1. Vaccines Tetanus Haemophilus MMR Nikki Hoheisel Morgan Rehm Michelle Savage Amy Lindgren

2. Mode of Transmission Tetanus is caused by a toxin produced by a bacterium, Clostridium tetani. They produce spores that are very difficult to kill as they are resistant to heat and many chemical agents. Enters through a break in the skin The toxin causes painful muscle spasms Attacks the jaw muscles first “lock jaw” Without the vaccine, 3 in 10 would die

3. Vaccine Several vaccines are used to prevent tetanus among children, adolescents, and adults including DTaP, Tdap, DT, and Td. Can be used in three ways: ◦ As a catch-up for people who did not get all their doses of DTaP when they were children ◦ As a booster, dose every 10 years ◦ For protection against tetanus infection after a wound

4. When to Vaccinate There are four combination vaccines used to prevent diphtheria, tetanus and pertussis: DTaP, Tdap, DT, and Td. DTaP and DT are given to children younger than 7 years of age Tdap and Td are given to older children and adults Children should get 5 doses of DTaP, one dose at each of the following ages: 2, 4, 6, and 15-18 months and 4-6 years.

5. Why do we vaccinate? Tetanus has a high fatality rate. In recent years, tetanus has been fatal in about 11% of reported cases and as high as 18% in persons age 60 years and older, and 22% in unvaccinated persons. There is no "cure" for tetanus (management) The best "treatment" is prevention through immunization. Almost all cases of tetanus are in persons who have never been vaccinated, or who completed their childhood series, but did not have a booster dose in the preceding 10 years.

6. Haemophilus Influenzae Type b Back ground: Also referred to as Hib Systemic bacterial disease of young children worldwide Germs spread from person to person Effects children under age 5 Peak time to get it is between 6-11 months of age 35% of survivors developed neurologic diseases 20,000 cases annually, 12,000 meningitis w/5% mortality (death rate 1 in 20)

7. Vaccine Information Is done as a combination Interchangeable w/ other Hib vaccines Number of vaccines needed (4 if use other brands than PedvaxHIB) May be given at the same time as other vaccines Given between 2 months and 6 years Do not give before 6 weeks as this will lead to a reduced anti-PRP response Not recommended for over 6 years of age, as these children are generally not at risk for the disease

8. Diseases that Hib Causes Pneumonia Severe swelling in the throat, making it hard to breathe Infections of the blood, joints, bones, and covering of the heart Death

9. Risks for the Hib Vaccine Can cause allergic reactions The risk of Hib vaccine causing serious harm or death is extremely small Most do not have any problems with it. Mild Problems: Redness, warmth, or swelling where the shot was given (up to ¼ of children) Fever over 101 degrees Fahrenheit (Up to 1 out of 20 children)

10. Reactions to Hib Vaccine Moderate or severe Reactions: What to look for ◦ High fever ◦ Behavior changes ◦ Allergic reaction  Difficulty Breathing, Hoarseness or Wheezing, Hives, Paleness, Weakness, Fast Heart Beat, Dizziness within a few minutes to a few hours after the shot. What to do ◦ Call a doctor, or get the person to a doctor right away ◦ Tell your doctor what happened, the date and time it happened, and when the vaccination was given ◦ Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System Form

11. Measles ◦ Virus causes rash, cough, runny nose, eye irritation, and fever ◦ It can lead to ear infection, pneumonia, seizures, brain damage and death Mumps ◦ Virus causes fever, headache, and swollen glands  30-40% Parotitis (swollen Parotid gland) ◦ It can lead to deafness, meningitis, painful swelling of the testicles or ovaries and rarely; death Rubella ◦ Virus causes rash, mild fever, and arthritis (mostly in women) ◦ If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects Measles, Mumps, Rubella Vaccine (MMR)

12. Mumps Measles Rubella Swollen Parotid gland Rash

13. Mode of Transmission Measles ◦ Large respiratory droplets Mumps ◦ Airborne transmission ◦ Direct contact with infected droplet nuclei or saliva Rubella ◦ Airborne transmission or droplets

14. Who should get vaccinated Children should get 2 doses of the MMR vaccine ◦ The first at 12-15 months of age ◦ The second at 4-6 years of age Generally anyone 18 years or older who were born after 1956 should get at least one dose of the MMR vaccine

15. Who should NOT get vaccinated People who have ever had a life threatening allergic reaction to gelatin, the antibiotic neomycin or to a previous dose of MMR vaccine People who are moderately or severely ill at the time of the shot Pregnant woman should wait to get MMR vaccine Check with your doctor if you: ◦ HIV/AIDS or other diseases that affect the immune system ◦ Is being treated with drugs that affect the immune system for 2 weeks or longer ◦ Has cancer of any kind ◦ Is taking cancer treatment with x-ray or drugs ◦ Has ever had a low platelet count

16. Risks from MMR vaccine Most people do not have any problems with it Mild problems ◦ Fever, mild rash swelling of glands in the cheeks or neck (rare) ◦ Usually occurs within 7-12 days after the shot Moderate problems ◦ Seizure caused by fever ◦ Temporary pain and stiffness in the joints ◦ Temporary low platelet count which can cause a bleeding disorder Severe problems ◦ Serious allergic reaction ◦ Deafness, long term seizures, coma, permanent brain damage.  These happen so rarely, experts can not be sure if they are actually caused by the vaccine.

17. How to learn more Ask your doctor or nurse. They can give you the vaccine package insert or suggest other sources of information Call your local or state health department’s immunization program Contact the Center for Disease Control and Prevention (CDC) ◦ Call 1-800-232-4636 ◦ Visit the National Immunization Program’s website at www.cdc.gov/vaccines