BE WISE IMMUNIZE

1. BE WISEIMMUNIZE

2. What is an immunization An immunization, also called a vaccination or a shot. Immunizations help our bodies fight diseases, and help prevent their spread.

3. Why Get Immunized Some immunizations are mandated by law. Immunizations help our bodies fight off diseases and also help prevent their spread.

4. Immunization Schedule • 2 months DTaP, Hib, Polio, Hepatitis B, Prevnar, Rotateq • 4 months DTaP, Hib, Polio, Prevnar , Rotateq, Hepatitis B  • 6 months DTaP, Hib, Hepatitis B, Prevnar, Roteq  • 12 months MMR, Varicella, Prevnar, Hep A   • 15 months DTaP, Hib • 18 months Hep A • 5 years DTaP, Polio, MMR, Varicella  • 11-18 years Tdap, Meningitis, Gardasil (females)

5. Vaccines Polio Chicken pox Measles Hepatitis A Mumps Hepatitis B Rubella, German measles HIB Diphtheria HPV,Guardasil Tetanus Whooping Cough Meningitis

6. Polio • IPV is a vaccine that stimulates the immune system of the body (through production of antibodies) to fight the virus if it comes in contact with it. IPV cannot cause polio. • If a serious allergic reaction occurred, it would happen • within a few minutes to a few hours after the shot. Signs • of a serious allergic reaction can include difficulty • breathing, weakness, hoarseness or wheezing, a fast heart • beat, hives, dizziness, paleness, or swelling of the throat

7. Measles • Measles is the most deadly of all childhood rash/fever illnesses. The disease spreads very easily, so it is important to protect against infection. To prevent measles, children (and some adults) should be vaccinated with the measles, mumps, and rubella (MMR) vaccine. Two doses of this vaccine are needed for complete protection. Children should be given the first dose of MMR vaccine at 12 to 15 months of age. The second dose can be given 4 weeks later, but is usually given before the start of kindergarten at 4 to 6 years of age. • Mild Problems • Fever (up to 1 person out of 6) • Mild rash (about 1 person out of 20) • Swelling of glands in the cheeks or neck (rare)If these problems occur, it is usually within 7-12 days after the shot. They occur less often after the second dose. • Moderate Problems • Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses) • Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4) • Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses) • Severe Problems (Very Rare) • Serious allergic reaction (less than 1 out of a million doses) • Several other severe problems have been known to occur after a child gets MMR vaccine. But this happens so rarely, experts cannot be sure whether they are caused by the vaccine or not. These include: • Deafness • Long-term seizures, coma, or lowered consciousness • Permanent brain damage

8. Mumps • Mumps vaccine is given as an MMR, a combination of vaccines • The mumps virus replicates in the upper respiratory tract and is spread through direct contact with respiratory secretions or saliva or through omits. • The infectious period or time that an infected person can transmit mumps to a non-infected person is from 3 days before symptoms appear to about 9 days after the symptoms appear. • The incubation time, which is the period from when a person is exposed to virus to the onset of any symptoms, can vary from 16 to 18 days (range 12-25 days). • Some children (about 1 in 5) get a mild rash or fever after MMR vaccine. • These reactions begin a week or two after the vaccination and • usually last for 1–3 days. About 1 child in 7 may get swollen lymph • glands, and 1 child in 100 may have pain or stiffness in the joints that • can last from a few days to a few weeks. There is a smaller risk of • painful swelling of the joints (arthritis). These joint symptoms • occur more often in adults, especially women. • Febrile seizures (seizures caused by a fever) have occasionally • been reported after MMR vaccination. These usually happen 1 or 2 • weeks after the shot and are caused by the fever than can accompany • the vaccination rather than by the vaccine itself. Children • recover from febrile seizures quickly and they do not cause permanent • harm. • There have been reports of children getting encephalitis (inflammation • of the brain) after an MMR shot. This happens so rarely — less • than once in a million shots — that experts can’t be sure whether the • vaccine is the cause or not. Remember, though, that if the same million • children were infected with measles, about 1,000 of them would • get encephalitis.

