Immunization

Views:
 
Category: Education
     
 

Presentation Description

everything about vaccination.....

Comments

Presentation Transcript

Slide 3:

“When you develop the habits of success, success will become a habit.”

Slide 4:

IMMUNISATION Shivaprakash Sosale C Asso.professor in Pediatrics, SIMSRC, Bangalore

OVERVIEW:

OVERVIEW IMMUNISATION NATIONAL IMMUNISATION PROGRAMME IAP IMMUNISATION PROGRAMME SHEDULES, STRAINS, ROUTE OF ADMINISTATION ADVERSE EFFECTS, COMPLICATIONS SPECIAL VACCINES

Immunisation ::

Immunisation : Defn : ‘ Induction of specific immune response’ by either A) Deliberate inoculation of immunogens to stimulate in vivo antibody production (Active immunisation ) or B) Administration of pre-formed antibodies i.e immunoglobulins (Passive immunization)

Immunisation v/z vaccination:

Immunisation v/z vaccination

Immunization agents::

Immunization agents: Vaccines: “Vaccines are formulations containing live /killed pathogens, their subunits, or their toxins devoid of virulence”

Slide 9:

1) Live Vaccine Live bacteria, attenuated BCG, Ty 21a Live virus, attenuated OPV, Measles, MMR, Varicella , Rotavirus ,Yellow fever 2) Inactivated Vaccine Killed bacteria Pertusis , Salmonella typhi , Cholera Killed virus IPV, ARV, HAV, JE, Influenza 3) Toxides DT ,TT 4) Subunit Vaccines Capsular polysaccharide Typhoid Vi, Hib ,(conjugated) Meningococcal ,Pneumococcal Viral subunit HBV Bacterial subunit Acellular Pertusis T Y P E S O F V A C C I N E

IMPORTANT:  :

IMPORTANT:   No vaccine is 100 % effective. Minor upper respiratory infections like cough, cold, mild fever are not a contraindications for immunizations. Two live vaccines should be given either simultaneously at different site at the same sitting or at least one month apart . Pulse polio vaccinations / other immunizations on national immunization days are different from routine vaccinations and should be followed as per the instructions in the national interest. Report adverse reactions if any, immediately

Slide 11:

Category 1 Category 2 Category 3 Category 4 EPI vaccines ( GOVT) IAP recommended (in addition to EPI) Given after one to one discussion Under special circumstances BCG OPV A DTP Measles DT TT Hep B* MMR* Hib Typhoid Hib Hep B MMR IPV Tdap Td HPV TCV typhoid PCV7 Hepatitis A Chicken pox DTaP Rotavirus Rabies Influenza PPV23 Japanese Encephalitis Meningococcal *Some districts only

Slide 12:

National immunization schedule Age Vaccines Birth  BCG, OPV0 ( for institutional deliveries) 6 weeks  DTP, OPV, Hep B, Hib 10 weeks  DTP, OPV, Hep B, Hib 14 weeks  DTP3 , OPV, HepB , Hib 9-12 months  Measles 16-24 months( B1  DTP , OPV, MMR $ 5-6 years (B2)  DPT * 10 years  TT** 16 years  TT Pregnant women  TT1 (early in pregnancy) TT2 (1 month later) TT booster (if vaccinated in past 3 years ) Vitamin A  9 , 18, 24, 30 and 36 months

Slide 13:

Age Vaccines Birth BCG, OPV HepB 1 6 weeks (W/A) DPT IPV Hib HepB2 PCV ROTA 10 weeks DPT IPV Hib PCV ROTA 14 weeks DPT IPV Hib PCV ROTA 6 months OPV Hep B 3 9 months MMR1 OPV 12 MONTHS HEP A 1 15 MONTHS MMR2 VARICELLA 1 PCV 16-18 months B1 DPT B IPV Hib HEP A 2 2 years Typhoid 5 years B2 DPT OPV VARICELLA 2 10 years Tdap / Td HPV ( FOR FEMALES)

