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Immunisation Update . Changes to the immunisation schedule Contraindications and precautions to vaccination Epidemic update. Three significant changes to the immunisation schedule in 2008: New pneumococcal vaccine for infants MeNZB vaccine programme HPV vaccine programme .
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Changes to the immunisation schedule Contraindications and precautions to vaccination Epidemic update
Three significant changes to the immunisation schedule in 2008: • New pneumococcal vaccine for infants • MeNZB vaccine programme • HPV vaccine programme
New pneumococcal vaccine for infants • PCV7 (Prevenar®) vaccine has been added • Effective in children < 2 years • Previous vaccine 23PPV (Pneumovax23) not effective in infants • Given at 6 weeks, 5 and 15 months • Children at high risk still have PCV7 + 23PPV
MeNZB vaccine programme • in cases group B meningococcus • MeNZB now removed from National immunisation schedule
Precautions There are a number of precautions to vaccination: • Giving a live vaccine less than four weeks after another live vaccine • Pregnancy. • Allergy to Vaccine components • History of Guillain Barré Syndrome • Thrombocytopenia or history of thrombocytopenic purpura and MMR • Haemophilia and related bleeding disorders
False contraindications • The following conditions or circumstances are not contraindications to vaccination: • Minor infections without significant fever or systemic upset • Asthma, hayfever, eczema, “snuffles” • Food or medications allergy • Treatment with antibiotics or locally acting steroids • Pregnancy in the child’s mother • A child who is breastfeeding • Neonatal jaundice • Low weight in an otherwise healthy child (continued on next slide)
False contraindications (..contd) • The child being over the usual age for immunisation • Family history of vaccine reactions, seizures or Sudden Infant Death Syndrome • Prematurity in an otherwise well infant who is not in hospital • Established neurological conditions such as cerebral palsy or Down syndrome • Contact with an infectious disease • Clinical history of pertussis, measles, mumps or rubella (clinical history without laboratory confirmation can not be taken as proof of immunity)
Epidemic update • Pertussis • Measles
Pertussis • New Zealand has a pertussis epidemic every four to five years – currently in early phases • Infants are vulnerable to disease • The best way to contain an epidemic is immunisation and effective management of confirmed cases • Exclude confirmed cases from school or work • Pertussis is a notifiable disease to MOH
Measles • in cases since start of 2009 • 95% of popn must be immunised to avoid outbreaks • Difficult as efficacy of measles vaccine is 90-95% • All children should be vaccined at 15 months and 4 years