9. Rubella (or German measles) • An acute viral disease that causes fever and rash • Rash and fever for two to three days (mild disease in children and young adults) • Birth defects if acquired by a pregnant woman: deafness, cataracts, heart defects, mental retardation, and liver and spleen damage (at least a 20% chance of damage to the fetus if a woman is infected early in pregnancy) • Spread by contact with an infected person, through coughing and sneezing • Some children (about 1 in 5) get a mild rash or fever after MMR vaccine. • These reactions begin a week or two after the vaccination and • usually last for 1–3 days. About 1 child in 7 may get swollen lymph • glands, and 1 child in 100 may have pain or stiffness in the joints that • can last from a few days to a few weeks. There is a smaller risk of • painful swelling of the joints (arthritis). These joint symptoms • occur more often in adults, especially women. • Febrile seizures (seizures caused by a fever) have occasionally • been reported after MMR vaccination. These usually happen 1 or 2 • weeks after the shot and are caused by the fever than can accompany • the vaccination rather than by the vaccine itself. Children • recover from febrile seizures quickly and they do not cause permanent • harm. • There have been reports of children getting encephalitis (inflammation • of the brain) after an MMR shot. This happens so rarely — less • than once in a million shots — that experts can’t be sure whether the • vaccine is the cause or not. Remember, though, that if the same million • children were infected with measles, about 1,000 of them would • get encephalitis.

10. Diphtheria • A respiratory disease caused by bacteria • Gradual onset of a sore throat and low-grade fever • Airway obstruction, coma, and death if not treated • Getting diphtheria, tetanus or pertussis disease is much riskier than getting DTaP vaccine. • However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DTaP vaccine causing serious harm, or death, is extremely small. • Mild Problems (Common) • Fever (up to about 1 child in 4) • Redness or swelling where the shot was given (up to about 1 child in 4) • Soreness or tenderness where the shot was given (up to about 1 child in 4) • These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. • Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, for 1 to 7 days (up to about 1 child in 30). • Other mild problems include: • Fussiness (up to about 1 child in 3) • Tiredness or poor appetite (up to about 1 child in 10) • Vomiting (up to about 1 child in 50) • These problems generally occur 1 to 3 days after the shot. • Moderate Problems (Uncommon) • Seizure (jerking or staring) (about 1 child out of 14,000) • Non-stop crying, for 3 hours or more (up to about 1 child out of 1,000) • High fever, 105 degrees Fahrenheit or higher (about 1 child out of 16,000) • Severe Problems (Very Rare)Serious allergic reaction (less than 1 out of a million doses) Several other severe problems have been reported after DTaP vaccine. These include: • Long-term seizures, coma, or lowered consciousness • Permanent brain damage. • These are so rare it is hard to tell if they are caused by the vaccine. • Controlling fever is especially important for children who have had seizures, for any reason. It is also important if another family member has had seizures. • You can reduce fever and pain by giving your child an aspirin-free pain reliever when the shot is given, and for the next 24 hours, following the package instructions.

11. Tetanus • A disease of the nervous system caused by bacteria • Early symptoms: lockjaw, stiffness in the neck and abdomen, and difficulty swallowing • Later symptoms: severe muscle spasms, generalized tonic seizure-like activity, severe autonomic nervous system disorders • Death in about 10-20% of cases, higher among older people • Mild problems • If these problems occur, they usually start within hours to a day or two after vaccination. They may last 1-2 days: • soreness, redness, or swelling where the shot was given • These problems can be worse in adults who get Td vaccine very often.  Acetaminophen or ibuprofen (non-aspirin) may be used to reduce soreness. • Severe problems • These problems happen very rarely: • serious allergic reaction • deep, aching pain and muscle wasting in upper arm(s). This starts 2 days to 4 weeks after the shot, and may last many months. • What to do if there is a serious reaction: • Call a doctor or get the person to a doctor right away, • Write down what happened and the date and time it happened. • Ask your doctor, nurse, or health department to file a Vaccine Adverse Event Report form or call: (800) 822-7967 (toll-free)

