immunity: A situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Malaysia Immunization Schedule . B vaccines. Worldwide eradication of smallpox was achieved in 1979. 4. Plagiarism not intended. easily stored and maintain a person’s immunity. DNA that is administered directly into the body. then use chemicals to break apart. Elicit both cellular and antibody responses and often (immunosuppressed) confer lifelong immunity with only one or two doses. To produce herd immunity. 3. Peer reviews and corrections are encouraged.Zac © 2013 Immunization Factors That Can Destroy A Vaccine No proper care and handling Reaching the expiry date Exposed to sunlight especially for Polio. 3. for example—cannot be given live vaccines. harvest the antigens Manufacture antigen molecules using recombinant DNA technology (known as recombinant subunit vaccines) DNA Influenzae. To reduce prevalence of many other disease. I do not own any of the materials. papillomavirus however. Does not cause mutation or reversion of virus. USE AT YOU OWN RISK. ISAAC 2013 . Don’t require refrigeration. Stable and long lasting. Creating the antigens necessary to stimulate the immune system. People who have damaged or weakened immune systems— because they’ve undergone chemotherapy or have HIV. Stimulate a weaker immune system response than do 2. take several additional doses. Possibility cause illness that they try to protect against 2. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community. 5. transported 3. To protect the health of our community. This could be a drawback in areas where people don’t have regular access to health care and can’t get booster shots on time. to 4. Too cold and frozen Chemical reagent such alcohol. It is cheaper to prevent a disease than to treat it. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. Polysaccharide coatings disguise a bacterium’s antigens so that the immature immune systems of infants and younger Pneumococcal children can’t recognize or respond to them. Human Identifying which antigens best stimulate the immune system is a time-consuming process. FOR PERSONAL USE ONLY. BCG and Measles because all these are life vaccine. they can make subunit vaccines in one of two ways: Produced: Culturing microbe in the lab. live vaccines. Vaccine Herpes When give vaccine.2008 Age Immunization 0 1 1 1 2 1 1 2 2 3 3 2 (mo nth) 3 4 5 6 3 9 10 12 15 18 2. or booster shots. Credits goes to the textbook authors. To reduce morbidity and mortality among children. especially those who cannot be immunized (eg children <1y/o cannot receive measles vaccine but can be infected by the measles virus). after linking it. cells of recipients take up DNA The cells secrete the antigens and display them on their surfaces. 7. To prevent children from getting diseases as the immunity from maternal antibody only lasts till first year of life. microbe’s genetic material especially those that code for antigens. 2. and those who cannot make an adequate response to vaccination. Safe – no possibility to turn virulent 1. Toxoid Modified biological toxin which is rendered non toxic but maintain its ability to provoke an immune response Tetanus Diphtheria Botulism Cholera Subunit Hepatitis B introduce a fragment of the microorganism (specific parts of the antigen that best stimulate immune response). To eradicate certain infection eg. 2. To reduce the cost in health management. Mumps Rubella Advantage Disadvantage Chickenpox 1. vaccine So. May cause mutation of microbe that cause it to revert to a virulent form and cause disease.
On chemotherapy (< 6 months after last dose) c. Prednisolone 2mg/kg/day for more than 7 days or low dose more than 2 weeks –delay vaccination for 3 months ii. If another LIVE vaccine was given less than 3 weeks ago – either give simultaneously or wait 3 weeks e. Plagiarism not intended. USE AT YOU OWN RISK. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. Minor infections without fever or systemic upset are NOT contraindication c. High dose steroid use i. I only compile various resources. Irradiation iii. Malignancy ii. Peer reviews and corrections are encouraged. Doris) 6. I do not own any of the materials. Live vaccines a. Postpone during acute febrile illness b. Mild illness without fever 2. controlled epilepsy 9. Unless – SEVERE local reaction – induration > 2/3 of limbs c. stable neurological conditions – CP. convulsions False 1. > 39 C ii. hay fever.3 4-6 12 15 PPSV – high risk Vari MCV 4 Influenza (yearly) Varicella Hep A 2 doses Why is it so important so follow the schedule? Interval between doses of vaccines: In the recommended time will increase antibody response to the second dose Shorter than the recommended time will decrease the immune response and vaccine efficacy Longer than the recommended time will inhibit immune response to the second dose ALL Vaccines are killed except MMR. Non progressive. eczema. Within 3 months of IV immunoglobulin except for yellow fever or oral polio – Kawasaki 11 months f. Primary