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IMMUNIZATIONS, PART I

IMMUNIZATIONS, PART I. Janine Clark Adjo, M.D. 2010 IMMUNIZATION SCHEDULE. DTaP (IM). Diptheria and Tetanus components are bacterial toxoids (modified bacterial toxin that has been made nontoxic but retains ability to stimulate antibody production)

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IMMUNIZATIONS, PART I

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  1. IMMUNIZATIONS, PART I Janine Clark Adjo, M.D.

  2. 2010 IMMUNIZATION SCHEDULE

  3. DTaP (IM) • Diptheria and Tetanus components are bacterial toxoids (modified bacterial toxin that has been made nontoxic but retains ability to stimulate antibody production) • Acellular pertusis- inactivated acellular bacterial components

  4. DTaP • DTaP- for use in children <7 • DT- for use in children <7, in whom pertussis vaccine is contraindicated • Dt- Tetanus toxoid, with 1/3- 1/6 the dose of diptheria toxoid, for use >7 • DTP- whole cell pertussis no longer marketed in US

  5. DTaPINDICATIONS • Routine schedule- 2 mths, 4mths, 6mth, 15-18 mths, followed by Tdap at 11/12 years and then every 10 years • Unimmunized pregnant women • Tetanus prophylaxis, wound management

  6. DTaPTrue Contraindications • Anaphylaxis to vaccine or constituent of vaccine • Encephalopathy within 7 days of receiving vaccine, then use DT for remaining doses

  7. DTaPPRECAUTIONS • Moderate or severe illness regardless of fever • Seizure within 3 days of administration • Persistent crying within 48 hours of prior dose • Collapse or hypotonic/hyporesponsive episode within 48 hours of prior dose • Neurologic disorders

  8. DTaPSIDE EFFECTS • Erythema, swelling, pain, fever, irritability • Anaphylaxis • Seizure • Hyporesponsive/hypotonic episode • Persistent crying • Fever >105

  9. DTaPDifferent Formularies • Daptacel- Sanofi Pasteur • Tripedia- Sanofi Pasteur • Infanrix- GlaxoSmithKline • DT- Sanofi Pasteur • Td- Decavac- Sanofi Pasteur • Adacel/Boostrix- Tdap- Sanofi Pasteur/GSK

  10. DTaPDifferent formularies • TriHIBit- Sanofi Pasteur • Pediarix- GSK • Pentacel- Sanofi Pasteur • Kinrix- GSK

  11. Haemophilus Influenza Type BHib (IM) • Conjugate vaccine of Hib capsular polysaccharide antigen and a carrier protein to enhance immunogenicity • Two types 1) PRP+CRM- given at 2,4,6, and 12-15 months 2) PRP+OMP- given at 2, 4 , 12-15 months

  12. HiB • Routine vaccination has led to a 99% decrease in invasive Hib disease • Schedule for unimmunized children 1)7-11 months: 3 doses, 2 months apart 2)12-14 months: 2 doses 2 months apart 3)15-59 months: 1 dose 4) >5 does not require immunization

  13. HiBSide Effects/Contraindications • Local pain, erythema, swelling, fever, irritability • Anaphylaxis

  14. HiBDifferent Formularies • HiB, HbOC, conjugate, 4 dose- Hib titer, Wyeth • HiB, PRP-OMP, conjugate, 3 dose- pedvaxHiB, Merck • HiB, PRPT, conjugate, 4 dose, ActHiB, Sanofi Pasteur • DTaP-HiB, TriHiBit, Sanofi Pasteur • Hep B/Hib- Comvax, Merck

  15. Hepatitis B (IM) • Inactivated viral antigen • Required for middle school entry in 1998 • Routine schedule 0-2 months, 1-4 months, 6-18 months • Dose 3 cannot be given prior to 6 months

  16. Hepatitis BSide Effects/Contraindications • Pain at site, fever • Anaphylaxis to vaccine or Baker’s yeast

  17. Hepatitis BDifferent Formularies • Hepatitis B, Recombivax, Merck • Hepatitis B, Energix- B, GSK • Hep B/Hib, Comvax, Merck

  18. POLIO (SC or IM) • IPV- trivalent vaccine of inactivated polio virus types 1, 2, and 3, grown in human diploid cells • Routine schedule- 2 mths, 4 mths, 6 mths, 4-6 years

  19. POLIOSide effects/Contraindications • Pain, swelling and erythema at site • Anaphylaxis to vaccine, polymyxin B, neomycin, or streptomycin

  20. POLIODifferent Formularies • IPV, IPOL, Sanofi Pasteur • Pentacel, Sanofi Pasteur • Pediarix, GSK

  21. Pneumococcal Vaccine (IM) • Prevnar 13- Pneumococcal Conjugate vaccine comprised of 13 capsular polysaccharides of Streptococcus pneumoniae • Routine schedule 2mths, 4 mths, 6mths, 12-15 mths

  22. PrevnarSide effects/Contraindications • Pain, swelling, and erythema at site of injection • Fever, irritability, decreased appetite • Anaphylaxis to vaccine

  23. PrevnarDifferent Formularies • Prevnar, Wyeth

  24. Pneumococcal vaacine Different Formularies • Pneumovax (IM or SC)- pneumococcal polysaccharide vaccine, 23 valent, Merck • Ages 2 and up • Immunosuppressed patients

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