1. Vaccinations in children

2. Vaccinations in children- types of immunity
Naturally acquired immunity
Active- after infection
Passive- antybodies transported through placenta
Artificially acquired immunity
Active- vaccinations
Passive- antybodies ie. anty HBs

3. Vaccinations in children- types of immunity
Differences between active and passive immunity
Active immunity
requires more time
long acting
safer
cheaper

4. Vaccinations in children- definitions
Vaccine-preparation containing life or killed or antigen deprived of pathogenicity to induce specific immunity( cell, humoral) against vaccine antigen.

5. Vaccinations in children- classification of vaccines
Classification according to type of antigen
Live atenuated
Bacterial- BCG
Viral- mumps, measles, rubella(MMR),polio vaccine OPV
Killed
Bacterial -pertussis
Viral- polio vaccine IPV
Component vaccines
Bacterial- Hib vaccine,
Viral- hepatitis B vaccine
Toxoid vaccines- diphtheria and tetanus vaccines ( DTP)

6. Vaccinations in children- classificaion
Classification according to their composition
Monovalent(hepatitis B vaccine)
Polyvalent ( MMR, DTP, infanrix hexa,penta)
Antigen included in polyvalent vaccine has better effect than a single vaccine alone

7. Vaccinations in children
Differences between live and killed vaccines
Live vaccines
Produce immunity faster
Immunity after one dose
Immunity lasts longer
More dangerous- especially in immunocompromised patients

8. Vaccinations in children
The immunization schedule in Poland covers the following diseases
Tuberculosis
Hepatitis B
Diphteria
Tetanus
Pertussis
Polio
Hepatitis
Measles
Mumps,
Rubella
Haemophilus influenze infection

9. recomended Rotavirus- Rotarix Pneumococcal -Prevenar Minigitis-Neisvic
Human Papillomavirus HPV -Cervix
Chicenpox-Voricela zoster
Flu-

11. Mandatory vaccinations in children
6 year
DTP revaccination dose
subcutaneously or intramusculary
Polio revacination dose( OPV)
Orally
10 year
MMR revaccination subcutaneously

12. 14year
Td II revaccination dose
19 year
Td III revaccination dose
intramusculary

13. Vaccinations in children- characteristics of individual vaccines
TUBERCULOSIS VACCINATION
only 1 dose, in first 24 hours of life( no revaccination)
live vaccine- brasilian strain of Mycobacterium bovinum-relatively low immunogenity
intradermal injection , 1/3 upper external part of an arm
proper administration very important to avoid local complications
no tuberculin test to check efficacy of vaccination

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15. Vaccinations in children- characteristics of individual vaccines
TUBERCULOSIS VACCINATION
Specific complications
local:
Ulceration larger than10 mm in a place of injection ,
Dermal abscess larger than 10 mm
Regional
Involvment of regional – axillar lymphnodes larger than10 mm),
general:
General infection (BCGitis) : sepsis, ostitis, pulmonary tuberculosis,

16. Hepatitis B
Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus.
Acute (short-term) illness. This can lead to:
• loss of appetite
• diarrhea and vomiting
• tiredness
• jaundice (yellow skin or eyes)
• pain in muscles, joints, and stomach
Acute illness, with symptoms, is more common among
adults. Children who become infected usually do not
have symptoms.

17. Hepatitis B
Chronic (long-term) infection. Some people go on to develop chronic hepatitis B infection. Most of them do not have symptoms, but the infection is still very serious, and can lead to:
• liver damage (cirrhosis)
• liver cancer
• death

18. Hep B Hepatitis B virus is easily spread through contact with
the blood or other body fluids of an infected person.
A baby whose mother is infected can be infected at birth;
Children, adolescents, and adults can become infected by:
contact with blood and body fluids
through breaks in the skin such as bites, cuts, or sores;
contact with objects that have blood or body fluids
having unprotected sex with an infected person;
sharing needles when injecting drugs;
being stuck with a used needle.

19. Hepatitis B • Babies normally get 3 doses of hepatitis B vaccine:
1st Dose: Birth
2nd Dose: 1-2 months of age
3rd Dose: 6-18 months of age
Some babies might get 4 doses, for example, if a combination vaccine containing hepatitis B is used. The extra dose is not harmful.

