Objectives.

‫اﻷھداف‬
‫ﻓﻲ اﻟﻧﮭﺎﯾﺔ ﺳﯾﺗﻣﻛن اﻟﺟﻣﮭور ﻣن ذﻟك‬
By the end the audience will be able to

Immunization Ø Define Immunity ,Immunization ‫ﺗﻌرﯾف اﻟﻣﻧﺎﻋﺔ واﻟﺗﺣﺻﯾن‬

Prepared by : Amna ,M, Ali
Mosby items and derived items © 2005, 2001 by Mosby, Inc.
Ø explain the immune response and immunoglobulin system
..‫ﺷرح اﻻﺳﺗﺟﺎﺑﺔ اﻟﻣﻧﺎﻋﯾﺔ وﻧظﺎم اﻟﻐﻠوﺑوﻟﯾن اﻟﻣﻧﺎﻋﻲ‬
Ø Identify types of the immunity ‫ﺗﺣدﯾد أﻧواع اﻟﻣﻧﺎﻋﺔ‬
Ø Discuss immunization and vaccines and the schedule for
deferent childhood diseases .
.‫ﻧﺎﻗش اﻟﺗﺣﺻﯾن واﻟﻠﻘﺎﺣﺎت واﻟﺟدول اﻟزﻣﻧﻲ ﻷﻣراض اﻟطﻔوﻟﺔ اﻟﻣﺧﺗﻠﻔﺔ‬
Ø Explain the cold chain system ‫اﺷرح ﻧظﺎم ﺳﻠﺳﻠﺔ اﻟﺗﺑرﯾد‬
Ø discuss the Nursing Responsibilities
..‫ﻣﻧﺎﻗﺷﺔ ﻣﺳؤوﻟﯾﺎت اﻟﺗﻣرﯾض‬
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Introduction ‫اﻟﻣﻘدﻣﺔ‬ Definitions ‫اﻟﺗﻌرﯾف‬

One of the most dramatic advances in
paediatrics has been the decline of infectious • Immunity is defined as the ability of the body
diseases during the 20th century because to recognize, destroy , and eliminate foreign
widespread use of immunization for antigenic material such as bacteria , viruses
preventable diseases . and proteins leading to resistance against
infections.
‫ﻛﺎن أﺣد أﻛﺛر اﻟﺗطورات اﻟدراﻣﺎﺗﯾﻛﯾﺔ ﻓﻲ طب اﻷطﻔﺎل ھو ﺗراﺟﻊ‬
‫اﻷﻣراض اﻟﻣﻌدﯾﺔ ﺧﻼل اﻟﻘرن اﻟﻌﺷرﯾن ﺑﺳﺑب اﻧﺗﺷﺎر اﺳﺗﺧدام اﻟﺗﺣﺻﯾن‬ ‫ﺗ ُﻌﱠرف اﻟﻣﻧﺎﻋﺔ ﺑﺄﻧﮭﺎ ﻗدرة اﻟﺟﺳم ﻋﻠﻰ اﻟﺗﻌرف ﻋﻠﻰ اﻟﻣواد‬
.‫ﻟﻸﻣراض اﻟﺗﻲ ﯾﻣﻛن اﻟوﻗﺎﯾﺔ ﻣﻧﮭﺎ‬ ‫اﻟﻣﺳﺗﺿدﯾﺔ اﻟﻐرﯾﺑﺔ وﺗدﻣﯾرھﺎ واﻟﻘﺿﺎء ﻋﻠﯾﮭﺎ ﻣﺛل اﻟﺑﻛﺗﯾرﯾﺎ‬
.‫واﻟﻔﯾروﺳﺎت واﻟﺑروﺗﯾﻧﺎت اﻟﺗﻲ ﺗؤدي إﻟﻰ ﻣﻘﺎوﻣﺔ اﻟﻌدوى‬
The WHO launched global immunization
program in 1974 known EPI (expanded • Immunization is the process of protecting an
program on immunization ) to protect all individual from a disease through introduction
children of the world against 6 killer disease . of live or killed or attenuated organisms in the
individual system
‫أطﻠﻘت ﻣﻧظﻣﺔ اﻟﺻﺣﺔ اﻟﻌﺎﻟﻣﯾﺔ ﺑرﻧﺎﻣﺞ اﻟﺗﺣﺻﯾن اﻟﻌﺎﻟﻣﻲ ﻓﻲ ﻋﺎم‬
‫ اﻟﻣﻌروف ﺑـ‬1974EPI ( ‫ﺑرﻧﺎﻣﺞ اﻟﺗﺣﺻﯾن اﻟﻣوﺳﻊ( ﻟﺣﻣﺎﯾﺔ‬ • ‫اﻟﺗﺣﺻﯾن ھو ﻋﻣﻠﯾﺔ ﺣﻣﺎﯾﺔ اﻟﻔرد ﻣن اﻟﻣرض ﻣن ﺧﻼل إدﺧﺎل‬
.‫ أﻣراض ﻗﺎﺗﻠﺔ‬6 ‫ﺟﻣﯾﻊ أطﻔﺎل اﻟﻌﺎﻟم ﻣن‬ ‫اﻟﻛﺎﺋﻧﺎت اﻟﺣﯾﺔ أو اﻟﻣﻘﺗوﻟﺔ أو اﻟﻣوھﻧﺔ ﻓﻲ اﻟﻧظﺎم اﻟﻔردي‬
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 The immune Response
‫اﻻﺳﺗﺟﺎﺑﺔ اﻟﻣﻧﺎﻋﯾﺔ‬ Immunoglobulin ‫اﻟﻣﻧﺎﻋﻲ‬
The immunological response to infective agents is 2types
::‫اﻻﺳﺗﺟﺎﺑﺔ اﻟﻣﻧﺎﻋﯾﺔ ﻟﻠﻌواﻣل اﻟﻣﻌدﯾﺔ ھﻲ ﻧوﻋﺎن‬ The human immunoglobulin (Ig) system is
composed of 5 major classes :
• Nonspecific ‫ﻏﯾر ﻣﺣدد‬
) ‫ﯾﺗﻛون ﻧظﺎم اﻟﻐﻠوﺑوﻟﯾن اﻟﻣﻧﺎﻋﻲ اﻟﺑﺷري‬Ig) :‫ ﻓﺋﺎت رﺋﯾﺳﯾﺔ‬5 ‫ﻣن‬
üPolymorphs and macrophages ( bacteria)(‫ﺗﻌدد اﻷﺷﻛﺎل واﻟﺿﺎﻣﺔ )اﻟﺑﻛﺗﯾرﯾﺎ‬
• IgM ; the first antibody produced following
üComplements ( bacterial lysis & opsonins)(‫اﻟﻣﻛﻣﻼت )اﻟﺗﺣﻠل اﻟﺑﻛﺗﯾري واﻷوﺑﺳوﻧﯾن‬ exposure to antigen
üLysozyme(bacterial wall) and interferon ( viral replications). IgM. ‫ﯾﺗم إﻧﺗﺎج أول ﺟﺳم ﻣﺿﺎد ﺑﻌد اﻟﺗﻌرض ﻟﻠﻣﺳﺗﺿد‬
.(‫ﻟﯾﺳوزﯾم )ﺟدار ﺑﻛﺗﯾري( وإﻧﺗرﻓﯾرون )ﻣﺿﺎﻋﻔﺎت ﻓﯾروﺳﯾﺔ‬ • IgG ; prodused within 10-14 days and becoming
the predominat antibody , transplacentally
• Specific ‫ﻣﺣدد‬ provide immunity for few monthes ( measles ,
üHumoral Immunity ( B cells) produce immunoglobulins polio , mumps)
‫ ﯾوًﻣﺎ وﯾﺻﺑﺢ اﻟﺟﺳم اﻟﻣﺿﺎد‬14-10 ‫ ﯾﺗم إﻧﺗﺎﺟﮫ ﻓﻲ ﻏﺿون‬.‫ﻣﻔﺗش‬
‫ﺗﻧﺗﺞ اﻟﻣﻧﺎﻋﺔ اﻟﺧﻠطﯾﺔ )اﻟﺧﻼﯾﺎ اﻟﺑﺎﺋﯾﺔ( اﻟﻐﻠوﺑوﻟﯾن اﻟﻣﻧﺎﻋﻲ‬ ‫ وﯾوﻓر ﻣﻧﺎﻋﺔ ﻋﺑر اﻟﻣﺷﯾﻣﺔ ﻟﺑﺿﻌﺔ أﺷﮭر )اﻟﺣﺻﺑﺔ وﺷﻠل‬، ‫اﻟﺳﺎﺋد‬
üCellular Immunity (T cells) against viral infection & TB (‫اﻷطﻔﺎل واﻟﻧﻛﺎف‬
‫وﯾﺔ )اﻟﺧﻼﯾﺎ اﻟﺗﺎﺋﯾﺔ( ﺿد اﻟﻌدوى اﻟﻔﯾروﺳﯾﺔ و اﻟﺳل‬Mosby
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Immunoglobulin Types of Immunity‫أﻧواع اﻟﻣﻧﺎﻋﺔ‬

