Immunizations Flashcards
what are immunizations/vaccines?
highly regulated,
complex biologic products designed to
induce a protective immune response
effectively and safely & economically
what is in a vaccine?
immunogen, adjuvant, additives, preservatives
immunogen (antigen)
the part of the vaccine that stimulates an immune response; biologically treated to be safe; also basis for the classification of vaccine type
adjuvant
added to vaccines to enhance immune response; makes it possible to reduce the dose or number of doses (ie. aluminum salts shown safe over 7 decades)
additives
substances to SUPPORT GROWTH of immunogens; confirm product quality; example: gelatin
preservatives:
chemicals added to multidose, killed, or subunit vaccines to prevent serious secondary infections
ie. phenol; thimerosal (ethyl mercury) no longer used
NOTE re mercury:
no vaccine made in CAN since march 2001 for routine use in children (except flu) contains thimerosal
- DTaP, polio, and Hib vaccines have not contained this preservative since 1997-8 and MMR used in canada has never contained thim
live (attenuated) vaccines
vaccine contains whole, living bacteria or viruses that produce immunity by actively replicating in the host; since it replicates within the host is more closely resembles natural infection; longer lasting and broader immunity; caution = immunosuppressed or pregnant
killed vaccines
the antigen has been rendered inactive, but the presence of it will still cause an immune response to be built; you need multiple doses of killed vaccines because they take more to be effective; use of live vaccines is preferredo
herd immunity
population is immunized to point when the carrier-disease process is interrupted (~90%); protects population; highly significant for vulnerable groups; different dxs have different levels of population vaccination needed to reach herd immunity; most around 85-90
what agencies in canada are involved in immunization?
NACI (national advisory committee on immunization)
biologics & genetic therapies directorate
provincial ministries
what problems are created by canadas immunization strategy?
no national program each province sets own program safety concerns equity concerns added expense - wasted time checking things that should be automated - cant order completely in bulk - only developed country without a national immunization program
role of RN
have legislative authority to immunize
require: direct order (specific pt) or medical directive (population)
medical directives should be available to treat adverse rxns
clients with known risks for adverse reactions (ie. immuno-comprimised) require RN (EC) or MD assessment
- risk communication
- education
- guidance re: legitimate information sources
evaluating health information on the web
NACI *** Best site to go to
Health on the Net
MedCIRCLE (the collaboration for internet rating, certification, labeling and evaluation of health information)
WMA (health-related content websites accreditation programme)
discern.org.uk – has quality criteria for consumer health information
what to look at in sites
- evaluate qualifications of authors
- information only to support the MD-pt relationship
- cites the sources of published information
- must back up claims relating to benefits and performance
- accessible presentation, accuracte email contact
- identify funding resources
- clearly distinguish advertising from editorial content
googling children’s health: reliability of medical advice on the internet
study structure, results, conclusion & recommendations
risk communication
making sure parents understand the pros of immunization and understands their child will be at risk for these things w/o immunization; and can also carry dxs to others
guidane re: legitimate information sources for parents
Health on the Net (regularly updated, continuously checked for scientific accuracy)
- Certification (HON, etc)
- Government sites (are accurate, may not have the most cutting edge info but will not give bad information) are fine; look at board of directors
- sites that are selling something are less accurate
implications for vaccine refusal
puts population at risk
if too many refusals, especially when based on false data, herd immunity drops below required level
