Session 6

Immunization

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Learning Objectives
By the end of this session, the students will be able to:

(1) review the principles of immunology; (2) check the child’s immunization status; (3) recommend the proper immunization to all sick children; and (4) demonstrate the proper technique of immunization
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Immunization
Disease prevention means immunizing infants and young children against preventable viral and bacterial diseases. Goal of immunization: to confer long lasting immunity against infectious diseases . - immediate goal is prevention of disease in individuals or groups - ultimate goal is eradication of disease . Physicians, therefore, must maintain timely immunization, (both active and passive) as high priority in the care of infants and children; and must complete the course of immunizations.

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Check the child’s Immunization Status
Age At Birth 6 weeks 10 weeks 14 weeks 9 months Vaccine BCG, HBVI DPT1, OPV1 DPT2, OPV2, HBV2 DPT3, OPV3,HBV3 Measles

Decide if child needs an immunization today or if the mother should be told to come back with the child at a later date for immunization.

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Follow DOH Recommended Immunization Schedule
Vaccine/ Route BCG /ID HBV /IM DPT/ IM OPV/PO Measles/ SC Minimum Age At First Dose Birth Birth 6 weeks 6 weeks 9 months Number Minimum Interval of Doses Between doses* 1 3 3 3 1

4 weeks 4 weeks 4 weeks

*This provides maximal immunity to the 7 EPI diseases before the child’s 1st birthday.

(1) Give the recommended vaccine when the child is at the appropriate age for each dose. (2) All children should receive all the recommended immunizations before their 1st birthday. (3) If the child do not come for an immunization at the recommended age. Give necessary immunization any time after the child reaches that age. (4) No need to repeat the whole schedule

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Contraindications to Immunization
 Minor

illness is not a contraindication to immunization, should not delay immunization is very important to immunize sick and malnourished children against tuberculosis, Hepatitis B, Measles, Polio, Diphtheria, Pertussis & Tetanus

 It

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Situations Contraindicated to Immunization
BCG – DO not give BCG to a child known to have AIDS DPT – DO not give DPT2/DPT3 to a child who had convulsive seizures, shock or any other adverse reaction after the most recent dose. Instead, give DT DPT – Do not give to a child with recurrent convulsions or another active neurological disease of the central nervous system OPV – If the child has diarrhea, give a dose of OPV, but do not count the dose, ask the mother to return in 4 weeks for the missing dose of OPV

 If

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the child is going to be referred, do not immunize the child before referral

Exercise: Decide if contraindicated or not
If the child pneumonia:
       

Immunize this child No Immunization Today today if scheduled Has no

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 

Has cough or cold Has diarrhea Has AIDS Has no immunization at all Has fever Has current antiMicrobial therapy Has local skin Infection Has convulsion after DPT1 & needs DPT2 & OPV2 today Has chronic Heart Problem Has Malnutrition

Exercise: Decide if contraindicated or not
If the Child: Immunize this child today if scheduled No Immunization Today

 

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Has recent exposure to Infectious Disease Is exclusively breastfed Has older brother with convulsion last year Has mild to moderate local reaction (soreness, redness, swelling) Is in the convalescent phase of Illness Has personal or family history of penicillin allergies/other allergies Has Tetanus

Exercise: Decide if contraindicated or not
If the child

Immunize this child Today if scheduled

No Immunization Today

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Is an atypical / special host – Congenital disorders of immune function ( no live virus nor live bacteria vaccines) – Corticosteroid /Immunosuppressive therapy – Has immuneglobulin or blood or packed rbc/ platelet/ FFP/ Cryoprecipitate transfusion – Has household contacts of Persons with immunologic Deficiency ( no OPV ) - Has postexposure to: Hepatitis B Measles Diphtheria Pertussis Tetanus

Assess other problems
 Assess

any other problems mentioned by the mother or observed during the physical examination.  Refer to any guidelines on treatment of the problems.  Refer to the hospital if: - The infant has a serious problem - You do not know how to help the infant
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