• IgA ; secreted in the gut , lungs, breast milk • Passive : ‫ﻏﯾر ﻧﺷط‬
( colostrum) protect against GI infections . üNatural transplacental immunity. .‫اﻟﻣﻧﺎﻋﺔ اﻟطﺑﯾﻌﯾﺔ ﻋﺑر اﻟﻣﺷﯾﻣﺔ‬
.‫ﯾﻔرز ﻓﻲ اﻷﻣﻌﺎء واﻟرﺋﺗﯾن وﺣﻠﯾب اﻟﺛدي )اﻟﻠﺑﺄ( ﻟﻠﺣﻣﺎﯾﺔ ﻣن اﻟﺗﮭﺎﺑﺎت اﻟﺟﮭﺎز اﻟﮭﺿﻣﻲ‬
üAcquired by administration of antibodies.
• IgD ; act as a lymphocyte receptor. .‫ﯾﺗم اﻟﺣﺻول ﻋﻠﯾﮭﺎ ﻋن طرﯾق إدارة اﻷﺟﺳﺎم اﻟﻣﺿﺎدة‬
IgD. .‫ﺑﻣﺛﺎﺑﺔ ﻣﺳﺗﻘﺑﻼت اﻟﺧﻼﯾﺎ اﻟﻠﯾﻣﻔﺎوﯾﺔ‬ • Active :‫ﻧﺷط‬
• IgE ; ( reaginic antibody) combines with üNatural as observed after natural infections and may
antigen on mucosal surfaces leading to be life long (Measles )
release of histamine , also important in (‫طﺑﯾﻌﻲ ﻛﻣﺎ ﻟوﺣظ ﺑﻌد اﻟﻌدوى اﻟطﺑﯾﻌﯾﺔ وﻗد ﯾﺳﺗﻣر ﻣدى اﻟﺣﯾﺎة )اﻟﺣﺻﺑﺔ‬
immunity against helminths . üAcquired by administration of vaccine
IgE. ( ‫ﺟﺳم ﻣﺿﺎد رﯾﺟﯾﻧﯾك( ﯾﺗﺣد ﻣﻊ ﻣﺳﺗﺿد ﻋﻠﻰ اﻷﺳطﺢ اﻟﻣﺧﺎطﯾﺔ ﻣﻣﺎ ﯾؤدي إﻟﻰ‬
ً ‫ وھو ﻣﮭم أﯾ‬، ‫إطﻼق اﻟﮭﯾﺳﺗﺎﻣﯾن‬
.‫ﻓﻲ اﻟﻣﻧﺎﻋﺔ ﺿد اﻟدﯾدان اﻟطﻔﯾﻠﯾﺔ‬Mosby
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‫ﯾﺗم اﻟﺣﺻول ﻋﻠﯾﮭﺎ ﻋن طرﯾق إﻋطﺎء اﻟﻠﻘﺎح‬
Mosby items and derived items © 2005, 2001 by Mosby, Inc.

