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‫م عدي فارس الفرطوسي‬.‫م‬
PhD Pediatric Nsg St.
Immunization
Immunity
natural
acquired
Active immunity:
Resistance developed in response to stimulus by an antigen (infecting agent or
vaccine) and is characterized by the production of antibodies by the host.
Passive immunity:
Immunity conferred by an antibody produced in another host. It may be acquired
naturally or artificially (through an antibody-containing preparation).
Immunizing agents
Immunoglobulin
There are 5 major classes: IgM, IgA, IgG, IgE, IgD.
Two types of immunoglobulin preparations are available for passive immunization:
 Normal human immunoglobulin
 Specific (hyper-immune) human immunoglobulin
Antisera or antitoxins
These are materials prepared in animals or non human sources such as horses.
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Immunoglobulin and antiserum
Human normal immunoglobulin
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Human specific
immunoglobulin
Hepatitis A
Measles
Rabies
Tetanus
Mumps
 Hepatitis B
 Varicella
 Diphtheria
Non human ig
(antisera)
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Diphtheria
Tetanus
Gas gangrene
Botulism ‫التسمم‬
‫الوشيقي‬
 Rabies
Vaccination
Vaccination: is a method of giving antigen to stimulate the immune response through active
immunization.
A vaccine is an immuno-biological substance designed to produce specific protection
against a given disease.
A vaccine is “antigenic” but not “pathogenic”.
Types of vaccines
a) Live vaccines ‫لقاحات حية‬
b) Attenuated live vaccines ‫لقاحات حية موهنة‬
c) Inactivated (killed vaccines) ‫معطلة‬
d) Toxoids ‫ذفان‬
e) Polysaccharide and polypeptide (cellular fraction) vaccines )‫السكاريد وببتيد (جزء خلوي‬
f) Surface antigen (recombinant) vaccines. ‫المستضد السطحي (المؤتلف) اللقاحات‬.
Live vaccines
 Live vaccines are made from live infectious agents without any amendment.
 The only live vaccine is “Variola” small pox vaccine, made of live vaccine cow-pox
virus (not variola virus) which is not pathogenic but antigenic, giving cross immunity
for variola.
Live attenuated (avirulent) vaccines
 Virulent pathogenic organisms are treated to become attenuated and a virulent but
antigenic. They have lost their capacity to induce full-blown disease but retain their
immunogenicity.
 Live attenuated vaccines should not be administered to persons with suppressed
immune response due to:
1. Leukemia and lymphoma
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2. Other malignancies
3. Receiving corticosteroids and anti-metabolic agents
4. Radiation
5. pregnancy
Types of vaccines
Live
vaccines
Small pox
variola
vaccine
Live
Attenuated vaccines
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BCG
Typhoid oral
Plague
Oral polio
Yellow fever
Measles
Mumps
Rubella
Intranasal
Influenza
Typhus
Killed
Inactivated
vaccines
Cellular fraction
vaccines
Toxoids
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Typhoid
 Diphtheria
Cholera
 Tetanus
Pertussis
Plague
Rabies
Salk polio
Intra-muscular
influenza
 Japanise
encephalitis
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Meningococcal
polysaccharide
vaccine
Pneumococcal
polysaccharide
vaccine
Hepatitis B
polypeptide
vaccine
Recombinant
vaccines
Hepatitis B
vaccine
Routes of administration
a) Deep subcutaneous or intramuscular route (most vaccines)
b) Oral route (sabine vaccine, oral BCG vaccine)
c) Intradermal route (BCG vaccine)
d) Scarification (small pox vaccine)
e) Intranasal route (live attenuated influenza vaccine)
Scheme of immunization
1) Primary vaccination
One dose vaccines (BCG, variola, measles, mumps, rubella, yellow fever)
Multiple dose vaccines (polio, DPT, hepatitis B)
2) Booster vaccination
To maintain immunity level after it declines after some time has elapsed (DT, MMR).
Periods of maintained immunity due to vaccines
a) Short period (months): cholera vaccine
b) Two years: TAB vaccine
c) Three to five years: DPT vaccine
d) Five or more years: BCG vaccine
e) Ten years: yellow fever vaccine
f) Solid immunity: measles, mumps, and rubella vaccines.
The Cold Chain
The "cold chain" is a system of storage and transport of vaccines at low temperature
from the manufacturer to the actual vaccination site.
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The cold chain system is necessary because vaccine failure may occur due to failure
to store and transport under strict temperature controls.
