Download Immunisation update

Immunisation
Update
Changes to the
immunisation schedule
Contraindications and
precautions to vaccination
Epidemic update
 Three significant changes to the
immunisation schedule in 2008:
– New pneumococcal vaccine for infants
– MeNZB vaccine programme
– HPV vaccine programme
New pneumococcal vaccine
for infants
 PCV7 (Prevenar®) vaccine has been added
 Effective in children < 2 years
 Previous vaccine 23PPV (Pneumovax23)
not effective in infants
 Given at 6 weeks, 5 and 15 months
 Children at high risk still have PCV7 +
23PPV
MeNZB vaccine programme
  in cases group B meningococcus
 MeNZB now removed from National
immunisation schedule
Contraindications and
precautions to vaccination
Vaccine
Contraindications
All Vaccines
Anaphylactic type reaction to a previous
dose of that vaccine, or to anyvaccine
component (not trace element)
Pertussis-containing
vaccines
•Previous encephalopathy within seven
days after a previouspertussis-containing
vaccine
•Evolving (undiagnosed) neurological
problem
Measles, Mumps,
•Immunosuppressed individuals
Rubella, MMR,Varicella, •If blood, plasma or immunoglobulin were
Yellow Fever, Oral Polio given in the last 11 months
•Pregnancy
Influenza, Yellow Fever
Anaphylactic reaction to chickens, including
eggs, egg protein, feathers etc
Precautions
There are a number of precautions to vaccination:
 Giving a live vaccine less than four weeks after another live vaccine
 Pregnancy
.
 Allergy to Vaccine components
 History of Guillain Barré Syndrome
 Thrombocytopenia or history of thrombocytopenic purpura and MMR
 Haemophilia and related bleeding disorders
False contraindications
 The following conditions or circumstances are not
contraindications to vaccination:
 Minor infections without significant fever or systemic
upset
 Asthma, hayfever, eczema, “snuffles”
 Food or medications allergy
 Treatment with antibiotics or locally acting steroids
 Pregnancy in the child’s mother
 A child who is breastfeeding
 Neonatal jaundice
 Low weight in an otherwise healthy child
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False contraindications (..contd)
 The child being over the usual age for immunisation
 Family history of vaccine reactions, seizures or
Sudden Infant Death Syndrome
 Prematurity in an otherwise well infant who is not in
hospital
 Established neurological conditions such as cerebral
palsy or Down syndrome
 Contact with an infectious disease
 Clinical history of pertussis, measles, mumps or
rubella (clinical history without laboratory
confirmation can not be taken as proof of immunity)
Epidemic update
 Pertussis
 Measles
Pertussis
 New Zealand has a pertussis epidemic every
four to five years – currently in early phases
 Infants are vulnerable to disease
 The best way to contain an epidemic is
immunisation and effective management
of confirmed cases
 Exclude confirmed cases from school or work
 Pertussis is a notifiable disease to MOH
Measles
  in cases since start of 2009
 95% of popn must be immunised to avoid
outbreaks
 Difficult as efficacy of measles vaccine is
90-95%
 All children should be vaccined at 15
months and 4 years