.
 Active Immunization
(Vaccination)(‫اﻟﺗﺣﺻﯾن اﻟﻔﻌﺎل )اﻟﺗطﻌﯾم‬ BCG (‫)ﯾﺳﺗﺧدم ﻟﻠﻘﺎح اﻟﺳل‬
Vaccines are prepared from ::‫ﯾﺗم ﺗﺣﺿﯾر اﻟﻠﻘﺎﺣﺎت ﻣن‬ Bacillus Calmette Guerin : vaccine protects against TB ,
it is a freeze dried live attenuated bacteria vaccine ,
• Live attenuated organisms ; BCG , oral reconstitute with diluent immediately before use .
polio(Sabin) , Measles , Rubella , Mumps Bacillus Calmette Guerin: ‫ ھو ﻟﻘﺎح ﻟﻠﺑﻛﺗﯾرﯾﺎ اﻟﺣﯾﺔ اﻟﻣوھﻧﺔ‬، ‫ﻟﻘﺎح ﯾﻘﻲ ﻣن اﻟﺳل‬
.‫ ﯾﻌﺎد ﺗﻛوﯾﻧﮫ ﺑﻣﺧﻔف ﻋﻠﻰ اﻟﻔور ﻗﺑل اﻻﺳﺗﺧدام‬، ‫اﻟﻣﺟﻔف ﺑﺎﻟﺗﺟﻣﯾد‬
‫اﻟﻛﺎﺋﻧﺎت اﻟﺣﯾﺔ اﻟﻣوھﻧﺔ؛‬BCG ، ‫ اﻟﻧﻛﺎف‬، ‫ اﻟﺣﺻﺑﺔ اﻷﻟﻣﺎﻧﯾﺔ‬، ‫ اﻟﺣﺻﺑﺔ‬، (‫ﺷﻠل اﻷطﻔﺎل اﻟﻔﻣوي )ﺳﺎﺑﯾن‬
• Should be kept away from direct light & stored below
10C*( 2-8c)
• Killed organisms ; Cholera , Typhoid ‫ درﺟﺔ ﻣﺋوﯾﺔ‬10 ‫ﯾﺟب إﺑﻌﺎده ﻋن اﻟﺿوء اﻟﻣﺑﺎﺷر وﺗﺧزﯾﻧﮫ ﻓﻲ درﺟﺔ ﺣرارة أﻗل ﻣن‬
IM polio (Salk) . (‫ درﺟﺔ ﻣﺋوﯾﺔ‬8-2) *
• .(‫ اﻟﺗﯾﻔود إم ﺷﻠل اﻷطﻔﺎل )ﺳﺎﻟك‬، ‫ﻟﻛﺎﺋﻧﺎت اﻟﺣﯾﺔ اﻟﻣﻘﺗوﻟﺔ اﻟﻛوﻟﯾرا‬ • Administered at birth or as soon as possible after birth or
at 6 weeks ‫ﯾﻌطﻰ ﻋﻧد اﻟوﻻدة أو ﻓﻲ أﻗرب وﻗت ﻣﻣﻛن ﺑﻌد اﻟوﻻدة أو ﻓﻲ‬
• Toxoids ; Diphtheria & Tetanus Toxoids . ‫اﻷﺳﺑوع اﻟﺳﺎدس‬
• Injected ID just above the insertion of deltoid muscle with
• Genetically Engineered ; Hepatitis B special tuberculin syringe
‫ﻣﻌرف ﻣﺣﻘون ﻓوق إدﺧﺎل اﻟﻌﺿﻠﺔ اﻟداﻟﯾﺔ ﻣﺑﺎﺷرة ﺑﻣﺣﻘﻧﺔ ﺗوﺑرﻛوﻟﯾن ﺧﺎﺻﺔ‬
‫اﻟﻣﮭﻧدﺳﺔ وراﺛﯾﺎ اﻟﺗﮭﺎب اﻟﻛﺑد ب‬ Mosby items and derived items © 2005, 2001 by Mosby, Inc. Mosby items and derived items © 2005, 2001 by Mosby, Inc.

BCG BCG
• The dose is 0.1ml ( 0.05 ml in newborn) (‫ ﻣل ﻋﻧد اﻟوﻟﯾد‬0.05) ‫ ﻣل‬0.1 ‫اﻟﺟرﻋﺔ‬
• Early reaction ; 2-3 days either previous BCG or TB
• Types of reaction ; ‫أﻧواع اﻟﺗﻔﺎﻋل‬ infection ‫ أﯾﺎم ﻋدوى ﺳﺎﺑﻘﺔ‬3-2 ‫رد ﻓﻌل ﻣﺑﻛر‬
• If no reaction repeat the test after 3 month
• Normal reaction a wheel about 5mm rappidly
disappears , after 2-3weeks a red papule appears , 6- ‫ أﺷﮭر‬3 ‫ ﻛرر اﻻﺧﺗﺑﺎر ﺑﻌد‬، ‫إذا ﻟم ﯾﻛن ھﻧﺎك رد ﻓﻌل‬
8 weeks small abscess then discharging ulcer about v Contraindication for BCG vaccine : ‫ﻣواﻧﻊ ﻟﻘﺎاح‬
10 mm , 8 -12 weeks the ulcer heals leaving small • Generalized eczema , hypogammaglobuliniemia ,
scar immunodeficiency conditions , HIV with symptoms of
AIDS related complex all a symptomatic
‫ أﺳﺎﺑﯾﻊ ﺧراج‬8-6 ، ‫ أﺳﺎﺑﯾﻊ ﺗظﮭر ﺣطﺎطﺔ ﺣﻣراء‬3-2 ‫ ﺑﻌد‬، ‫ ﻣﻠم ﺑﺳرﻋﺔ‬5 ‫رد ﻓﻌل طﺑﯾﻌﻲ ﺗﺧﺗﻔﻲ ﻋﺟﻠﺔ ﺣواﻟﻲ‬ HIV infected children should receive BCG vaccine
‫ﻋﺎ ﺗﻠﺗﺋم اﻟﻘرﺣﺔ ﺗﺎرﻛﺔ ﻧدﺑﺔ ﺻﻐﯾرة‬
ً ‫ أﺳﺑو‬12-8 ، ‫ ﻣﻠم‬10 ‫ﺻﻐﯾر ﺛم ﺗﻔرﯾﻎ اﻟﻘرﺣﺔ ﺣواﻟﻲ‬
‫ ﻓﯾروس‬، ‫ ﺣﺎﻻت ﻧﻘص اﻟﻣﻧﺎﻋﺔ‬، ‫ ﻧﻘص اﻟﺳﻛر ﻓﻲ اﻟدم‬، ‫اﻷﻛزﯾﻣﺎ اﻟﻣﻌﻣﻣﺔ‬
• Sever reaction ; after accidental injection in SC or ‫ ﯾﺟب أن‬، ‫ﻧﻘص اﻟﻣﻧﺎﻋﺔ اﻟﺑﺷرﯾﺔ اﻟﻣﺻﺣوب ﺑﺄﻋراض ﻣﻌﻘدة ﻣرﺗﺑطﺔ ﺑﺎﻹﯾدز‬
large dose , enlargement of axillary LN, cold abscess , ‫ﯾﺗﻠﻘﻰ اﻷطﻔﺎل اﻟﻣﺻﺎﺑون ﺑﻔﯾروس ﻧﻘص اﻟﻣﻧﺎﻋﺔ اﻟﺑﺷرﯾﺔ ﻟﻘﺎح‬BCG
some cases required anti TB
‫ أﺳﺎﺑﯾﻊ‬8-6 ، ‫ أﺳﺎﺑﯾﻊ ﺗظﮭر ﺣطﺎطﺔ ﺣﻣراء‬3-2 ‫ ﺑﻌد‬، ‫ ﻣﻠم ﺑﺳرﻋﺔ‬5 ‫رد ﻓﻌل طﺑﯾﻌﻲ ﺗﺧﺗﻔﻲ ﻋﺟﻠﺔ ﺣواﻟﻲ‬
‫ﻋﺎ ﺗﻠﺗﺋم اﻟﻘرﺣﺔ ﺗﺎرﻛﺔ ﻧدﺑﺔ ﺻﻐﯾرة‬
ً ‫ أﺳﺑو‬12-8 ، ‫ ﻣﻠم‬10Mosby
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‫ﻐﯾر‬2001
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‫ ﺧر‬Inc. Mosby items and derived items © 2005, 2001 by Mosby, Inc.