12. Whooping cough • A respiratory disease caused by bacteria • Runny nose, sneezing, low grade fever, cough, similar to the common cold. After 1-2 weeks, may progress to stage characterized by bursts of numerous rapid coughs (paroxysms). A final recovery stage with coughing may last weeks or months. • Bacterial pneumonia and rib fracture. Other complications of adult pertussis occur rarely. Infants are at highest risk for apnea, pneumonia, seizures, encephalopathy, and death. • Up to one third of children who get DTaP have local reactions • (tenderness, pain, redness, swelling). These are most common after • the 4th or 5th doses. When they occur it is usually within 2 days • after the shot. Some children also experience swelling of the entire • arm or leg after the 4th or 5th DTaP dose. This happens within 3 • days of the shot and usually lasts around 4 days, with no aftereffects. • Up to about 1 child in 20 will get a fever of over 101°F — also • more often after the fourth or fifth dose. And up to about 1 child in • 5 may become fussy or lose their appetite for a day or two; nearly • half may become drowsy after the shot. • More serious side effects include a fever of 104°F or higher (1 in • 3,000), continuous crying for 3 hours or more (separate studies have • found this in 1 in 900 to 1 in 8,000), and convulsions (1 in 14,000). • Convulsions that occur after DTaP are usually not caused directly • by the vaccine, but by a fever, which in turn was triggered by the • vaccine. These are called “febrile seizures” and, while they might be • alarming, children recover from them quickly and they do not cause • permanent harm. Some experts recommend giving a non-aspirin • pain reliever, such as acetaminophen, to reduce the chances of a fever. • Over the years several cases of permanent brain damage were • reported following DTP vaccine (an earlier version of DTaP). • Whether these were true vaccine reactions or merely coincidence is • impossible to say, because they occurred so infrequently. Some • people used to believe that DTP vaccine could cause Sudden Infant • Death Syndrome (SIDS), but studies have discredited that theory.

13. Meningitis • A severe bacterial infection, occurring primarily in infants and children under 5 years • Meningitis, pneumonia, sepsis, epiglotittis (a severe throat infection), skin infections, and arthritis • Hib meningitis (death in one out of 20 children, and permanent brain damage in 10% - 30% of the survivors) • Mild problems • Up to about half of people who get meningococcal vaccines have mild side effects, such as redness or pain where the shot was given. • If these problems occur, they usually last for 1 or 2 days. They are more common after MCV4 than after MPSV4. • A small percentage of people who receive the vaccine develop a fever. • Severe problems • Serious allergic reactions, within a few minutes to a few hours of the shot, are very rare. • A serious nervous system disorder called Guillain-Barré Syndrome (or GBS) has been reported among some people who received MCV4. This happens so rarely that it is currently not possible to tell if the vaccine might be a factor. Even if it is, the risk is very small.

14. Chicken pox • A disease caused by infection with the varicella zoster virus, which causes fever and an itchy rash • A skin rash of blister-like lesions, covering the body but usually more concentrated on the face, scalp, and trunk. Most, but not all, infected individuals have fever, which develops just before or when the rash appears. If exposed, persons who have been vaccinated against the disease may get a milder illness, with less severe rash (sometimes involving only a few red bumps that look similar to insect bites) and mild or no fever. • Bacterial infection of the skin, swelling of the brain, and pneumonia. Adolescents and adults are more at risk for severe disease. • Mild Problems • Soreness or swelling where the shot was given (about 1 out of 5 children and up to 1 out of 3 adolescents and adults) • Fever (1 person out of 10, or less) • Mild rash, up to a month after vaccination (1 person out of 20, or less). It is possible for these people to infect other members of their household, but this is extremely rare. • Note: MMRV vaccine has been associated with higher rates of fever (up to about 1 person in 5) and measles-like rash (about 1 person in 20) compared with MMR and varicella vaccines given separately. • Moderate Problems • Seizure (jerking or staring) caused by fever (less than 1 person out of 1,000). • Severe Problems • Pneumonia (very rare) • Other serious problems, including severe neurological problems (brain reactions) and low blood count, have been reported after chickenpox vaccination. These happen so rarely, however, that experts cannot tell whether they are caused by the vaccine or not. If they are, it is extremely rare.