immunodeficiency syndromes (NOT asymptomatic HIV) b. lecturers and friends. Immunosuppressed i. heat rash 3. Treatment with antibiotics 4.Zac © 2013 Immunization Polio (IPV) Measles JE MMR HPV Suggested Vaccines = USA Immunization 0 Rotavirus Pneumococcal Influenza Varicella Hep A Meningococcal 1 Age 2 rot PCV (mo nth) 3 rot PCV Age (year) 7 1 2 3 SBH SWK 1 2 B 3 dose B 4 rot PCV 5 6 9 10 12 PCV 15 18 2. Do not give vaccine within 2 weeks of elective surgery 2. Killed a. Family hx of comvulsions 10. General a. Anaphylaxis iii. Neonatal jaundice – BUT SHOULD REFER to MO if PROLONGED JAUNDICE (Dr. Pregnancy 3. lymphoma iv. Hx of heart disease 11. impetigo. measles or rubella unless confirmed medically 8. Generally safe b. Underweight or malnourished 7. FOR PERSONAL USE ONLY. ISAAC 2013 . Leukaemia. Severe generalized reaction I previous dose i. down’s simple febrile convulsions. Persistent screaming iv. Breastfed child 5. Past history of pertussis. Credits goes to the textbook authors. Prematurity 3 Disclaimer: NOT INTENDED FOR PROFIT. BCG and OPV Contraindications True 1. If tropical or inhaled steroids or low dose systemic less than 2 weeks allow vaccination d. Asthma.
regular sexual contacts of Hep BsAg +ve persons 1.ras h Influenza like syndrome Arthritis. ISAAC 2013 . Plagiarism not intended. BCG osteitis and osteomyelitis Contraindications Symptomatic HIV Hepatitis B 1st dose : within 48 hours of birth 0. Moderate or severe acute illness DIPHTERIA – effective. Severe hypersensitivity to aluminium and thiomersal 4 Disclaimer: NOT INTENDED FOR PROFIT. 1. Local reaction – papule at site of vaccination occurs within 2 to 56 weeks – reaction =papule(2-3 weeks). lecturers and friends. pain Small painless nodule at injection site Transient fever.5 ml of HBIG within 12 H or birth. at 9 – 18 months of well child visit o Those that have antiHepB level < 10mIU/ml and HBsAg . Severe hypersensitive to aluminium or thiomersal DTT 1. 4.scar(end of 3 months).6 Birth 1 month (up till 2 months) 6months (no earlier than 24 weeks) Special Consideration Birth At 6 years if no scar Preterm infants (< 33weeks) and low birth weight infants – usually not given until the infant is 34 week old or weight is 1800-2000g Rationale Cases of TB have increasing steadily since 1995 Primary TB infections are most common in children and may spread to meninges. I only compile various resources. USE AT YOU OWN RISK. Rarely anaphylaxis and neurological symptoms Local swelling and redness within 24 to 72 hours lasting 1. Rare: Allergy reaction and anaphylaxis These symptoms usually resolve 24-48 hrs after vaccine administration and frequency of reaction decrease with subsequent doses of vaccine.18 Precaution with 1. DTaP Primary: 2.babies born to HepBsAg +ve mothers o immunocompromised pt with risk of exposure to Hep B o .dizzyness. Systemic infection 5. 1. FOR PERSONAL USE ONLY.ulceration(6-8 weeks). 6 months followed by testing anti-HepB one month after the 3rd dose Preterm infants weighing <2kg. 1. 7.ve. redness.Myalgia(l ess frequent in infant and children than adulthood. ) should be given simultaneously at different sites. Credits goes to the textbook authors.occupational risk of exposure to sharp injuries o . routine booster doses are not recommended Routine post-immunization testing for anti-HepB level is not necessary However. 2.Zac © 2013 Immunization Vaccine BCG Type Dose 0. 2ndary infection 3. ASAP o check for HBsag and antibody to HBsag 1to 2 months after complete at least 3 doses 1-3 months after completing the vaccine series.Athralgia. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. 3. bloodstrea m and bones Highly protective against meningeal and miliary TB (80%) Major complicat ions such as liver cirrhosis and HCC infants that become infected by perinatal transmiss ion are 90% at risk of getting chronic infection and 25% risk of dying from HCC children younger than 5 years old living with a Hepatitis B +ve person can become infected via horizonta l transmiss ion and are at a higher likelihood of getting chronic infection.3. headaches. 6 Monovalent If mother is HBsag (+) o administer HepB vaccine and 0.1. 3. malaise.hemodialysis o . cirrhosis and subseque ntly HCC in early adulthoo d Hep B vaccine provides adequate protection to majority of the recipients and prevents both vertical and horizonta l transmiss ion Side Effect 1. 2. administer HepB within 12 hours of birth For immunocompetent children. 6. Transient soreness/redness at injection site Low grade temperature Nausea. it is indicated 1-2 months after the 3rd immunization for : o . Peer reviews and corrections are encouraged.HIV +ve o . 4. grows and flattens with scaling and crusting – with discharging ulcer and heals to leave a scar of at least 4mm 2. I do not own any of the materials.malaise. Primary 1. should be given another 3 doses at 0. 5.5. the initial dose should not be counted(receive total of 4 doses) If Mothers HepB status is unknown. BCG axillary and cervical lymphadenitis 4. Swelling.