Mosby items and derived items © 2005, 2001 by Mosby, Inc.
Polio Vaccine ‫ﻟﻘﺎح ﺷﻠل اﻷطﻔﺎل‬
• 2 kinds are available : Salk IPV (
IM, SC route) , Sabin OPV (oral)
• OPV live attenuated polio virus its administered
as a trivalent vaccine TOPV , administered with
zero dose at birth then 2 – 4 – 6 months
‫ﻓﯾروس ﺷﻠل اﻷطﻔﺎل اﻟﺣﻲ اﻟﻣوھن ﻟـ‬OPV ‫اﻟذي ﯾُﻌطﻰ ﻛﻠﻘﺎح ﺛﻼﺛﻲ اﻟﺗﻛﺎﻓؤ‬TOPV
، ‫ أﺷﮭر‬6 - 4 - 2 ‫ﯾُﻌطﻰ ﺑﺟرﻋﺔ ﺻﻔرﯾﺔ ﻋﻧد اﻟوﻻدة ﺛم‬
• 2 drops /oral repeat the dose if the child spit it
‫ ﻓﻣوﯾﺎ ﺗﻛرر اﻟﺟرﻋﺔ إذا ﻗﺎم اﻟطﻔل ﺑﺑﺻﻘﮭﺎ‬/ ‫ﻗطرﺗﺎن‬
• Continue BF , hold hot water , milk , for ½ hour
after .
‫اﺳﺗﻣر ﻓﻲ‬BF ، .‫اﻣﺳك اﻟﻣﺎء اﻟﺳﺎﺧن واﻟﺣﻠﯾب ﻟﻣدة ﻧﺻف ﺳﺎﻋﺔ ﺑﻌد‬
Mosby items and derived items © 2005, 2001 by Mosby, Inc.
Severe suppurative adenopathy
post-BCG vaccination. Consent
was obtained
‫ ﺗم اﻟﺣﺻول ﻋﻠﻰ اﻟﻣواﻓﻘﺔ‬.‫اﻋﺗﻼل اﻟﻐدد اﻟﻘﯾﺣﻲ اﻟﺷدﯾد ﺑﻌد اﻟﺗطﻌﯾم‬
Mosby items and derived items © 2005, 2001 by Mosby, Inc.
Polio Vaccine
• Contraindications ; .‫ﻣواﻧﻊ‬
• Acute infectious disease ,fever , diarrhea , leukemia ,
corticosteroid therapy .
.‫ اﻟﻌﻼج ﺑﺎﻟﻛورﺗﯾﻛوﺳﺗﯾروﯾد‬، ‫ اﻟﻠوﻛﯾﻣﯾﺎ‬، ‫ اﻹﺳﮭﺎل‬، ‫ اﻟﺣﻣﻰ‬، ‫اﻷﻣراض اﻟﻣﻌدﯾﺔ اﻟﺣﺎدة‬
• IPV ; killed polio vaccine , is expensive and produce
short live immunity .
IPV. .‫ ﻣﻛﻠف وﯾﻧﺗﺞ ﻣﻧﺎﻋﺔ ﻗﺻﯾرة اﻟﻌﻣر‬، ‫ﻟﻘﺎح ﺷﻠل اﻷطﻔﺎل اﻟﻣﻘﺗول‬
• Polio eradication campaign : its includes periodic
mass vaccination to all children under 5 years at the
same time , even if previously vaccinated to raise the
level of population immunity .(PPI pulse polio
immunization ) to eradicate poliomyelitis.
• ‫ وﺗﺷﻣل اﻟﺗطﻌﯾم اﻟﺷﺎﻣل اﻟدوري ﻟﺟﻣﯾﻊ اﻷطﻔﺎل‬:‫ﺣﻣﻠﺔ اﺳﺗﺋﺻﺎل ﺷﻠل اﻷطﻔﺎل‬
‫ ﺣﺗﻰ ﻟو ﺳﺑق ﺗطﻌﯾﻣﮭم ﻟرﻓﻊ ﻣﺳﺗوى اﻟﻣﻧﺎﻋﺔ‬، ‫دون ﺳن اﻟﺧﺎﻣﺳﺔ ﻓﻲ ﻧﻔس اﻟوﻗت‬
) ‫اﻟﺳﻛﺎﻧﯾﺔ‬PPI pulse polo immunization) .‫ﻟﻠﻘﺿﺎء ﻋﻠﻰ ﺷﻠل اﻷطﻔﺎل‬
Mosby items and derived items © 2005, 2001 by Mosby, Inc.
 DPT
Polio Vaccine (‫ﻟﻘﺎح ﺛﻼﺛﻲ )ﯾﺳﺗﺧدم ﻟﻌﻼج ﻋدة اﻣراض‬
• Protects against Diphtheria , Pertussius (whooping
• Notification system : whenever a case cough) and Tetanus .
of acute flaccid paralysis is discovered .‫ﯾﻘﻲ ﻣن اﻟدﻓﺗﯾرﯾﺎ واﻟﺳﻌﺎل اﻟدﯾﻛﻲ واﻟﺗﯾﺗﺎﻧوس‬
health authorities are Immediately • It is a triple vaccine containing D.toxoid & T.toxoid and
brodetella pertussis
notified .
‫وھو ﻟﻘﺎح ﺛﻼﺛﻲ ﯾﺣﺗوي ﻋﻠﻰ داء اﻟﺗوﻛﺳوﯾد واﻟﺗوﻛﺳوﯾد واﻟﺗوﻛﺳوﯾد واﻟﺳﻌﺎل اﻟدﯾﻛﻲ‬
‫ ﯾﺗم‬، ‫ ﻓﻲ ﺣﺎﻟﺔ اﻛﺗﺷﺎف ﺣﺎﻟﺔ ﺷﻠل رﺧو ﺣﺎد‬:‫ﻧظﺎم اﻹﺧطﺎر‬ • The dose 0.5ml IM in the middle of lateral aspect of the
thigh
.‫إﺧطﺎر اﻟﺳﻠطﺎت اﻟﺻﺣﯾﺔ ﻋﻠﻰ اﻟﻔور‬
‫ ﻣل ﻋﺿﻠﻲ ﻓﻲ ﻣﻧﺗﺻف اﻟﺟﺎﻧب اﻟﺟﺎﻧﺑﻲ ﻣن اﻟﻔﺧذ‬0.5 ‫ﺟرﻋﺔ‬
• Reaction after DPT ; fever (give paracetamol ). Local
soreness , abscess , convulsion due to components of
pertussius vaccine (very rare )
‫رد ﻓﻌل ﺑﻌد‬DPT. ، ‫ وﺟﻊ ﻣوﺿﻌﻲ‬.(‫اﻟﺣﻣﻰ )اﻋطﺎء اﻟﺑﺎراﺳﯾﺗﺎﻣول‬
(‫ اﺧﺗﻼج ﺑﺳﺑب ﻣﻛوﻧﺎت ﻟﻘﺎح اﻟﺳﻌﺎل اﻟدﯾﻛﻲ )ﻧﺎدر ﺟدا‬، ‫ﺧراج‬
Mosby items and derived items © 2005, 2001 by Mosby, Inc. Mosby items and derived items © 2005, 2001 by Mosby, Inc.

