immunization advice

Question 1

case

Answer 1

Your next patient is baby Laura brought by her mother to a general practice at six weeks of age,
as part of routine postnatal followup. Laura is the couples first child. The babe is breastfed and
gaining weight normally. Her mother wants to know what you would advise about immunisation
because she and her husband have recently heard conflicting views expressed in the media.
General examination of the baby reveals no abnormality. She was given her first hepatitis B
vaccination soon after birth.

YOUR TASKS ARE TO:
* Outline the current immunisation protocol you would recommend and what diseases the
programme is protecting against.
* Discuss any concerns the parents have about immunisation.
You will not be expected to take any additional history or ask for examination findings. The

Question 2

what is the national immunization schedule

Answer 2

look up

Question 3

advice

Answer 3

-stress the importance of vaccines are safe, few side effects and how to ta kel them
-give pcm for pain and fever, and can give prophylactically 30 min b4 if previous reaction to DTP

Question 4

contraindications

Answer 4

-encephelopathy within seven days of pertussis vaccine
-severe ana[hylaxis after DTP
-simple febrile convulsion and neurologic disease not a c/i
-major illness or high fever postpone till better, but slight fever ok

Question 5

LIVE VACCINES

Answer 5

-MMR, POLIO, CHICKEN POX, RUBELLS
-should not be administered in immunocompromised children
-allergy to egg not a c/i to MMR but sm observe 4 hours

Question 6

not a c/i

Answer 6

• family history of adverse reactions to immunisation;
• family history of convulsions;
• previous pertussis-like illness, measles, mumps or rubella infection;
• prematurity (immunisation should not be delayed);
• stable neurological conditions (e.g. cerebral palsy, Down syndrome);
• contact with an infectious disease
• asthma, eczema, atopy, hay fever, ‘snuffles’;
• treatment with antibiotics;
• treatment with locally inhaled or low dose topical steroids;
• child’s mother is pregnant;
• child is breastfed;
• history of jaundice after birth;
• over the age recommended in vaccination schedule;
• recent or imminent surgery; and
• replacement corticosteroids.

Question 7

other

Answer 7

no asst between autism and measels
-discuss prevalence of diseases pertussis, varicella, meningococcus, pneumococcal