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vaccinations at birth
Hepatits B (H-B-Vax II)
vaccinations at 2 months
- diptheria, tetanus, pertusis - Haemophilus influenzae B - Hep B -Polio >>(Infanrix Hexa) Pneumococcal (Prevenar) Rotavirus (Rotarix - oral)
vaccinations at 4 months
- Diptheria, tetanus, pertusis - HiB -Hep B - polio >> (Infanrix Hexa) Pneumococcal (prevenar) Rotarvirus (Rotarix - oral)
vaccinations at 6 months
- diptheria, tetanus, pertusis - HiB - Heoatits - Polio >> (Infanrix Hexa) Pneumococcal (Prevenar)
vaccinations at 12 months
measles, mumps and rubella (Priorix) Haemophilus influenzae B (Hiberix) Meningococcal C (Meningitec)
vaccinations at 18 months
Varicella (Varilrix)
vaccinations at 4 years
diptheria, tetanus, pertusis, polio (Infanrix -IPV) Measles, mumps and rubella (Priorix)
vaccinations at 12 years
Hep B (H-B-Vax II) Varicella (Varilrix) Human Papilloma virus (Gardasil)
vaccinations at 15 years
diptheria, tetanus, pertusis (Boostrix)
vaccinations at 50yrs and over if aboriginal
Influenza Pneumococcal (Pneumovax 23)
vaccinations at 65 yrs and over
Influenza Pneumococcal (Pneumovax 23)
Absolute contraindications applicable to ALL vaccines
1. anaphylaxis following previous dose of the relevant vaccine 2. anaphylaxis following any component of the relevant vaccine
Contraindications applicable to live vaccines (parenteral and oral)
1. live vaccines should not be administered to individuals with impaired immunity. With specialist advice MMR can be administered to HIV-infected individuals whose impairment is only mild 2. Generally live vaccines should not be administered during pregnancy, and women should be advised not to become pregnant within four weeks of receiving live vaccine
General precaution when giving vaccines
postpone 2-3 days if major illness of temp >38.5
contraindications to DTP
- major reaction to previous dose (anaphylaxis or severe allergic reaction) - encephalopathy, prolonged seizures, focal neuro signs (referral needed)
contraindications to MMR
- altered immunocompetence - corticosteroids, immunosuppressants - immunoglobulin injection or whole blood transfusion in last three months - pregnancy - anaphylactic reaction to neomycin or gelatin - other live virus vaccine in last year
what vaccines should an asplenic patient (both functional, congenital and iatrogenic) receive?
pnumococcal meningococcal influenza
who should receive yearly influenza vaccine?
Chronic pulmonary disease chronic cardiac disease immunosuppressive therapy over 65's aboriginals over 50
live attenuated parenteral vaccines
MMR, MMRV, varicella, monovalent rubella, yellow fever, BCG (just remember MMR and varicella - priorix and varilrix)
live attenuated oral vaccines
rotavirus vaccine (Rotarix) and oral typhoid
what extra vaccination do preterm babies require and when?
infants born <28 weeks or below 1500g birth weight require an extra dose of PRP-OMP Hib at 6months <28 weeks and /or chronic luncg disease = extra pneumococcal <32 weeks or <2000g = extra dose of hep B
Which vaccine needs to be reconstituted prior to use?
Infanrix! Don't forget to draw up the liquid from the separate vial!!!
What to do if vaccine is in a vial
remove cap carefully. Use a 19 or 21g needle to draw up. Replace needle with a fresh 23g 25mm before injecting!!
which vaccine should be given sub cut?
varicella (Varilrix) use 25g 16mm needle, 45 degree angle
Injection site in <12m
the vastus lateralis muscle in the anterolateral thigh. Alternatively can use the ventrogluteal area
Positions best for vaccination in <12m
Cuddle position - semi-recumbant on lap of parent. Infant's arm adjacent to parent is restrained under parent's arm or against parent's chest.Flex childs knees to relax vastus lateralis. Infant's other arm and outside leg must be held securely. Supine on exam table - feet towards immuniser, parent beside immuniser to restrain arms and legs and distract the baby. Use the thumb and index finger of the non-injecting hand to stabilise hub of needle once inserted.
positions best for vaccination in >12m
Cuddle position - sit child sideways on parent's lap with inecting arm held close to the child's body while the other arm is tucked under the armpit and behind back of parent. Exposed arm should be secured at the elbow, and legs also secured. Hug position - straddle child facing parent with arms crossed over their chest. Parent hugs child to their chest. Solo sitting position for older children and adults.
post-vaccination procedures
Apply pressure for 1-2 minutes Move child from injection position and distract. record details into blue book get them to stay in waiting area for 15 minutes
common adverse events
swelling, redness, soreness, itching or burning at site for 1-2 days. Paracetamol may be used to ease the discomfort. MMR may be followed by 5-12 days of fever, malaise or rash (fever occurs in 5-15% - paracetamol) Varicella - mild local soreness and sweeling, 5% get mild maculopapular rash Injection site nodules not uncommon, may remain for several weeks. oral rotavirus may cause mild fever +/- diarrhoea

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