1. 10/27/2015Immunization schedule1

2. Immunization M. Emadoleslami MD

3. 10/27/2015Immunization schedule3 Vaccines Live (Attenuated) Killed (Inactivated)

4. 10/27/2015Immunization schedule4  Maintance of long lasting immunity with inactivated ones, require Booster Doses  Immunologic response with live vaccines, is more than killed ones

5. 10/27/2015Immunization schedule5 Immunizing Agents  Active immunizing Ag  Conjugating agents  Suspending fluid  Preservative, stabilizers,…  Adjuvants

6. 10/27/2015Immunization schedule6 Active Antigens A single Ag (T/D Toxoid) Different Ags (H/P/M/Pertusis) Live attenuated virus (MMR/OPV) Killed virus/Virus Portions (IPV/Influenza) Recombinant ones (HBV)

7. 10/27/2015Immunization schedule7 Conjugating Agents Outer membrane protein (M/ T/ D)+ Polysaccharide Ag (H/M/P) It can establish immunity in infants less than 2 years old

8. 10/27/2015Immunization schedule8 Suspending Fluid Sterile water Saline solution

9. 10/27/2015Immunization schedule9 Additives  Preservative (Thimerosal)  Stabilizer  Antimicrobial agents (Neomycin)

10. 10/27/2015Immunization schedule10 Adjuvants Aluminum salt HBV Vaccine DT,Td Vaccine

11. 10/27/2015Immunization schedule11 Vaccine handling/ Storage MMR/OPV Vaccine, sensitive to increased temperature DTaP/IPV/Hib vaccine/Polysaccharide and conjugate vaccine/Inactivated Influenza / Meningococcal vaccine …… are damaged by freezing

12. 10/27/2015Immunization schedule12 Personnel  Designate one person as vaccine coordinator  Assign responsibility for ensuring for corrected handling, storing in recommended and documented manner  Assign a backup person to assume theses responsibilities during vacation

13. 10/27/2015Immunization schedule13 Equipment and Procedures (1)  Refrigerators and Freezers  Temperature Reading Logbook  Chilled water & Ice packs  The Vaccine Expiration Date  Weekly Unit Inspection for Outdated Vaccines  Avoid reconstituting multiple vaccine doses or drawing vaccines in multiple syringes  Do not open > 1 vial of a vaccine at a time

14. 10/27/2015Immunization schedule14 Vaccine Administration (1)  Gloves aren't required unless: The health care professional has open hand lesion He will come into contact with potentially infectious body fluids  Changing needles between drawing vaccine isn't necessary  Different Vaccines shouldn't mix in the same syringe  Patients should be observed for an allergic reaction for 15- 20 min after receiving immunization

15. 10/27/2015Immunization schedule15 Immunization Sites and Routes  Oral Vaccines Breast feeding….. Vomiting within 10 minutes of receiving….  Parenteral Vaccines (IM, IV, SC) In children <1 y/o, Ant. Lat. aspect of the thigh In children >1y/o, Deltoid muscle  Hepatitis B and Rabies vaccines should not be given in the buttocks at any age

16. 10/27/2015Immunization schedule16 Injection Technique  There are no data to document the necessity for aspiration before injection  The distance separating the 2 injections should be at least 1 inch  A brief bleeding period at the injection site is common  Applying pressure, EMLA, Lidocaine injection  The Z- track method of injection also is reported to decrease associated pain

17. 10/27/2015Immunization schedule17 Routine Vaccination  At Birth (BCG, HBV, OPV)  2 Month (DTP, OPV,HBV)  4 Month (DTP, OPV)  6 Month (OPV, DTP, HBV)  12 Month (MMR)  18 Month (OPV, DTP, MMR)  4-6 Y/O (OPV, DTP)

18. 10/27/2015Immunization schedule18 Precautions and Contraindications A precaution specifies a situation in which vaccine may be indicated (after judgment) A contraindication indicates that a vaccine should not be administered

19. 10/27/2015Immunization schedule19