Medicine in 5 minutes (Immunization and vaccination)

Immunization and Vaccination in Pediatric Care

Importance of Immunization

• Immunization and vaccination are crucial components of child care and pediatric preventive care.

• There are two types of immunization: active (involves injecting components of the etiological organism) and passive (involves injecting antibodies).

Types of Active Immunization

• Active immunization can include live attenuated vaccines or inactivated vaccines.

• Live attenuated vaccines provide long-term immunity, examples include oral polio vaccine, measles, rubella, and mumps.

• Non-live vaccines confer shorter immunity requiring boosters; examples include diphtheria, tetanus, hepatitis A & B.

Considerations for Immunocompromised Patients

• Live attenuated vaccines should not be administered to immunocompromised individuals due to risks associated with their condition.

Passive Immunization Applications

• Passive immunization involves administering antibodies like hepatitis B immunoglobulins to at-risk patients or newborns from infected mothers.

Vaccines Administered in Zambia

• Common vaccines include BCG, oral polio vaccine (OPV), intravenous polio vaccine (IPV), DPT-Hib-HepB combination.

• BCG protects against severe forms of TB; administered at birth and again if no scar appears after 12 weeks.

Polio Vaccination Strategy

• OPV induces both host and secondary immunity through gut activation; IPV is given subcutaneously/intramuscularly without risk of vaccine-associated disease.

• The vaccination schedule starts with OPV zero at birth followed by multiple doses at specified intervals up to nine months.

Changes in Polio Vaccine Composition

• IPV was introduced to replace type two from OPV due to its association with vaccine-related diseases while maintaining efficacy against all three polio types.

Pneumococcal Vaccination Insights

• Pneumococcal vaccines protect against common infections like pneumonia; options include polysaccharide capsular antigens for broader protection or a conjugate vaccine for seven serotypes.

Vaccination Schedule and Rationale

Overview of Vaccine Administration

• The PCV (Pneumococcal Conjugate Vaccine) is administered in three doses: the first at 6 weeks, the second at 10 weeks, and the third at 14 weeks. Preferred injection sites are the vastus lateralis muscle in infants and young children, while the deltoid muscle is preferred for older children and adults.

• Vaccines like Diphtheria, Pertussis, and Tetanus (DPT) are crucial as these diseases pose serious health risks globally, particularly to infants. Hepatitis B affects over 300 million people worldwide.

Historical Context of Vaccination

• Prior to vaccination programs initiated in 1985, diseases such as diphtheria and tetanus caused significant morbidity. The vaccines used today are inactivated and injected into specific muscle groups for optimal efficacy.

Measles and Rubella Vaccination

• The measles vaccine is given at 9 months with a follow-up dose at 18 months. Measles can lead to severe complications like pneumonia; thus, vaccination is critical.

• Rubella can cause mild viral symptoms but poses risks during pregnancy. This vaccine is also live attenuated.

Rotavirus Immunization

• The rotavirus vaccine protects against severe viral diarrhea. It is administered in two doses: one at six weeks and another four weeks later.

Side Effects of Immunization

• Most vaccines may cause mild to moderate side effects within the first 24 hours post-administration, including local inflammation or low-grade fever.

• Live attenuated vaccines like measles or rubella may result in fever or rash about one to two weeks after immunization.

Contraindications for Vaccination