DPT Measles ‫ﻣرض اﻟﺣﺻﺑﺔ‬

• DPT is contraindicated in ; progressive • It contains live attenuated measles virus
neurological problems and with sever freeze dried material at the bottom of the
reaction in the 1st dose , subsequent container diluted immediately before use.
vaccines recommended without ‫ﯾﺣﺗوي ﻋﻠﻰ ﻣﺎدة ﻣﺟﻔﻔﺔ ﻣﺟﻔﻔﺔ ﺑﻔﯾروس اﻟﺣﺻﺑﺔ اﻟﺣﻲ اﻟﻣوھن ﻓﻲ‬
Pertussius component. .‫ﻗﺎع اﻟﺣﺎوﯾﺔ اﻟﻣﺧﻔﻔﺔ ﻣﺑﺎﺷرة ﻗﺑل اﻻﺳﺗﺧدام‬
‫ھو ﺑطﻼن‬DPT ، ‫ﻓﻲ ؛ ﻣﺷﺎﻛل ﻋﺻﺑﯾﺔ ﻣﺗرﻗﯾﺔ ﻣﻊ رد ﻓﻌل ﺷدﯾد ﻓﻲ اﻟﺟرﻋﺔ اﻷوﻟﻰ‬
‫ﯾوﺻﻰ ﺑﺎﺳﺗﺧدام ﻟﻘﺎﺣﺎت ﻻﺣﻘﺔ ﺑدون ﻣﻛون اﻟﺳﻌﺎل اﻟدﯾﻛﻲ‬ • It is given at 9 month of age ..‫ أﺷﮭر‬9 ‫ﯾﻌطﻰ ﻓﻲ ﻋﻣر‬
• SC injection , 0.5ml
• Reaction after vaccination; fever developed 7-8 days
after vaccination, a mild measles rash may
appeared .
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• ‫ وﻗد ﯾظﮭر طﻔﺢ ﺟﻠدي‬، ‫ أﯾﺎم ﻣن اﻟﺗطﻌﯾم‬8-7Mosby
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‫ﻟﺣ‬derived
‫ورت ا‬items
‫©ﺗط‬.2005,
‫طﻌﯾم‬2001
‫ اﻟﺗ‬by‫ﻌد‬Mosby,
‫ﻌل ﺑ‬Inc.
‫رد ﻓ‬
.‫ﺧﻔﯾف ﺑﺳﺑب اﻟﺣﺻﺑﺔ‬
 Hepatitis B Vaccine Tetanus Toxoid (TT)
‫ﻟﻘﺎح اﻟﺗﮭﺎب اﻟﻛﺑد ب‬ Vaccine ) ‫ﻟﻘﺎح اﻟﺗﯾﺗﺎﻧوس ﺗوﻛﺳوﯾد‬
• Immunization during pregnancy to protect the newborn
• It is an inactivated product produced by against neonatal tetanus and the mother against tetanus
yeast into which the gene governing the during or after labour.
.‫اﻟﺗﺣﺻﯾن أﺛﻧﺎء اﻟﺣﻣل ﻟﺣﻣﺎﯾﺔ اﻟﻣوﻟود ﻣن اﻟﻛزاز اﻟوﻟﯾدي واﻷم ﺿد اﻟﺗﯾﺗﺎﻧوس أﺛﻧﺎء أو ﺑﻌد اﻟﻣﺧﺎض‬
production of Hep B surface antigen • Pregnant mother should receive 2 doses TT1 , TT2 4 weeks
(HBsAg) has been inserted by genetic apart , TT2 at least 4weeks before labour
‫ﯾﺟب أن ﺗﺗﻠﻘﻰ اﻷم اﻟﺣﺎﻣل ﺟرﻋﺗﯾن ﻣن‬TT1 ، TT2 ، ‫ أﺳﺎﺑﯾﻊ‬4 ‫ﺑﻔﺎﺻل‬TT2 ‫ أﺳﺎﺑﯾﻊ ﻗﺑل اﻟﻣﺧﺎض‬4 ‫ﻋﻠﻰ اﻷﻗل‬
engineering . • TT3 booster dose at least 6 month after TT2 or during
subsequent pregnancy .
‫إﻧﮫ ﻣﻧﺗﺞ ﻣﻌطل ﺗﻧﺗﺟﮫ اﻟﺧﻣﯾرة ﺣﯾث ﺗم إدﺧﺎل اﻟﺟﯾن اﻟذي ﯾﺗﺣﻛم ﻓﻲ‬
‫إﻧﺗﺎج ﻣﺳﺗﺿد ﺳطﺢ‬Hep B (HBsAg) .‫ﺑواﺳطﺔ اﻟﮭﻧدﺳﺔ اﻟوراﺛﯾﺔ‬ ‫ﺟرﻋﺔ ﻣﻌززة ﻣن‬TT3 ‫ أﺷﮭر ﻋﻠﻰ اﻷﻗل ﻣن‬6 ‫ﺑﻌد‬TT2 .‫أو أﺛﻧﺎء اﻟﺣﻣل اﻟﻼﺣق‬
• TT4 at least one year after TT3 or during subsequent
• 0.5 ml IM in the middle of the lateral pregnancy . TT5 at least one year after TT4 or during
subsequent pregnancy
aspect of the thigh . TT4 ‫ﺑﻌد ﺳﻧﺔ واﺣدة ﻋﻠﻰ اﻷﻗل ﻣن‬TT3 .‫أو أﺛﻧﺎء اﻟﺣﻣل اﻟﻼﺣق‬TT5 ‫ﺑﻌد ﺳﻧﺔ واﺣدة ﻋﻠﻰ اﻷﻗل ﻣن‬TT4 ‫أو أﺛﻧﺎء اﻟﺣﻣل اﻟﻼﺣق‬

• 0.5 ml IM in the upper part of the left arm .

