04/20/23 Immunization schedule 1

Immunization

M. Emadoleslami MD

04/20/23 Immunization schedule 3

Vaccines

Live (Attenuated)

Killed (Inactivated)

04/20/23 Immunization schedule 4

Maintance of long lasting immunity with inactivated ones, require Booster Doses

Immunologic response with live vaccines , is more than killed ones

04/20/23 Immunization schedule 5

Immunizing Agents

Active immunizing Ag

Conjugating agents

Suspending fluid

Preservative, stabilizers,…

Adjuvants

04/20/23 Immunization schedule 6

Active Antigens

A single Ag (T/D Toxoid)

Different Ags (H/P/M/Pertusis)

Live attenuated virus (MMR/OPV)

Killed virus/Virus Portions (IPV/Influenza)

Recombinant ones (HBV)

04/20/23 Immunization schedule 7

Conjugating Agents

Outer membrane protein (M/ T/ D)+

Polysaccharide Ag (H/M/P)

It can establish immunity in infants less than 2 years old

04/20/23 Immunization schedule 8

Suspending Fluid

Sterile water

Saline solution

04/20/23 Immunization schedule 9

Additives

Preservative (Thimerosal)

Stabilizer

Antimicrobial agents (Neomycin)

04/20/23 Immunization schedule 10

Adjuvants Aluminum salt

• HBV Vaccine

• DT,Td Vaccine

04/20/23 Immunization schedule 11

Vaccine handling/ Storage

MMR/OPV Vaccine, sensitive to increased temperature

DTaP/IPV/Hib vaccine/Polysaccharide and conjugate

vaccine/Inactivated Influenza / Meningococcal vaccine …… are damaged by freezing

04/20/23 Immunization schedule 12

Personnel

Designate one person as vaccine coordinator

Assign responsibility for ensuring for corrected handling, storing in recommended and documented manner

Assign a backup person to assume theses responsibilities during vacation

04/20/23 Immunization schedule 13

Equipment and Procedures (1)

Refrigerators and Freezers Temperature Reading Logbook Chilled water & Ice packs The Vaccine Expiration Date Weekly Unit Inspection for Outdated Vaccines Avoid reconstituting multiple vaccine doses or

drawing vaccines in multiple syringes Do not open > 1 vial of a vaccine at a time

04/20/23 Immunization schedule 14

Vaccine Administration (1) Gloves aren't required unless:

The health care professional has open hand

lesion

He will come into contact with potentially

infectious body fluids Changing needles between drawing vaccine isn't

necessary Different Vaccines shouldn't mix in the same syringe Patients should be observed for an allergic reaction

for 15- 20 min after receiving immunization

04/20/23 Immunization schedule 15

Immunization Sites and Routes

Oral Vaccines

Breast feeding…..

Vomiting within 10 minutes of receiving…. Parenteral Vaccines

(IM, IV, SC)

In children <1 y/o, Ant. Lat. aspect of the thigh

In children >1y/o, Deltoid muscle Hepatitis B and Rabies vaccines should not be given

in the buttocks at any age

04/20/23 Immunization schedule 16

Injection Technique

There are no data to document the necessity for aspiration before injection

The distance separating the 2 injections should be at least 1 inch

A brief bleeding period at the injection site is common

Applying pressure, EMLA, Lidocaine injection

The Z- track method of injection also is reported to decrease associated pain

04/20/23 Immunization schedule 17

Routine Vaccination

At Birth (BCG, HBV, OPV) 2 Month (DTP, OPV,HBV) 4 Month (DTP, OPV) 6 Month (OPV, DTP, HBV) 12 Month (MMR) 18 Month (OPV, DTP, MMR) 4-6 Y/O (OPV, DTP)

04/20/23 Immunization schedule 18

Precautions and Contraindications

• A precaution specifies a situation in which vaccine may be indicated (after judgment)

• A contraindication indicates that a vaccine should not be administered

04/20/23 Immunization schedule 19