20. Diphtheria, Tetanus, and Pertussis
Diphtheria, tetanus, and pertussis are serious diseases caused by bacteria. Diphtheria and pertussis are spread from person to person.
Tetanus enters the body through cuts or wounds.

21. DTP DIPHTHERIA causes a thick covering in the back of the throat.
It can lead to breathing problems, paralysis, heart failure,
Because of widespread and routine childhood DPT immunizations, diphtheria is now rare in many parts of the world.

22. DTP
TETANUS (Lockjaw) causes painful tightening of the muscles, usually all over the body.
It can lead to “locking” of the jaw so the victim cannot open his mouth or swallow.

24. DTP
PERTUSSIS (Whooping Cough) highly contagious bacterial disease caused by Bordetella pertussis,causes dry coughing spells so bad that it is hard for infants to eat, drink, or breathe. These spells can last for weeks.
It can lead to pneumonia,

25. DTP
Children should get 5 doses of DTaP vaccine, one dose at each of the following ages:
2 months
4 months
6 months
15-18 months
4-6 years

26. polio
Polio is a disease caused by a virus. It enters the body through the mouth. it may causes paralysis, and meningitis . It can kill people who get it, usually by paralyzing the muscles that help them breathe.

27. polio

28. polio Children get 4 doses of IPV, at these ages: A dose at 2 months
A booster dose at 4-6 years-OPV

29. Hib
Haemophilus influenzae type b (Hib) usually strikes children under 5 years old.
Your child can get Hib disease by being around
other children or adults who may have the bacteria
and not know it. The germs spread from person to
person. If the germs stay in the child’s nose and
throat, the child probably will not get sick. But
sometimes the germs spread into the lungs or the
bloodstream, and then Hib can cause serious
problems.

30. Hib Hib disease can cause: pneumonia Laryngitis epiglotic,
infections of the blood, joints, bones,
and covering of the heart

31. Subglottic laryngitis
Epiglottitis
Onset
over days
over hours
Preceding coryza + -
Cough
severe, barking
slight or absent
Ablity to swallow
Drooling saliva
Appearence
unwell
toxic, very ill
Fever
<38,5
>38,5
Stridor
harsh, rasping
soft,whispering
Voice,cry
hoarse
Reluctant to speak

32. Hib Children should get Hib vaccine at: 2 months of age

33. MMR
Measles, also known as morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus.
The classical symptoms of measles include four-day fevers and the three Cs—cough, coryza (head cold) and conjunctivitis (red eyes). The fever may reach up to 40 °C (104 °F). Koplik's spots seen inside the mouth are pathognomonic (diagnostic) for measles, but are not often seen, even in real cases of measles, because they are transient and may disappear within a day of arising.

34. measles The characteristic measles rash is classically
described as a generalized, maculopapular,
erythematous rash that begins several days after
the fever starts. It starts on the head before
spreading to cover most of the body, often causing
itching. The rash is said to "stain", changing color
from red to dark brown, before disappearing. The
measles rash appears two to four days after initial
symptoms, and lasts for up to eight days.

36. Measles

37. mumps Mumps virus causes fever, headache, and swollen glands.
It can lead to deafness, meningitis, painful swelling of the testicles or ovaries,

38. MMR

39. Mumps

40. Rubella
Rubella, commonly known as German measles, is a disease caused by the rubella virus
rash on the face which spreads to the trunk and limbs and usually fades after three day
slow grade fever,
swollen glands (sub occipital & posterior cervical lymphadenopathy),
joint pains
headache
conjunctivitis.

41. Rubella

42. Rubella
Infection of the mother by Rubella virus during pregnancy can be serious; if the mother is infected within the first 20 weeks of pregnancy, the child may be born with congenital rubella syndrome (CRS)

44. MMR Children should get 2 doses of MMR vaccine:
The first at months of age
and the second at 4-6 years of age.
These are the recommended ages. But children can get
the second dose at any age, as long as it is at least 28
days after the first dose.

45. Rota
Rotavirus is a virus that causes diarrhea (sometimes severe), mostly in babies and young children.
It is often accompanied by vomiting and fever, and can lead to dehydration.

46. Rota Rotavirus vaccine is an oral (swallowed) vaccine,
The doses are recommended at these ages:
First Dose: 2 months of age
Second Dose: 4 months of age
Third Dose: 6 months of age
The first dose may be given as early as 6 weeks of
age, and should be given by age 14 weeks 6 days.
The last dose should be given by 8 months of age.
Rotavirus vaccine may be given at the same time
as other childhood vaccines.

