Vaccination

Applied Science University Faculty of Nursing Department Of community Nursing Community Nursing course Clinical sitting ( UNRWA ) MCH center

Prepared by : Raed H. Gazawi 200510548 Malek Ahmmad Mutaz Al lawzi

Submited to : Dr. Reda AL Mawafi Accademic year 2009

Outline

1- Objectives 2- Introduction 3- Defintion 4- Types of vaccines 5- Recommended immunization 6- Storage of vaccine 7- Role of nurse 8- Vaccination schedule (( Roster )) 9- References

Objectives: At the end of this presentation, the nurse student will be able to: 1- Define vaccination. 2- List different types of vaccines. 3- Describe the cold chain of storage. 4- Explain routine vaccination schedule. Introduction: Vaccination

is

key

population.Vaccines the

unvaccinated

longer and

spread.In

to

benefit

both

people

from

disease

the

around

addition,

disability

preventing

people

them,

who

because

vaccenation

infection,

among

reduce

such

receive

the the

as

the

general

them,

infection number

measles

and

can of

and

no

deaths chickenpox.

Definition of vaccination: Injection

of

system, the

akilled

microbe in

order

natural disease - fighting

to

stimulate

system

of

the

immune

the body

against

the microbe, thereby preventing disease. Types of vaccines: Inactivated

vaccines:

microorganism and They

safe;

they

often

accessible

with

to

do the

are

produced

chemicals

cannot not

return

require

people

of

or to

by heat.

the

Such

virulence

refrigeration, many

killing

a

the vaccines

are

stable

((disease-causing))

quality

developing

disease-causing

that

countries,

makes as

well

form. them as

practical

for

vaccinating

members

of

the

stimulate

a

more limited

than

armed

relatively

forces.

weak

once. A vaccine

usefulness,

people

especially

who

are

However,

immune that in

several

where

mobile,

most

response

requires areas

highly

such

inactivated

vaccines

and

must

doses

((boosters))

people

have

less

as

be

given has

access

a to

regular health care. The flu shot is an inactivated vaccine, as are the vaccines for cholera, plague, and hepatitis A. Live, Attenuated Vaccines: To make a live, attenuated vaccine, the disease-causing organism is grown under special laboratory conditions that cause it to lose its virulence. Although live vaccines require special handling and storage in order to maintain their potency, and generally require only one boost, or additional dose. Most live vaccines are injected; some others, such as the polio vaccine, are given orally. While there are advantages to live vaccines, there is one caution. There is a remote possibility that the organism may return to a virulent form and cause disease. It is for this reason that live vaccines continue to be carefully tested and monitored. For their own protection, people with compromised immune systems such as people who are taking immunosuppressive drugs, people who have cancer or people living with HIV are usually not given live vaccines. The vaccines for measles, rubella, and mumps are all produced from live, attenuated vaccines. Toxoid vaccines: is an inactivated toxin, the harmful substance produced by a microbe. For example, the bacterium that causes tetanus is found everywhere in nature, and in an environment with plenty of oxygen, it is harmless. If that same organism is put into an environment without oxygen, the organism starts to change and produce tetanus toxin, a substance far more potent than the well-known poison sodium cyanide. To inactivate such powerful toxins, vaccine manufacturers treat them with materials to completely cripple any disease-causing ability. Formalin, a solution of formaldehyde and sterile water, is most often used to inactivate toxins and produce Toxoids. Toxoids are used to immunize people against diphtheria. Conjugate Vaccines: The bacteria that cause

some diseases, such as pneumococcal

pneumonia and certain types of meningitis, have special outer coats. These coats disguise

antigens so that the immature immune systems of infants and younger children are unable to recognize these harmful bacteria. In a conjugate vaccine, proteins or toxins from a second type of organism, one that an immature immune system can recognize, are linked to the outer coats of the disease-causing bacteria. This enables a young immune system to respond and defend . Currently, conjugate vaccines are available to protect against a type of bacterial meningitis caused by Haemophilus Influenza type B (( HIB )). Subunit Vaccines: Sometimes vaccines developed from antigenic fragments are able to evoke an immune response, with fewer side effects than might be caused by a vaccine made from the whole organism. Subunit vaccines can be made by taking apart the actual microbe, or they can be made in the laboratory using genetic engineering techniques. Today, subunit vaccines are used to protect against pneumonia caused by Streptococcus pneumonia. A recombinant subunit vaccine for hepatitis B virus infection is now licensed for use. The recombinant vaccine is made by inserting a tiny portion of the hepatitis B virus genetic material into common baker’s yeast. This process induces the yeast to produce an antigen, which is then purified. The purified antigen, when combined with an adjuvant, a substance that stimulates the immune system, results in a safe and very affective vaccine. Recommended immunization: Bacille Calmette Guerin (( BCG of Tuberculosis )) : Is the most widely used vaccination in the world. This vaccine is made of a live, weakened strain of mycobacterium bovis, (( a cousin of mycobacterium tuberculosis, the tuberculosis bacteria )). It was developed in the 1930's and it remains the only vaccination available against tuberculosis today. Reaction: Swelling or slight discharge at the site of injection. Poliomyelitis (( Polio )): is a highly contagious infectious disease caused by three poliovirus. The poliovirus affect the whole body, including muscles and destruction to the nervous system causing paralysis or death. The majority of individuals who are infected with polio, have no symptoms and few have mild symptoms such as anorexia, vomiting, abdominal pain. There are two type of polio vaccine: A: Oral vaccine: It is a vaccine containing live attenuated viruses. B: Salk vaccine: It is an inactivated injectable form of vaccine. Reaction: Diarrhea, headache, and/or muscle pain. In countries using IPV, no increased risk for serious adverse events has been observed. Some people who get IPV get a sore spot where the shot is given. Haemophilus Influenza B (( HIB )): This vaccine protects us from the HIB bacteria. This bacteria causes meningitis, and may cause brain damage. Also this bacteria can infect the blood, joints, bones, muscles, throat and the cover surrounding the heart. This is especially dangerous for children because Children can carry this bacteria without showing any signs

