Vaccination Flashcards
Infantile colic
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Prevalence
• Crying for no apparent reason that lasts
for ≥3 hours per day and occurs on ≥3
days per week in an otherwise healthy
infant <3 months of age. • Prevalence of colic in infants range
from 8 to 40 percent. • The incidence does not differ by
gender or the type of feeding.
Infantile colic
Etiology
Etiology is not known but some
possible explanation: • feeding techniques: overfeeding,
underfeeding or inadequate burping. • Cow’s milk protein intolerance but
usually has other symptoms. • Lactose intolerance. • Gastrointestinal immaturity:
incomplete absorption of
carbohydrates. • Intestinal hypermotility • Parental variables: anxiety of the
parents are transmitted to the child.
Injuries prevention
Children should be seated in the
rear seat of a vehicle until they are
13 years of age.
Baby Walkers
American Academy of Pediatrics
and The Canadian Pediatric
Society called for complete ban of
baby walkers.
Pa cifier Use
Pacifier use help soothing the child and may decrease risk of SIDS. • It should not be discouraged in the 1st year of life but should be restricted in children with chronic/recurrent otitis media. • Pacifier should NOT be given earlier than 3 to 4 weeks of age or before breastfeeding has been established
Sc reen Time
For children under 2 years • old, screen time is not recommended. • For children 2 to 5 years old, limit routine or regular screen time to less than 1 hour per day.
Dental Care
Consider the first dentist visit by
6 months after eruption of 1st
tooth or at age 1 year then every
6 months.
Active immunization
Naturally can be acquired by getting infected by the organism/Vaccines are defined as whole or parts of microorganisms administered to prevent an infectious disease.
Ty pes of vaccines
- Whole inactivated microorganisms (e.g., polio and hepatitis A) 2. Parts (subunits) of the organism (e.g., acellular pertussis, HPV, and hepatitis B). 3. Polysaccharide capsules conjugated to protein carriers (e.g., Haemophilus influenzae B, pneumococcal, and meningococcal conjugate vaccines).
- Live attenuated microorganisms (measles, mumps, rubella, varicella, rotavirus). 5.Toxoids (tetanus and diphtheria).
Diphtheria
• Caused by Corynebacterium diphtheriae • Incubation 2-5 days • Early – malaise, sore throat, difficulty in swallowing, loss of
appetite, hoarseness, mild fever • Within 2-3 days, adherent, gray membrane on oral mucous
membranes
– Extensive membrane - life-threatening airway obstruction. • Toxin – serious systemic complications including myocarditis • Death rate 5%-10%
TeTanus
• Spread by contact with soil
containing Clostridium tetani • Most infections from
contaminated wounds • Incubation 1-2 weeks • Not contagious • Produces exotoxin • Progressive muscle tightening,
descending pattern
Pe rtussis
• Caused by Bordetella pertussis • Highly contagious • 90% of household contacts will acquire • Starts as URI • After 1-2 weeks – paroxysms of severe coughing followed by “whoop” with loud inspiration, apnea and post tussive vomiting • Worse for very young • Can lead to pneumonia, seizure and encephalopathy
CI of DTaP
Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose – Encephalopathy (e.g., coma, decreased level of consciousness; prolonged seizures) • not attributable to another identifiable cause • within 7 days of administration of previous dose of DTP or DTaP clarified and stabilized – Progressive neurologic disorder • including infantile spasms • uncontrolled epilepsy • progressive encephalopathy – Defer DTaP until neurologic status
Polio
• Very infectious virus • Up to 95% of people infected with
polio have no symptoms • 4-8% minor symptoms – fatigue,
myalgias, stiffness • <1% have paralysis from virus
attacking motor neurons Polio Vaccine: • 2 types, Live attenuated (oral),
Inactivated (IPV). • Ideally all countries should switch to
IPV only.
• Trivalent OPV can cause Vaccine
Associated Paralytic Poliomyelitis
(VAPP) • Multiple doses series.
Hemophilus Influenza B(Hib)
Prior to vaccine, Hib was leading cause of childhood – Bacterial meningitis – Epiglottitis – Pneumonia – Empyema – Pericarditis – Bacteremia • Hib vaccine available in combination vaccine.
Streptococcus pneumoniae
– Common cause of community
acquired pneumonia and otitis media
High risk children of pneumococcal disease PCV13
include – Immunocompromised children • HIV • Chronic renal failure • Nephrotic syndrome • Lymphoma and leukemia • Chemotherapy • Organ transplant • Congenital immunodeficiencies
High risk children include
– Immunocompetent children with
• Cyanotic congenital heart
defects • Chronic lung disease • Asthma needing oral steroid
treatment • Diabetes • CSF leaks • Cochlear implants • Asplenia (congenital or
acquired) • Sickle cell and other
hemoglobinopathies
High risk children of pneumococcal disease PCV13
include – Immunocompromised children • HIV • Chronic renal failure • Nephrotic syndrome • Lymphoma and leukemia • Chemotherapy • Organ transplant • Congenital immunodeficiencies
High risk children include
– Immunocompetent children with
• Cyanotic congenital heart
defects • Chronic lung disease • Asthma needing oral steroid
treatment • Diabetes • CSF leaks • Cochlear implants • Asplenia (congenital or
acquired) • Sickle cell and other
hemoglobinopathies
Rotavirus
Most common cause of
gastroenteritis worldwide • Can cause severe dehydration
Live attenuated rotavirus • Given orally on multiple doses • Narrow administration window
– First dose must be before 15
weeks – Last dose must be before 8
months
Mumps
Fever, malaise, headache, myalgias • 48 hours later: parotitis (parotid gland
inflammation)
Rubella
Rash and fever for 2-5 days • If acquired while pregnant, severe congenital defects
– Cataracts – Heart defects – Deafness – Mental retardation
MMR
• Measles, Mumps, Rubella • Live attenuated vaccine • Given after 12 months old. • Not contraindicated in children with
egg allergy.
Varicella Vaccine
Contraindications – Severe allergic reaction (e.g., anaphylaxis) after previous dose – Substantial suppression of cellular immunity
Safe Situations to Administer Varicella Vaccine
• Immunodeficient family member
or household contact. • Asymptomatic or mildly
symptomatic HIV infection (CD4
count >200).
Meningococcal vaccine
• All currently available vaccines
effective against Groups A, C, Y,
and W-135 • Meningococcal B vaccine is only
recommended to high risk
population for invasive
meningococcal disease such as
sickle cell anemia or asplenia. • Conjugated vaccines developed
– Produces memory cells – Preferred vaccine choice
Vaccines contain Aluminum!
• Aluminum is an adjuvant that helps increase the body’s immune response to the antigen in the vaccine which decrease the amount of the number doses needed. • Aluminum is in our food, air, and water. • Formula and breast milk include aluminum. • The amount of aluminum in vaccines is similar to that found in 975 ml of infant formula.
Thimerosal
v Thimerosal is a mercury-based preservative that has been used to prevent contamination of vaccines with bacteria and fungi. v Many studies have shown that there is no link between thimerosal and autism.
• The form of organic mercury contained within thiomersal • is ‘ethyl mercury’ which does not accumulate in the body, unlike the closely related ‘methyl mercury’ which does accumulate and is neurotoxic.