.‫ ﻣل ﻋﺿﻠﻲ ﻓﻲ ﻣﻧﺗﺻف اﻟﺟﺎﻧب اﻟﺟﺎﻧﺑﻲ ﻣن اﻟﻔﺧذ‬0.5 • .‫ ﻣل ﻋﺿﻠﻲ ﻓﻲ اﻟﺟزء اﻟﻌﻠوي ﻣن اﻟذراع اﻟﯾﺳرى‬0.5

• There are no side effects ‫ﻟﯾس ھﻧﺎك أي آﺛﺎر ﺟﺎﻧﺑﯾﺔ‬

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Vaccine Timing route amount

BCG + Bacille Calmette- Birth ID 0.05ml

Other Vaccines
‫ﯾﺳﺗﺧدم ﻟﻠﻘﺎح اﻟﺳل‬ Guérin vaccine
‫ﻟﻘﺎح ﻛﺎﻟﻣﯾت ﻏﯾران‬ ‫وﻻدة‬
‫ﻟﻘﺎﺣﺎت أﺧرى‬
Hepatitis B Birth ,2,4,6 IM 0.05ml • Haemophilus Influnzae type b Vaccine:
months
‫اﻟﺗﮭﺎب اﻟﻛﺑد ب‬ ، 4 ، 2 ، ‫اﻟوﻻدة‬
important cause of meningitis and
‫ أﺷﮭر‬6 pneumonia among children below 5 years.
OPV Diphtheria and tetanus 2, 4, 6 .‫ﺳﺑب ﻣﮭم ﻻﻟﺗﮭﺎب اﻟﺳﺣﺎﯾﺎ واﻻﻟﺗﮭﺎب اﻟرﺋوي ﺑﯾن اﻷطﻔﺎل دون ﺳن اﻟﺧﺎﻣﺳﺔ‬
DTaP toxoid with whole cell months IM 0.5ml
PHibHep pertussis, Hib and ‫ ﺷﮭور‬6 ، 4 ، 2 • Conjugated vaccine (HbCV) consist of a
(Pentavalent) HepB vaccine Booster capsular polysaccharide conjugated to a
pnemococal ‫ﻟﻘﺎح اﻟدﻓﺗﯾرﯾﺎ واﻟﺗﯾﺗﺎﻧوس ﻣﻊ‬ dose @16 – protein .
Rota ‫اﻟﺳﻌﺎل اﻟدﯾﻛﻲ ﻛﺎﻣل اﻟﺧﻠﯾﺔ‬ 24 month
‫ﺟرﻋﺔ ﻣﻌززة ﻣن‬ ) ‫ﯾﺗﻛون اﻟﻠﻘﺎح اﻟﻣﻘﺗرن‬HbCV) .‫ﻣن ﻋدﯾد اﻟﺳﻛﺎرﯾد اﻟﻣﺗراﻓق ﻣﻊ اﻟﺑروﺗﯾن‬
‫ ﺷﮭر‬24 ‫ إﻟﻰ‬16
• IM route 0.5 ml 2 – 4 – 6 month , booster
‫ﻣرض اﻟﺣﺻﺑﺔ‬ Measles vaccine 9 months SC 0.5 ml dose at 18 month
Measles ‫ﻟﻘﺎح اﻟﺣﺻﺑﺔ‬ ‫ أﺷﮭر‬9 ‫ ﺷﮭر‬18 ‫ ﺟرﻋﺔ ﻣﻌززة ﻋﻧد‬، ‫ ﺷﮭور‬6 - 4 - 2 ‫ ﻣل‬0.5 ‫طرﯾق اﻟﻌﺿل‬
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OPV-1 ‫ﻟﻘﺎح ﺷﻠل اﻷطﻔﺎل اﻟﻔﻣوي‬ 2 months Oral 2 drops
.
 Other Vaccines Other Vaccines
• Varicella Vaccine ( chickenpox)::(‫ﻟﻘﺎح اﻟﺣﻣﺎق )ﺟدري اﻟﻣﺎء‬ • Meningococcal Vaccine : available for
Live attenuated vaccine , recommended for children at Neisseria meningitidiis it is not routine
risk of developing severe chickenpox e.g leukemia ,
and patients receive steroids 0.5ml SC. vaccination it is for epidemics and
‫ ﻣوﺻﻰ ﺑﮫ ﻟﻸطﻔﺎل اﻟﻣﻌرﺿﯾن ﻟﺧطر اﻹﺻﺎﺑﺔ ﺑﺟدري اﻟﻣﺎء‬، ‫ﻟﻘﺎح ﺣﻲ ﻣوھن‬ outbreaks .
‫ ﻣل‬0.5 ‫ وﯾﺗﻠﻘﻰ اﻟﻣرﺿﻰ اﻟﻣﻧﺷطﺎت‬، ‫اﻟﺷدﯾد ﻣﺛل ﺳرطﺎن اﻟدم‬SC.
• Pneumococcal Vaccine : protection from infections ‫ وھو ﻟﯾس ﺗطﻌﯾًﻣﺎ‬، ‫ ﻣﺗوﻓر ﻟﻠﻧﯾﺳﯾرﯾﺎ اﻟﺳﺣﺎﺋﯾﺔ‬:‫ﻟﻘﺎح اﻟﻣﻛورات اﻟﺳﺣﺎﺋﯾﺔ‬
caused by strep-pneumonia resulting pneumonia , .‫روﺗﯾﻧﯾًﺎ ﺑل ﻟﻸوﺑﺋﺔ وﺗﻔﺷﻲ اﻷﻣراض‬
meningitis, otitis media its indicated for nephrotic
syndrome , CRF, immunosuppressive, SC , 0.5ml. • SC , 0.5ml
‫ اﻟﺣﻣﺎﯾﺔ ﻣن اﻻﻟﺗﮭﺎﺑﺎت اﻟﺗﻲ ﺗﺳﺑﺑﮭﺎ اﻻﻟﺗﮭﺎب اﻟرﺋوي‬:‫ﻟﻘﺎح اﻟﻣﻛورات اﻟرﺋوﯾﺔ‬
‫ واﻟﺗﮭﺎب اﻷذن اﻟوﺳطﻰ‬، ‫ واﻟﺗﮭﺎب اﻟﺳﺣﺎﯾﺎ‬، ‫اﻟﻌﻘدي اﻟﻧﺎﺗﺞ ﻋن اﻻﻟﺗﮭﺎب اﻟرﺋوي‬
، ‫ واﻟﻣﺷﺎر إﻟﯾﮫ ﻓﻲ اﻟﻣﺗﻼزﻣﺔ اﻟﻛﻠوﯾﺔ‬،CRF ، ، ‫ﻣﺛﺑط اﻟﻣﻧﺎﻋﺔ‬SC ، 0.5 ‫ﻣل‬
• Rotavirus Vaccine : tetravalent rhesus
rotavirus vaccine (RRTTV) below 2years
age 3doses 4 – 6 – 26 weeks of age .
• ) ‫ ﻟﻘﺎح اﻟﻔﯾروﺳﺔ اﻟﻌﺟﻠﯾﺔ رﺑﺎﻋﻲ اﻟﺗﻛﺎﻓؤ‬:‫ﻟﻘﺎح اﻟﻔﯾروﺳﺔ اﻟﻌﺟﻠﯾﺔ‬RRTTV) ‫ﺑﻌﻣر أﻗل‬
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‫ﻣ‬