Local swelling. 10. Peer reviews and corrections are encouraged. exacerbation of weakness and/or new paralysis/weaknes s 1. Collapse or shock like states c. 6.5 C within 48 hours f. I only compile various resources. Provides immunity for 310 years Tetanus – reduce case Pertusis – cause significant morbidity to those between 3 months to 6 years of age 2. lecturers and friends. HiB 2. 1. Hyporesponsive states d. Drowsyness.inconsolable crying >3 hours or more (within 48 hrs of vaccination) collapse or shock-like episodes( within 48 hrs) short-lived convulsions (usually febrile)within 3 days Acute encephalopathy Anaphylaxis – shock. Encephalitis within 7 days g.01mIU/ml ). febrile seizure. Progressive neurological disease like infantile spasm. hepatic and renal conditions Poliovirus infection can result in paralysis with permanent disability Adults that have contracted paralytic poliomyelitis in childhood can develop postpolio syndrome 30-40yrs later. More serious side effects but rare: persistent crying. 3. diabetes. high fever ( >40.5 1. characterized by muscle pain. acute exacerbation of cardiac.3. fever. headaches. 7.not due to DTP). 8. polymyxin or anaphylaxis to egg ingestion 5 Disclaimer: NOT INTENDED FOR PROFIT. 11.Zac © 2013 Immunization months 2. Fits and fever within 72 hours e. PV started in 2008 because wild type no longer endemic in Malaysia. 2.shock. Hypersensitivity to neomycin. 2. Japanese Encephalitis Polio OPV – live IPV – inactivate d 9. SOB 2. 5. hypotension. 4. 3. USE AT YOU OWN RISK. MMR For HIV infected children : o first dose given at 12 months and second dose may be given after 28 days of the first dose o If there is an outbreak of measles. 1 to 2 weeks Fever(24 hrs after vaccination. vaccination with monovalent measles or MMR may be given to infants as young as 6 months old when exposure is considered likely Patients on steroid(prednisolone>2mg/kg/day) 2. Anaphylaxis b. Pertussis aP – acellular –contains only endotoxin – less risk of local reaction and s/e 4. Severe local reaction involving 2/3 of limbs Static neurological diseases. Vaccine associated paralytic polio (OPV) Local reaction at injection side Neurological disorder. Most of the cases of HiB meningitis occur < 12 months old and rarely among children < 3 months or > 5 years old 1st dose must be given at 6/52 after birth and not earlier because possible immune tolerance to HiB vaccine 1. irritability. 10. Fever > 40. Plagiarism not intended. 11 yo) 2. Fretfulness Anorexia. 2. developmental delay. 18 months Then every 3 years (5. 3. 8. unexplained by other cause. redness and pain lasting up to 24 hours in 10% Malaise. ISAAC 2013 . 9. FOR PERSONAL USE ONLY. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. Persistent.if persits>24 hrs .5oC) within 48 hours. 5 months Booster at 18 months Supplementar y: 6 years old Immunodeficiency and malignancy. hypertension and allergy reaction. hx of fits are NOT contraindications Severe hypersensitive to aluminium or thiomersal 3. 3. 5. inconsolable crying Rarely seizures 6. I do not own any of the materials. Credits goes to the textbook authors. tuberous sclerosis Severe reaction to previous dose a. apyretic seizure. uneasiness. Risk of infection if OPV through GI excretion after vaccination 4. Booster: 6 and 12 yrs 3. with or without fever Infant weighing less than 2000 grams Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoidcontaining vaccine immunization stimulates the production of Ab in considerable excess of the minimum protective level(0.