Slide 14:

Age < 5years > 5 years 1 st visit BCG, OPV, DPT, HBV TT/ Tt , HBV 2 nd visit (1 month later) OPV, DPT, HBV TT/Td, HBV 3 rd visit ( 1 month later) OPV,DPT, MMR/ Measles ,Typhoid MMR, Typhoid 1 year later OPV, DPT, HBV HBV Every 3 year Typhoid booster Typhoid booster VACCINATION SCHEDULE OF AN UNIMMUNISED CHILD

Strains :

Strains BCG-  MEASLES  MUMPS  Typhoid Varicella ( chicken pox) DANIS 1331 Edmonston -Zagreb, schwartz , moraten Jeryn lynn Ty 21a OKA

VACCINE AND DILUENT:

VACCINE AND DILUENT VACCINE DILUENT BCG ---  MEASELES / MMR VARICELLA MENINGOCOCCAL/ JE/RABIES NORMAL SALINE STERILE WATER

Vaccines and strains:

Vaccines and strains VACCINE STRAIN BCG  MEASLES  VARICELLA  POLIO  YELLOW FEVER  DANISH 1331 EDMONSTON-ZAGRAB/SCHWARTS OKA SALK / SABIN RA/27

ADMINISTRATION :

ADMINISTRATION All live vaccines given----SC Except BCG  ID Measles/ MMR/ varicella /---SC ROTAVIRUS AND SALK POLO--ORAL

BACILLUS CALMETTE GUERIN (BCG):

BACILLUS CALMETTE GUERIN (BCG)

BCG:

BCG Bovine tuberculosis strain (1921) Albert Calmette ( French microbiologist ) & Camille Guerin (veterinary surgeon) 231 repeated subcultures over 13 years. 2 strains in use are Copenhagen (Danish 1331 ) and Pasteur India  BCG laboratories, Guindy , Tamil Nadu . BCG has an efficacy of 50-80% for prevention of miliary and meningeal form of the disease. Protective efficacy for pulmonary tuberculosis is around 50%.

BCG…..:

BCG….. Contains 0.1–0.4 million live viable bacilli / Dose Lyophilized (freeze-dried) preparation in Vacuum sealed multi-dose dark colored ampoules or 2 ml vials with normal saline as diluent . The vaccine is light sensitive and deteriorates on exposure to ultraviolet rays. In lyophilized form it can be stored at 2 to 8° C for up to 12 months.

DON’T ADMINISTER BCG AFTER 4 Hrs:

DON’T ADMINISTER BCG AFTER 4 Hrs As the vaccine contains no preservative , bacterial contamination  Toxic Shock Syndrome(TSS) may occur if kept for long after reconstitution

BCG CONT….:

BCG CONT…. The reconstituted vaccine – -Stored at 2 to 8°C, -Protect from light and -Discard within 4-6 hours . The recommended dose is 0.1 ml . Strictly intradarmal , -- tuberculin syringe -- 26G/27G needle. The convex aspect of the left shoulder at level of deltoid insertion is preferred for easy visualization of the BCG scar and for optimum lymphatic drainage. Other sites such as thigh should be avoided.

Slide 27:

Intradermal : Most accurate method because  Dose can be measured precisely &  Administration can be controlled. Minimum rate of adverse reactions.