Contraindications
Other Vaccines ‫ﻣواﻧﻊ‬
• Hep A vaccine : live attenuated vaccine from age of
2years , 3 doses IM one month interval in high risk
• Acute febrile illness immunization should
children. be postponed. .‫ﯾﺟب ﺗﺄﺟﯾل اﻟﺗﺣﺻﯾن ﺿد أﻣراض اﻟﺣﻣﻰ اﻟﺣﺎدة‬
‫ﻟﻘﺎح‬Hep A: ‫ ﺟرﻋﺎت ﻓﻲ اﻟﻌﺿل ﺑﻔﺎﺻل ﺷﮭر‬3 ، ‫ﻟﻘﺎح ﺣﻲ ﻣوھن ﻣن ﺳن ﺳﻧﺗﯾن‬
.‫واﺣد ﻋﻧد اﻷطﻔﺎل اﻟﻣﻌرﺿﯾن ﻟﻠﺧطر‬ • Live-virus in leukemia , CA .
• Typhoid vaccine : monovalent prepared from killed
S.typhi , bivalent anti-typhid vaccine prepared from
Immunodeficiency disease
s.tayph & para typhi.
‫ ﻣرض ﻧﻘص اﻟﻣﻧﺎﻋﺔ‬.‫ ﻛﺎﻟﯾﻔورﻧﯾﺎ‬، ‫ﯾﻌﯾش اﻟﻔﯾروس ﻓﻲ ﺳرطﺎن اﻟدم‬
‫ أﺣﺎدي اﻟﺗﻛﺎﻓؤ ﻣﺣﺿر ﻣن‬:‫ﻟﻘﺎح اﻟﺗﯾﻔوﺋﯾد‬S.typhi ‫ ﻟﻘﺎح ﺛﻧﺎﺋﻲ اﻟﺗﻛﺎﻓؤ‬، ‫اﻟﻣﻘﺗوﻟﺔ‬
‫ﻣﺿﺎد ﻟﻠﺗﯾﻔﯾد ﻣﺣﺿر ﻣن‬
• Children sensitive to egg , chicken
• Consist of 2 doses SC ,0.5ml 4-6 weeks interval children
1-10 years needs 0.25 ml dose (measles) (‫اﻷطﻔﺎل ﺣﺳﺎﺳون ﻟﻠﺑﯾض واﻟدﺟﺎج )اﻟﺣﺻﺑﺔ‬
. ‫ ﺗﺗﻛون ﻣن ﺟرﻋﺗﯾن‬SC ، 0.5 ‫ ﺳﻧوات‬10-1 ‫ أﺳﺎﺑﯾﻊ ﻟﻸطﻔﺎل‬6-4 ‫ﻣل ﺑﻔﺎﺻل‬
.‫ ﻣل ﺟرﻋﺔ‬0.25 ‫ﯾﺣﺗﺎﺟون‬ • Reaction to DPT ‫رد ﻓﻌل ﻋﻠﻰ‬
• Oral typhoid vaccine (Typhoral) . .(‫ﻟﻘﺎح اﻟﺗﯾﻔود اﻟﻔﻣوي )ﺗﺎﯾﻔورال‬
• Anaphylactic reaction to vaccine ..‫رد ﻓﻌل ﺗﺣﺳﺳﻲ ﻟﻠﻘﺎح‬
Mosby items and derived items © 2005, 2001 by Mosby, Inc. • Resent administration of IG ‫إدارة ﻣﺳﺗﺎءة ﻣن‬ Mosby items and derived items © 2005, 2001 by Mosby, Inc.
 Types of Cold Chain
Equipments
Cold Chain ‫ﺳﻠﺳﻠﺔ اﻟﺗﺑرﯾد‬ ‫أﻧواع ﻣﻌدات ﺳﻠﺳﻠﺔ اﻟﺗﺑرﯾد‬
• Is a system for storage , transport , and distribution • Walk in cold rooms (WIC) .‫اﻟﻣﺷﻲ ﻓﻲ ﻏرف اﻟﺗﺑرﯾد‬
of vaccines in the state of efficiency and potency at • Deep freezers top opening cold chain.
recommended temp from manufacture to the
.‫اﻟﻣﺟﻣدات اﻟﻌﻣﯾﻘﺔ أﻋﻠﻰ ﺳﻠﺳﻠﺔ اﻟﺗﺑرﯾد‬
actual recipient of the vaccine .
• Ice Linked Refrigerators ..‫ﺛﻼﺟﺎت ﺛﻠﺟﯾﺔ‬
‫ھو ﻧظﺎم ﻟﺗﺧزﯾن اﻟﻠﻘﺎﺣﺎت وﻧﻘﻠﮭﺎ وﺗوزﯾﻌﮭﺎ ﻓﻲ ﺣﺎﻟﺔ اﻟﻛﻔﺎءة واﻟﻔﻌﺎﻟﯾﺔ ﺑﺎﻟدرﺟﺔ اﻟﻣوﺻﻰ ﺑﮭﺎ‬
.‫ﻣن اﻟﺗﺻﻧﯾﻊ إﻟﻰ اﻟﻣﺗﻠﻘﻲ اﻟﻔﻌﻠﻲ ﻟﻠﻘﺎح‬ • Cold boxes available in PHC centers

• All vaccines required stored at 4-8C*, protected ‫اﻟﺻﻧﺎدﯾق اﻟﺑﺎردة ﻣﺗوﻓرة ﻓﻲ ﻣراﻛز اﻟرﻋﺎﯾﺔ اﻟﺻﺣﯾﺔ اﻷوﻟﯾﺔ‬
from sunlight except polio -20C* • Vaccine carriers ( 16-20 vials only ). .(‫ ﻗﻧﯾﻧﺔ ﻓﻘط‬20-16) ‫ﻧﺎﻗﻼت اﻟﻠﻘﺎح‬
‫ ﻣﺣﻣﯾﺔ ﻣن أﺷﻌﺔ اﻟﺷﻣس‬، * ‫ درﺟﺔ ﻣﺋوﯾﺔ‬8-4 ‫ﯾﺗم ﺗﺧزﯾن ﺟﻣﯾﻊ اﻟﻠﻘﺎﺣﺎت اﻟﻣطﻠوﺑﺔ ﻓﻲ‬ • Day carriers only for few hours 6-8 vials
* ‫ درﺟﺔ ﻣﺋوﯾﺔ‬20- ‫ﺑﺎﺳﺗﺛﻧﺎء ﺷﻠل اﻷطﻔﺎل‬
‫ ﻗوارﯾر‬8-6 ‫ﻧﺎﻗﻼت اﻟﯾوم اﻟواﺣد ﻓﻘط ﻟﺑﺿﻊ ﺳﺎﻋﺎت‬
• Multidose opened vial which is not fully used must • Ice packs used for cold boxes and vaccine carriers
be discarded. ‫ﻋﺑوات اﻟﺛﻠﺞ اﻟﻣﺳﺗﺧدﻣﺔ ﻓﻲ اﻟﺻﻧﺎدﯾق اﻟﺑﺎردة وﻧﺎﻗﻼت اﻟﻠﻘﺎح‬
‫ﻣﺗﻌددة اﻟﺟرﻋﺎت اﻟﺗﻲ ﻟم ﯾﺗم اﺳﺗﺧداﻣﮭﺎ ﺑﺷﻛل ﻛﺎﻣل‬Mosby
‫وﺣﺔ‬items
‫ﻣﻔﺗ‬and‫ اﻟ‬derived
‫رورة‬items
‫ن© اﻟﻘﺎ‬2005,
‫صﻣ‬ ‫ﺧﻠ‬by‫ﻟﺗ‬Mosby,
2001 ‫ﺟب ا‬Inc.‫ﯾ‬ Mosby items and derived items © 2005, 2001 by Mosby, Inc.

