1. Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Chapter 68 Childhood Immunization

2. 2Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 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

3. 3Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. General Considerations  Definitions  Vaccine  Killed vaccines vs. live vaccines  Toxoid  Vaccination  Immunization; active vs. passive  Specific immune globulins

4. 4Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 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

5. 5Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. General Considerations  Immunization records  National Childhood Vaccine Act of 1986 requires a permanent record of each mandated vaccination Date of vaccination Date of vaccination Route and site of vaccination Route and site of vaccination Vaccine type, manufacturer, lot number, expiration date Vaccine type, manufacturer, lot number, expiration date Name, address, title of person administering the vaccine Name, address, title of person administering the vaccine  Reason for record To ensure appropriate vaccination To ensure appropriate vaccination To avoid overvaccination To avoid overvaccination

6. 6Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. General Considerations  Adverse effects of immunization  Immunocompromised children are at special risk from live vaccines Congenital immunodeficiency Congenital immunodeficiency HIV infection HIV infection Leukemia Leukemia Lymphoma Lymphoma Generalized malignancy Generalized malignancy Therapy with radiation Therapy with radiation Cytotoxic anticancer drugs Cytotoxic anticancer drugs High-dose glucocorticoids High-dose glucocorticoids

7. 7Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Target Diseases  Measles  Mumps  Rubella  Diphtheria  Tetanus (lockjaw)  Pertussis (whooping cough)  Poliomyelitis (polio or infantile paralysis)

8. 8Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Target Diseases  Haemophilus influenzae type b  Varicella (chickenpox)  Hepatitis B  Hepatitis A  Pneumococcal infection  Meningococcal infection  Influenza  Rotavirus gastroenteritis  Genital human papillomavirus infection

9. 9Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 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

10. 10Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 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