Slide 28:

Transfer exactly 1.0 ml NS to the vial using a sterile syringe with a long needle. Do not remove the rubber stopper To suspend the vaccine turn the vial gently upside down a few times - Do not shake The suspension should be homogenous, slightly opaque and colourless Any reconstituted vaccine not used should be discarded after maximum 3 hours   Reconstitution of BCG VACCINE

Slide 29:

Deltoid region of the left arm , about one third down the upper arm over the insertion of the deltoid muscle The site of injection Gently swirl the vial before drawing up each dose Draw up slightly more than one dose and remove any air bubbles and extra vaccine

Slide 30:

The skin should “not” be cleansed with antiseptic The skin is stretched between the thumb and forefinger The needle should be almost parallel with the skin surface and the bevel of the needle facing upwards The needle should only be inserted approximately 2 mm into the superficial layers of the dermis Injection technique Feel a slight pressure as you press the plunger, and a small flat swelling will appear If the skin does not swell or you feel you can press the plunger too easily, then the    vaccine is probably given too deeply. You can try to draw back the needle into correct position and give the rest of the vaccine No alcohol or spirit please..

Slide 31:

The swelling will disappear within 10 to 15 minutes If there is no swelling never give a second dose of vaccine. Large scar, an abscess or enlarged lymph nodes may result from a vaccination given deeply. Make a note on the person's chart for careful follow-up After injection  

POLIO VACCINES:

POLIO VACCINES Background The availability of two effective vaccines against poliomyelitis . The Global Polio Eradication initiative( 1988 )using OPV as the eradication tool and employing a 4 pronged strategy comprising High routine immunization coverage, Supplementary immunization activities (SIAs)/pulse immunization, Acute flaccid paralysis (AFP) surveillance and Outbreak response/“mopping up” immunization.

OPV:

OPV Contains stabilizing agent Mg cl - OPV-major weapon for polio eradication, onset of action faster(outbreak control ) Why multidose ? Take rate low No wild virus transmission from vaccinated kid

Polio - storage:

Polio - storage 20 degree C @ state and district level In freezer at clinic level Must reach outstretch @ 2-8 degree C in vaccine carrier with ice packs.

IPV –INJECTABLE POLIO VAC:

IPV –INJECTABLE POLIO VAC Killed Seroconversion 99% after 3 doses Safe In immunocompromised patients Heat stable No risk of VAPP, VDPV

DPT( triple vaccine) DPT+ HIB+ HEP B= > PENTAVAC/ EASY FIVE / COMVAC 5:

DPT( triple vaccine) DPT+ HIB+ HEP B= > PENTAVAC/ EASY FIVE / COMVAC 5 Diphtheria , Tetanus , Purtusis Usually in combination with Hib and hep B Store @ 2-8 c 0.5ml, IM, lateral aspect of thigh < 7yrs Whole cellular vz Acellular ( ? Painless) Middle compartment ( Never frozen)

DPT –ADVERSE EFFECT:

DPT –ADVERSE EFFECT Local pain , swelling , tender Fever more than 40.5°c, Persistent crying, Hypotonic hyporesponsive episodes (HHE), Seizures and encephalopathy . Contraindicated- Progressive neurological disease and serious adverse reaction to previous dose

MMR:

MMR SCHWARTZ STRAIN 0.5ml , SC, 9 and 15 month DELTOID Used within 6hrs

HEPATITIS A:

HEPATITIS A 0.5ML , IM, 2 DOSES 6 MONTH APART 1 ST DOSE @ 12 MONTH

VARICELLA:

VARICELLA Highly contagious disease All affordable and without previous ds Contact with case within preceding 3 days, immunocompromised 0.5ml , SC, OKA strain Lypholysed powder 2 doses--15month and 5yrs

Slide 47:

Rotavirus vaccine

HPV:

HPV CERVICAL CANCER-mc cancer in india 0.5ml , IM, deltoid 9yrs -45yrs 10 -15yrs --- 2 doses @ 6month apart 15-45yrs--- 3doses @ 0, 1, 6 shedule Cervarx / gardasil

Cold cahin system :

Cold cahin system A system of transporting and storing the vaccine at recommended temparature and from manufacture level till the point of administration ”

Eqiupments :

Eqiupments Walk in coolers Deep freezers ILR ice (lined refregerators ) Refregetators Vaccine carriers / isothermic boxes

Slide 53:

THANK YOU HOSPITAL SAPTHAGIRI

authorStream Live Help