Nursing Responsibilities
‫ﻣﺳؤوﻟﯾﺎت اﻟﺗﻣرﯾض‬
• Nurses are mostly responsible for administration
of immunization and its related activities :
:‫اﻟﻣﻣرﺿﺎت ﻣﺳؤوﻟون ﻓﻲ اﻟﻐﺎﻟب ﻋن إدارة اﻟﺗطﻌﯾم واﻷﻧﺷطﺔ اﻟﻣرﺗﺑطﺔ ﺑﮫ‬
• Motivation of general people about the
importance of immunization.
.‫ﺗﺣﻔﯾز ﻋﺎﻣﺔ اﻟﻧﺎس ﻋﻠﻰ أھﻣﯾﺔ اﻟﺗﺣﺻﯾن‬
• Assess family’s beliefs and values to assist in
the education of the family .
.‫ﺗﻘﯾﯾم ﻣﻌﺗﻘدات اﻷﺳرة وﻗﯾﻣﮭﺎ ﻟﻠﻣﺳﺎﻋدة ﻓﻲ ﺗﻌﻠﯾم اﻷﺳرة‬
• acquire up-to-date information because
recommendations are revised frequently .
Mosby items and derived items © 2005, 2001 by Mosby, Inc.
‫ﺗوﺻﯾﺎت ﺗﺗم ﻣراﺟﻌﺗﮭﺎ ﺑﺷﻛل ﻣﺗﻛرر‬Mosby
‫ن اﻟ‬items
‫ت ﻷ‬and‫ﻣﺎ‬derived
‫ﻟﻣﻌﻠو‬items
‫ﺣد©ث ا‬2005,
‫ﻰ أ‬2001
‫ ﻋﻠ‬by‫ول‬Mosby,
‫ﺣﺻ‬Inc.‫اﻟ‬
Family Centered care Special Considerations
‫رﻋﺎﯾﺔ ﺗﺗﻣﺣور ﺣول اﻷﺳرة‬ ‫إﻋﺗﺑﺎرات ﺧﺎﺻﺔ‬
• Communicating with parents about • The gluteal site is not recommended at
immunizations : any age for the administration of the hep-
:‫اﻟﺗواﺻل ﻣﻊ أوﻟﯾﺎء اﻷﻣور ﺑﺷﺄن اﻟﺗطﻌﯾﻣﺎت‬ B vaccine , because there is diminished
immunogenicity in the gluteal site
vProvide accurate information about ( AAP - 2003).
vaccines. .‫ﻗدم ﻣﻌﻠوﻣﺎت دﻗﯾﻘﺔ ﻋن اﻟﻠﻘﺎﺣﺎت‬ ‫ﻻ ﯾوﺻﻰ ﺑﺎﺳﺗﺧدام ﻣوﻗﻊ اﻷﻟوﯾﺔ ﻓﻲ أي ﻋﻣر ﻹﻋطﺎء ﻟﻘﺎح‬
vAvoid judgmental or threatening ‫اﻟﻛﺑد‬B ، ‫ﻧظًرا ﻟوﺟود ﻣﻧﺎﻋﺔ ﻣﺗﻧﺎﻗﺻﺔ ﻓﻲ ﻣوﻗﻊ اﻷﻟوﯾﺔ‬
language . .‫ﺗﺟﻧب ﻟﻐﺔ إﺻدار اﻷﺣﻛﺎم أو اﻟﺗﮭدﯾد‬ )AAP - 2003).
vInvolve the parent in minimizing the
potential adverse effects of the vaccine
‫إﺷراك اﻟواﻟدﯾن ﻓﻲ اﻟﺗﻘﻠﯾل ﻣن اﻵﺛﺎر اﻟﺿﺎرة اﻟﻣﺣﺗﻣﻠﺔ ﻟﻠﻘﺎح‬
Mosby items and derived items © 2005, 2001 by Mosby, Inc. Mosby items and derived items © 2005, 2001 by Mosby, Inc.

Special Considerations
• Live measles vaccine is produced by chick
embryo cell culture , there is a remote
possibility of anaphylactic hypersensitivity
in children with egg allergies so it is
contraindicated in those children (AAP-2003).
‫ وھﻧﺎك‬، ‫ﻟﻘﺎح اﻟﺣﺻﺑﺔ اﻟﺣﻲ ﯾﺗم إﻧﺗﺎﺟﮫ ﻋن طرﯾق زراﻋﺔ اﻟﺧﻼﯾﺎ اﻟﺟﻧﯾﻧﯾﺔ ﻟﻠﻛﺗﺎﻛﯾت‬
‫ ﻟذا ﻓﮭو‬، ‫اﺣﺗﻣﺎل ﺑﻌﯾد ﻟﻔرط اﻟﺣﺳﺎﺳﯾﺔ اﻟﺗﺄﻗﯾﺔ ﻟدى اﻷطﻔﺎل اﻟﻣﺻﺎﺑﯾن ﺑﺣﺳﺎﺳﯾﺔ اﻟﺑﯾض‬
) ‫ﻣواﻧﻊ ﻋﻧد ھؤﻻء اﻷطﻔﺎل‬AAP-2003).

• Any immunization may cause an

anaphylactic reaction all offices and clinics
must have epinephrine available
‫ﻗد ﯾﺗﺳﺑب أي ﺗﻣﻧﯾﻊ ﻓﻲ ﺣدوث رد ﻓﻌل ﺗﺣﺳﺳﻲ ﯾﺟب أن ﯾﺗوﻓر ﻓﻲ ﺟﻣﯾﻊ اﻟﻌﯾﺎدات‬
‫رﯾن‬2001
Mosby items and derived items © 2005, ‫ﺑﯾﻧﻔ‬by‫ت إ‬ ‫ﯾﺎدا‬Inc.
Mosby, ‫واﻟﻌ‬ Mosby items and derived items © 2005, 2001 by Mosby, Inc.
Thanks

Mosby items and derived items © 2005, 2001 by Mosby, Inc.