47. Prevenar
Infection with Streptococcus pneumoniae bacteria can causes blood infections, pneumonia, and meningitis, mostly in young children. Children younger than 2 years of age are at higher risk for serious disease than older children.
Pneumococcal bacteria are spread from person to person through close contact.

48. . There are more than 90 types of pneumococcal bacteria.
The new pneumococcal conjugate vaccine (PCV13)
protects against 13 of them. These bacteria types are
responsible for most severe pneumococcal infections
among children. PCV13 replaces a previous conjugate
vaccine (PCV7), which protected against 7 pneumococcal
types and has been in use since During that
time severe pneumococcal disease dropped by nearly
80% among children under 5.

49. PCV PCV13 may also prevent some cases of pneumonia and
some ear infections. But pneumonia and ear infections
have many causes, and PCV13 only works against the
types of pneumococcal bacteria targeted by the vaccine.
In addition to receiving PCV13, older children with
certain chronic illnesses may get a different vaccine
called PPSV23.(Pneumo 23)

50. PCV Infants and Children Under 2 Years of Age
PCV13 is recommended as a series of 4 doses, one dose at each of these ages
2 months, 4 months, 6 months,
and 12 through 15 months
Children who have begun their immunization series with PCV7 should complete the series with PCV13.

51. Voricella Chickenpox (also called varicella) is a common
childhood disease. It is usually mild, but it can be
serious, especially in young infants and adults.
It causes a rash, itching, fever, and tiredness.
It can lead to severe skin infection, scars,
pneumonia, brain damage,

52. Chickenpox
The chickenpox virus can be spread from person to person through the air, or by contact with fluid from chickenpox blisters.
A person who has had chickenpox can get a painful rash called shingles years later.

53. . Children who have never had chickenpox should get 2
doses of chickenpox vaccine at these ages:
1st Dose: months of age
2nd Dose: 4-6 years of age (may be given earlier,
if at least 3 months after the 1st dose)
People 13 years of age and older (who have never had
chickenpox or received chickenpox vaccine) should
get two doses at least 28 days apart.

54. Chickenpox

55. Neiseria meningitidis
Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis (also termed meningococcus). It carries a high mortality rate if untreated. While best known as a cause of meningitis, widespread blood infection (sepsis) is more damaging and dangerous.
The most common symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an inability to tolerate light (photophobia) or loud noises (phonophobia). Sometimes, especially in small children, only nonspecific symptoms may be present, such as irritability and drowsiness. If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash.

56. Neisvac
The meningitis C vaccine is part of the childhood immunisation schedule. It is given as two separate doses, at three and four months of age. The child will then be given a booster dose at twelve months,
For children aged 12 months and over, adolescents and adults, only one dose of the vaccine is needed.

57. Rash, meningococal sepsis

58. HPV vaccine
Genital human papillomavirus (HPV) is the most common sexually transmitted virus
More than half of sexually active men and women are infected with HPV at some time in their lives.

59. HPV
Most HPV infections don’t cause any symptoms, and go away on their own. But HPV can cause cervical cancer in women. Cervical cancer is the 2nd leading cause of cancer deaths among women around the
world.

60. HPV • HPV vaccine is recommended for girls 11 or 12
years of age. It may be given to girls starting at
age 9.
It is important for girls to get HPV vaccine before
their first sexual contact – because they won’t have been exposed to human papillomavirus.
The vaccine is also recommended for girls and women 13 through 26 years of age who did not get all 3 doses when they were younger

61. HPV HPV vaccine is given as a 3-dose series 1st Dose Now
2nd Dose 1 to 2 months after Dose 1
3rd Dose 6 months after Dose 1
Additional (booster) doses are not recommended.

62. FLU
Influenza viruses are always changing, so annual vaccination is recommended. Each year scientists try to match the viruses in the vaccine to those most likely to cause flu that year. It takes up to 2 weeks for protection to develop after the
shot. Protection lasts about a year.

63. FLU All people 6 months of age and older should get flu vaccine.
Young children, people 65 and older, pregnant women, people with certain health conditions – such as heart, lung or kidney disease, or a weakened immune system

64. Thank you