4. 2. 2. Two doses of MMR vaccine will effectively deal with all the cases of primary vaccine failure that are at risk of getting mumps later in life Vaccine induced antibody is shown to persists for at least 16 years and protection against clinical rubella appears ro be long term 1. FOR PERSONAL USE ONLY. ongoing severe illness. 2. transient peripheral neuritis Arthritis and arthralgia occurs in up to 3% of children Polyneuropathy – GuillainBarre syndrome like Transient rash in 5% Fever between D5 to D12 post vaccination lasting for 1 to 3 days URTI symptoms Febrile convulsions D6 to D14 Encephalopathy within 30 days Subacute sclerosing panencephalitis Hypersensitivity to neomycin. Measles 2. lymphomas of any type. up to a month after vaccination Seizure (jerking or staring) caused by fever (very rare). generally well tolerated. 2. Peer reviews and corrections are encouraged. Pneumonia (very rare) Immunocompromised. Two vaccines are currently available in Malaysia: -Varivax (MSD) -Varilrix (GSK) Children who have not had chicken pox by 12 years of age are encouraged to receive the vaccine as the illness is more severe in older age groups. HPV Varicella zoster Minimum 9 yo Quadrivalent HPV vaccine HPV 4 Bivalent HPV HPV2 70 – 90 % effectiveness. pregnancy . leukemia. polymyxin or anaphylaxis to egg ingestion Pregnancy Hypersensitivity to neomycin.Zac © 2013 Immunization should avoid MMR vaccine until one month after the cessation of the therapy Mumps 1. 6. Highly infectious and major health issue Mortality is highest among children <2 yrs Efficacy is 95% for those vaccinated at 12 months and 98% for those vaccinated at 15 months Failure rate would be higher if vaccine is given<12 months Provides lifelong immunity in majority of vaccinated individual s Vaccinate d individual s develop milder disease 1. 1. advanced immune disorders of any type. 4. Children with leukaemia & are in remission for at least 1 year. Credits goes to the textbook authors. polymyxin or anaphylaxis to egg ingestion 4. 2. USE AT YOU OWN RISK. lymphadenopathy. 3. Rubella 1. pruritic and purpura Parotitis in 1 % of vaccines. 6 rotarix 1. 6. HIV infection. Reactions to the rotavirus vaccine are much less frequent.4. From 12 months to 12 years: single dose. fever. & have > 700/ml circulating lymphocytes may receive vaccination under supervision of the attending paediatrician 1. 3. receiving immunosuppressive therapy Rota virus 2. 3. anaphylactic reactions to any component of the vaccine .individuals with blood dyscrasias. 5. Occurs primarily in children with peak incidence at 5-9 yrs of age 2. fever diarrhoea (in the week after 6 Disclaimer: NOT INTENDED FOR PROFIT. I do not own any of the materials. 4. ISAAC 2013 . I only compile various resources. 3. 5. two doses with a 3 month interval are recommended. 5. thrombocytopenia. Soreness or swelling where the shot was given High Fever(over 39’C) Mild rash. Rash. Plagiarism not intended. lecturers and friends. Rarely transient rash. > 12 years old : 2 doses at least 28 days apart. 3. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. or other malignant neoplasms affecting the bone marrow or lymphatic systems. 3 or more weeks after vaccination Orchitis and retrobulbar neuritis very rare Menignoencephalitisis mild and rarely occur Severe reaction to eggs or neomycin Non-HIV related immunodeficiency 3.
Booster 3 . thimerosal. They help the body create a better immune response.Three doses two days apart and whole cell typhoid vaccines are also available. Y & W-135 (Does not cover B) Polysaccharide vaccine : Immunogenic in children 2 years or older. a fast heart beat or dizziness.g. Protects only 50% of vaccines (for 3 – 6 months). Immunity up to 3 years. 7. Category A (specialist prescription) 6. 14 and 30. lactose. IPV Administer the liquid slowly down one side of inside of the cheek( between cheek and gum) towards the infant’s back of mouth. Booster every 6 months. I do not own any of the materials.breathe normally. albumin. Meningococc al MCV4 A . pregnancy 4. MSG and glycine. Credits goes to the textbook authors. rotavirus vaccine Intranasal live attenuated influenza vaccine Intradermal Subcutaneous BCG MMR Intramuscular DTaP. Category B (MO IM/SC (available in KKM as HDC-human diploid cell vaccine) Pre-exposure immunization: 3 doses at Day 0. ISAAC 2013 . They keep the vials from getting contaminated with germs. Then boosters every 2-3 years. rotavirus vaccination) vomiting (in the week after rotavirus vaccination) anaphylaxis (severe allergic reaction) intussusception Drowsy Temporary loss of appetite Redness. These are aluminum salts. b)Oral typhoid vaccine(Ty21a vaccine)* . hoarseness or wheezing. First dose given SC/IM. 5. They help the vaccine stay effective while being stored. 