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Chapter 68
Childhood Immunization
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
Immunizations
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Purpose is to protect against infectious
diseases
Most effective method is to create a highly
immune population
Universal vaccine is the goal
Vaccines carry risk, but risks of disease are
much greater
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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General Considerations
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Definitions
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Vaccine
Killed vaccines vs. live vaccines
Toxoid
Vaccination
Immunization; active vs. passive
Specific immune globulins
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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General Considerations
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Reporting vaccine-preventable disease
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Determine whether an outbreak is occurring
Evaluate prevention and control strategies
Evaluate the impact of national immunization
policies and practices
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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General Considerations
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Immunization records
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National Childhood Vaccine Act of 1986 requires a
permanent record of each mandated vaccination
• Date of vaccination
• Route and site of vaccination
• Vaccine type, manufacturer, lot number, expiration date
• Name, address, title of person administering the vaccine
Reason for record
• To ensure appropriate vaccination
• To avoid overvaccination
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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General Considerations
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Adverse effects of immunization
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Immunocompromised children are at special risk
from live vaccines
• Congenital immunodeficiency
• HIV infection
• Leukemia
• Lymphoma
• Generalized malignancy
• Therapy with radiation
• Cytotoxic anticancer drugs
• High-dose glucocorticoids
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Target Diseases
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Measles
Mumps
Rubella
Diphtheria
Tetanus (lockjaw)
Pertussis (whooping cough)
Poliomyelitis (polio or infantile paralysis)
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Target Diseases
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Haemophilus influenzae type b
Varicella (chickenpox)
Hepatitis B
Hepatitis A
Pneumococcal infection
Meningococcal infection
Influenza
Rotavirus gastroenteritis
Genital human papillomavirus infection
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Specific Vaccines and Toxoids
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Measles, mumps, and rubella virus vaccine
(MMR)
Diphtheria and tetanus toxoids and acellular
pertussis vaccine (DTaP)
Poliovirus vaccine
H. influenzae type b conjugate vaccine
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Specific Vaccines and Toxoids
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Varicella virus vaccine
Hepatitis B vaccine
Hepatitis A vaccine
Pneumococcal conjugate vaccine
Meningococcal conjugate vaccine
Influenza vaccine
Rotavirus vaccine
Human papillomavirus vaccine
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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