Immunizations in pediatrics & public health Flashcards
Immunization vs. Vaccination
– Immunization: the process of rendering a subject immune, or of becoming
immune.
– Vaccination: the introduction of vaccine into the body to produce
immunity
T/F Passive immunization (introducing immunoglobulin) is NOT vaccination
T
Types of ImmunizaAon
- Active → An’gen introduced
– Types: live, killed, or derivative (a protein or polysaccharide of a microorganism) or a toxoid (deactivated toxin)
– Acquired immunity is long term immunity (years to lifetime) - Meaningful immunity → 2 to 4 weeks after vaccination
– Live versions more efficacious & provide longer lasting immunity than nonliving vaccines - Passive → Antibody introduced (immunoglobulin)
– Results in immediate protecQve immunity
– Immunity is short term (3-6 months
Acquired Immunity
-Activates the host immune system to
create immunoglobulins (antibodies) to
combat a foreign antigen, both now
& in the future
Passive Immunity
-Supplies host with immunoglobulins
(antibodies) for immediate ability to
combat foreign antigens → which
ability wanes after the short term
IMMUNIZATION PEARL
The more similar a vaccine is to the disease-
causing form of the organism, the better the
immune response to the vaccine
Live Attenuated virus vaccine
- Fight viruses & some bacteria
- Do replicate
- Fewer doses needed to maintain immunity
Inactivated Virus vaccine
- Fight viruses & bacteria
- Do not replicate
- Cannot cause disease or infecAon
- Requires mulAple doses to maintain immunity
- Types
– InacAvated Whole Viral
– Subunit
– Polysaccharide
– Conjugate Toxoid
Adjuvants (ingredients in vaccines)
- Enhance immune response to an anAgen
- Aluminum (found water, food, even air)
– 4 mg total in all recommended vaccines - For comparison - In the same 1me period…
– 10 mg from breasGeeding
– 40 mg from regular infant formula
– 120 mg from soy based infant formula
Vaccine ingredients for virus inactivation & bacterial toxification
- Formaldehyde
– Diluted in the process, but residual quanQQes may be found - So small it poses no safety concern
Gelatin in vaccines
- A vaccine stabilizer to protect active ingredients during
manufacture, transport & storage - Made from the skin or hooves of pigs
- Religious concerns (Jews, Muslims, & Seventh Day Adventists)
– Dietary rules prohibit pig products
However, ALL major religious groups have approved the use of gelatin-containing vaccines
Ethyl Mercury (Thimerosal) in vaccines
- Originally added to multi-dose vials of vaccine
– preservative against bacteria - Thimerosal contains a form of mercury
– ethyl mercury
Ethyl mercury vs. Methylmercury
– Thimerosal in vaccines → No signs of mercury poisoning
* Symptoms of mercury poisoning are different than those of autism
– Manufacturing of multidose vials stopped in late 90s
* except multidose Flu shot vials
Fetal Cells are used to make 5 vaccines
– Rubella
– Chickenpox
– Hepatitis A
– Shingles
– Rabies
T/F Increasing the interval between doses of a multidose vaccine does not diminish the effectiveness of the vaccine.
T
All vaccines can be administered at the
same visit as all other vaccines
Exception:
- Children with functional or anatomic
asplenia - PCV13 & menactra should be separated
at least 4 weeks
Systems that help in Ensuring Vaccines are Safe:
- Vaccine Adverse Event ReporQng System (VAERS)
– Surveillance system by FDA & CDC
– Parent & provider reporQng - Vaccine Safety Datalink (VSD)
– Conduct populaQon based research on immunizaQon
safety quesQons
– Evaluate immunizaQon safety hypotheses that arise from
medical literature, passive surveillance systems,
adjustments to immunizaQon schedules, & introducQon
of new vaccines - VAERS raises the quesQon; VSD answers it
USIIS
Utah Statewide Immunization Information System
* Access immunization records for new & current paQents
* Consolidate immunizations from all providers into a single record
* Saves staff time locating immunization records
* Prevents missed immunization opportunities
Herd or community immunity
- Protection of an individual from
infection by virtue of the other
members of the population
being incapable of transmitting the
virus to that individual - Immunization of ~9 in 10 can generally
protect the one unimmunized person by
interrupting transmission
Facts & Tips for
Talking with
Parents about HPV
Most common STI - spread by vaginal, anal, oral sex
* More than 120 types, categorized as:
– Low –risk- includes types 6 & 11- cause of genital warts
– High- risk- carcinogenic- includes types 16 & 18
* High- risk HPV types are found in 99% of cervical cancers
* Cancer of the vulva, vagina, penis, anus, oropharynx
* High Incidence
* No specific treatment- medical management
* No approved test to determine person’s “HPV status”
HPV VACCINE
- Gardasil 9- HPV9
– male & female age 11-26
– types 16,18,6,11 plus -adds 5 addi[onal types which contribute
to an ~addi[onal 15% of cervical cancers