15. Hepatitis A • A disease of the liver caused by hepatitis A virus • Potentially none (likelihood of symptoms decreases with the person's age) If present: yellow skin or eyes, tiredness, stomach ache, loss of appetite, or nausea • Because young children might not have symptoms, the disease is often not recognized until the child's caregiver becomes ill with hepatitis A. • A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of hepatitis A vaccine causing serious harm, or death, is extremely small. • Getting hepatitis A vaccine is much safer than getting the disease. • Mild problems • soreness where the shot was given (about 1 out of 2 adults, and up to 1 out of 6 children) • headache (about 1 out of 6 adults and 1 out of 25 children) • loss of appetite (about 1 out of 12 children) • tiredness (about 1 out of 14 adults) • If these problems occur, they usually last 1 or 2 days. • Severe problems • serious allergic reaction, within a few minutes to a few hours of the shot (very rare)

16. Hepatitis B • Hepatitis B is also a liver disease (the word “hepatitis” comes from the Greek words for “liver” and “inflammation”). It is caused by the hepatitis B virus. It is spread through contact with the blood, or other body fluids, of an infected person. Adolescents and adults can be infected through sharing drug needles or through unprotected sex, and health-care and public safety workers are often exposed to blood in the course of their jobs. Pregnant women can infect their newborn babies. People infected with hepatitis B might not feel sick, or might suffer loss of appetite or tiredness, muscle or stomach pains, diarrhea or vomiting, or yellow skin or eyes (jaundice). People usually recover from hepatitis B after several weeks, but others become “chronically infected.” They might not feel sick themselves, but they continue to carry the virus and can infect other people. A baby who is born to a chronically infected mother has a70%–90% chance of being infected at birth. Many people who are chronically infected will suffer from serious problems such as cirrhosis (scarring of the liver) or liver cancer. More than a million people in the United States are chronically infected with hepatitis B. In 1996 an estimated 200,000 people became infected, and 4,000 to 5,000 people die each year from hepatitis B. • A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of hepatitis B vaccine causing serious harm, or death, is extremely small. • Getting hepatitis B vaccine is much safer than getting hepatitis B disease. • Most people who get hepatitis B vaccine do not have any problems with it. • Mild problems • soreness where the shot was given, lasting a day or two (up to 1 out of 11 children and adolescents, and about 1 out of 4 adults) • mild to moderate fever (up to 1 out of 14 children and adolescents and 1 out of 100 adults) • Severe problems • serious allergic reaction (very rare)

17. Hib (Haemophilus influenzae type b) • A severe bacterial infection, occurring primarily in infants and children under 5 years • Meningitis, pneumonia, sepsis, epiglotittis (a severe throat infection), skin infections, and arthritis • Hib meningitis (death in one out of 20 children, and permanent brain damage in 10% - 30% of the survivors) • A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of Hib vaccine causing serious harm or death is extremely small. • Most people who get Hib vaccine do not have any problems with it. • Mild Problems • Redness, warmth, or swelling where the shot was given (up to 1 out of 4 children) • Fever over 101 degrees Fahrenheit (up to 1 out of 20 children) • If these problems happen, they usually start within a day of vaccination. They may last 2 to 3 days.

18. HPV • Human Papillomavirus (HPV) is a common virus that is spread through sexual contact. Most of the time HPV has no symptoms so people do not know they have it. There are approximately 40 types of genital HPV. Some types can cause cervical cancer in women and can also cause other kinds of cancer in both men and women. Other types can cause genital warts in both males and females. The HPV vaccine works by preventing the most common types of HPV that cause cervical cancer and genital warts. It is given as a 3-dose vaccine. • HPV vaccine does not appear to cause any serious side effects. • However, a vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of any vaccine causing serious harm, or death, is extremely small. • Several mild problems may occur with HPV vaccine: • Pain at the injection site (about 8 people in 10) • Redness or swelling at the injection site (about 1 person in 4) • Mild fever (100 degrees Fahrenheit) (about 1 person in 10) • Itching at the injection site (about 1 person in 30) • Moderate fever (102 degrees Fahrenheit) (about 1 person in 65) • These symptoms do not last long and go away on their own. • Life-threatening allergic reactions from vaccines are very rare. If they do occur, it would be within a few minutes to a few hours after the vaccination. • Like all vaccines, HPV vaccine will continue to be monitored for unusual or severe problems.

19. Not being vaccinated can lead to serious illness, hospitalization and even death. Please vaccinate your children.

20. THANK YOU • http://www.in.gov/isdh/17094.htm • coneal15@ivytech.edu