7 and 28. hives. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. 5.5 years only for high risk persons. sucrose. Care should be taken not to go far back enough to initiate gag reflex Patient seated upright with head tilted back.risk of injury to sciatic nerve . 3.in infant 2) Mid deltoid muscle in older children/adult 3)Gluteal region. 7 Disclaimer: NOT INTENDED FOR PROFIT. 6. Additives. Adjuvants. Unimmunized: 6 doses at Day 0. USE AT YOU OWN RISK.Zac © 2013 Immunization 4. 1. PCV –conjugate vaccine PPSV –polysaccharide vaccine Pneumococcal polysaccharide vaccine Protective efficacy ranges from 56 .Boosters every 3 years. Rabies specific Ig unnecessary.Confers 60 – 80% protection commencing within 14 days from vaccination.tenderness. E. Category C (medical officers) Killed whole cell vaccine : 2 doses 4 weeks apart (minimum 1 week).and swelling at the site of injection Mild fever Very rare life threatening allergic reaction(difﬁculty breathing. 3. Peer reviews and corrections are encouraged.insert needle fully into muscle at 90 º angle What are the ingredients? Preservatives. . FOR PERSONAL USE ONLY. Single dose.best avoided. Post-exposure treatment: Fully immunized: 2 doses at Day 0 and Day 3 or 7. second dose and boosters given ID to reduce systemic side effects. Category B Cholera Rabies Typhoid routes of immunisation Route Vaccine Oral Oral polio vaccine. 2. Category B ) Vi polysaccharide vaccine : . weakness. Single dose. Immunogenicity < 2 years of age has not been established. Pinch the fatty tissue above the muscle by supporting the tissue between the thumb n fingers Needle is inserted in the skin fold at 45 degree angle 1) anterolateral thigh ( middle of vastus lateralis muscle). Hib and Hep B. Not highly effective & short duration of protection < 6 months. Plagiarism not intended. cholera vaccine. Rabies specific Ig (20 IU/kg given half around the wound and the rest IM). I only compile various resources. Vaccine is not recommended for infants < 6 months of age.bunch up the muscle between forefinger and thumb . lecturers and friends. tip of nasal sprayer inserted slightly into naris Half of content sprayed into nostril and repeat procedure in the other nostril Deltoid area of upper arm BCG usually injected on left deltoid anterolateral aspect of thigh (infant) upper outer tricep ( older children /adult) administered into the fatty tissue which is found below the dermis and above muscle tissue. Not recommended for children < 2 years old as vaccine is not effective in this group Conjugate vaccine is immunogenic in these infants but currently not widely available. Additives include gelatin. Seroconversion in > 90% of vaccines .81%.Single dose. paleness. ) Fussy or irritable Pneumococal Children <2 years age. patient that will undergo chemotheraphy/radiotheraphy 10 days prior to starting such therapy. C. live typhoid vaccine.
Depending on how the vaccine is made. Treatment Febrile convulsions o Give Paracetamol 120 mg prophylaxis after immunization 4 hourly for 48 hours regardless of whether the child is febrile or not o Rectal diazepam given for patients with previous febrile convulsions Local Reactions o Self-limiting. Thimerosal organic mercury-based (contains ethyl mercury) preservative used in some vaccines. USE AT YOU OWN RISK. I do not own any of the materials.Zac © 2013 Immunization Residuals of the vaccine production process. Peer reviews and corrections are encouraged. o Abscesses drainage till the wounds heal. o Relieved by cold compress and paracetamol. β-agonist nebulizer if wheezing o IM Adrenaline 0. FOR PERSONAL USE ONLY. o Antibiotics if secondary bacterial infection Anaphylaxis o Ensure ABC o Oxygen. Although these ingredients are removed. egg protein or yeast protein. I only compile various resources. lecturers and friends. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. Credits goes to the textbook authors.01ml/kg body weight o Fluid resuscitation (NS) o Antihistamine (IV Chlorpheniramine maleate) o Corticosteroids (IV Hydrocortisone) o β-agonist inhalation (Salbutamol) o Adrenaline/Dopamine infusion Disease Definition Epidemiology Causes Pathophysio Classification Clinical course Symptoms Complication Differential Investigation Sign Management Details Prevention Rehabilitation 8 Disclaimer: NOT INTENDED FOR PROFIT. tiny (residual) amounts are left in the final product. including MMR and some influenza vaccines. it may include tiny amounts of antibiotics (neomycin). ISAAC 2013 . Plagiarism not intended.