 Vaccine carriers: Vaccine carriers are used to carry small quantities of vaccines (16-20
vials) for the out of reach sessions. 4 fully frozen ice packs are used for lining the sides, and
vials of DPT, DT, TT and diluents should not be placed in direct contact with frozen ice
packs. The carriers should be closed tightly.
 Ice packs: The ice packs contain water and no salt should be added to it.
Among the vaccines, polio is the most sensitive to heat, requiring storage at minus 20
degree C.
Vaccines which must be stored in the freezer compartment are : polio and
measles.
Vaccines which must be stored in the COLD PART but never allowed to
freeze are : typhoid, DPT, tetanus toxoid, DT, BCG and diluents
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‫جدول اللقاحات الروتينية في العراق ‪1027‬‬
‫اللقاح‬
‫موعد اعطاء اللقاح‬
‫خالل ‪ 12‬ساعة بعد الوالدة‬
‫التهاب الكبد الفايروسي نمط ب االحادي ‪ -‬جرعة اولى‬
‫خالل ‪ 71‬ساعة بعد الوالدة‬
‫‪ BCG‬بي سي جي‬
‫‪ OPV0‬شلل االطفال الفموي ‪ -‬جرعة الصفر‬
‫عمر شهرين‬
‫‪ OPV1‬شلل االطفال الفموي ‪ -‬جرعة اولى‬
‫‪ Rota Virus Vaccine‬اللقاح الفايروسي الدوار ‪ -‬جرعة اولى‬
‫اللقاح الخماسي ‪ -‬جرعة اولى‬
‫عمر اربعة أشهر‬
‫‪ OPV2‬شلل االطفال الفموي ‪ -‬جرعة ثانية‬
‫‪ Quad vaccine‬اللقاح الرباعي ‪ -‬جرعة اولى‬
‫‪ Rota Virus Vaccine‬اللقاح الفايروسي الدوار ‪ -‬جرعة ثانية‬
‫عمر ستة اشهر‬
‫‪ OPV3‬شلل االطفال الفموية ‪ -‬جرعة ثالثة‬
‫‪ Rota Virus Vaccine‬اللقاح الفايروسي الدوار ‪ -‬جرعة ثالثة‬
‫‪ Penta vaccine‬اللقاح الخماسي ‪ -‬جرعة ثانية‬
‫عمر تسعة أشهر‬
‫‪ Measles‬الحصبة المنفردة ‪-‬‬
‫‪ -‬فيتامين ‪ A‬م ‪100‬الف وحدة عالمية‬
‫عمر خمسة عشر شهرا‬
‫‪ German Measles‬جرعة اولى ‪ MMR‬المختلطة‬
‫عمر ثمانية عشر شهرا‬
‫من ‪ 6 - 2‬سنوات‬
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‫‪.2‬‬
‫‪.3‬‬
‫‪.4‬‬
‫‪.5‬‬
‫‪.6‬‬
‫‪ OPV1‬شلل االطفال الفموي ‪ -‬جرعة منشطة اولى‬
‫‪ Quad vaccine‬اللقاح الرباعي ‪ -‬جرعة منشطة ثانية‬
‫م‪ 200‬الف وحدة عالمية فيتامين ‪A‬‬
‫‪ OPV2‬شلل االطفال الفموي ‪ -‬جرعة منشطة ثانية‬
‫اللقاح الثالثي ‪ -‬جرعة منشطة ثانية ‪DPT‬‬
‫جرعة ثانية ‪ MMR‬المختلطة ‪.‬‬
‫اللقاح الفايروسي الدوار) ‪. ( Rota Virus Vaccine‬‬
‫ال نبدأ بتلقيح الطفل بلقاح الفايروسي الدوار اذا تجاوز عمر ‪ -‬ثالث اشهر ‪.‬‬
‫اليتم اعطاء اي جرعة من لقاح الفايروسي الدوار اذا اكمل الطفل عمر ثمانية اشهر‪.‬‬
‫اللقاح الخماسي = )لقاح الثالثي ‪ +‬كبد نمط ب ‪ +‬لقاح المستدمية النزلية‪( HIB‬‬
‫اللقاح الرباعي = ( لقاح الثالثي ‪ +‬لقاح المستدمية النزلية ‪ HIB‬نوع ب )‬
‫في حال عدم ظهور الندبة بعد مضي شهرين على التلقيح بلقاح ال ( بي سي جي ) يعاد التلقيح‬
‫مرة ثانية‬
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