of the disease but they can infect others. Reaction: mild fever, unsettled, swelling or soreness at the injection site Diphtheria, Pertussis and Tetanus (( DPT )): Diphtheria: is an infection that attacks the throat, mouth and nose. This is a very contagious disease, but rare ever since the vaccine was created. Diphtheria can form a gray web that may completely cover the windpipe and cause someone to stop breathing. Also, if this disease is not treated right away it could cause pneumonia, heart failure or paralysis. Pertussis: also called Whooping Cough, is a bacteria that clogs the lungs with mucus . This can cause a severe cough that sounds like a whoop and allows for other bacteria such as pneumonia and bronchitis attack the body. Tetanus: is an infection caused by a bacteria found in dirt and rusty metal. It usually enters the body through a cut. Tetanus bacteria causes the muscles to spasm. If tetanus attacks the jaw muscles it causes lockjaw, Tetanus can also cause the breathing muscles to spasm. That can be deadly. Reaction: Mild fever, unsettled, swelling or soreness at the injection site. Measles, Mumps and Rubella (( MMR )): Measles: Measles is a highly contagious disease that causes a high fever, cough, and a spotty rash all over. It may also cause ear infections and pneumonia. Mumps: It is acute virus infectious disease , which may involve many organs But commonly affects the salivary gland (( mainly parotids glands )). Rubella: Also called German measles. It is most dangerous for women who are pregnant. Rubella can cause a mother to have a miscarriage or deliver a baby with heart disease, blindness, hearing loss or learning problems Reaction: Mild fever, rash, unsettled, swelling of glands in the cheeks. Hepatitis B: Is a viral disease that cause acute and chronic liver damage. It is transmitted by contact with blood of an infected person Reaction: Mild fever, unsettled, soreness at the injection site, nausea, malaise, muscle or joint pain. Hepatitis A: This is not anew vaccine, it has been in use for years, but has Not been part of the standard recommended vaccine schedule until now. This viral disease is very mild in infants and children.

Reaction: soreness where the shot was given, loss of appetite and tiredness. Storage of vaccine: To provide safe storage and transportation for the vaccine, and maintain their potency we should take into consideration : 1- Don't break the cold chain. The cold chain is the system of transporting and storing vaccines within the safe temperature range of 2˚C to 8˚C. 2Use a dedicated vaccine fridge to store all vaccines . 3- Don’t store food, drinks and medical samples in the vaccine fridge. 4- Don’t store vaccines on the door shelves of the vaccine fridge. 5- Don’t place the vaccine fridge in direct sunlight or near heat source. 6Don’t keep any used vaccine vials in the vaccine fridge. 7- Don’t over filled the vaccine fridge (( less than 55 % )). 8- Monitor and record maximum / minimum and current temperature daily. 9- Rotating stock so that vaccines with the shortest expiry date are used first. Role of nurse: 12345678-

Welcomes patient/family, establish intimacy and answer any questions. Explain what vaccine will be given and which type of injection. Chick vial expiration date and double chick for label and content. Maintain Aseptic technique while injecting the vaccine. Applies gentle pressure to injection site for several seconds. inform the patient and his family about the reaction. Fully document each immunization in patient chart. Ask the patient to bring with him this chart to each visit.

References: - Wong's. Essentials of Pediatric Nursing , 2001, 6the edition, Mosby. -

Research:

SmithKline

Beecham,

2000

childhood

immunization.

- Research: U. S. Department of Health and Human Services. Standards for Pediatric Immunization Practice. Centers for Disease Control and Prevention (CDC). Atlanta: National Immunization Program. -

www.moh.gov.jo

(Statistics

of

poliomyelitis

related

to

Jordan).