Community Health Nursing Vaccination PDF

Community Health Nursing Vaccination Outlines  Introduction.  Definition of vaccination.  Importance of vaccination.  Types of vaccination:  Live Attenuated Vaccines  Inactivated Vaccines...

Community Health Nursing Vaccination Outlines  Introduction.  Definition of vaccination.  Importance of vaccination.  Types of vaccination:  Live Attenuated Vaccines  Inactivated Vaccines  Toxoid Vaccines  Subunit vaccines  Schedule of vaccination applied by ministry of health.  The role of community health nursing. Objectives By the end of this topic, the students will be able to:  Define the vaccination.  Recognize importance of vaccination.  List the types of immunity.  List the types of vaccination.  Explain the role of community health nursing. 51  Community Health Nursing Introduction A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as foreign, destroy it, and keep a record of it, so that the immune system can more easily recognize and destroy any of these microorganisms that it laterencounters. Vaccines can be prophylactic (example: to prevent or ameliorate the effects of a future infection by any natural or "wild" pathogen),or therapeutic (e.g., vaccines against cancer are also being investigated;see cancer vaccine). Definition Vaccine: A preparation that is used to stimulate the body’s immune response against diseases. Vaccines are usually administered through needle injections, but some can be administered by mouth or sprayed into the nose. Vaccination is the administration of antigenic material (a vaccine) tostimulate an individual's immune system to produce antibodies and cellular immune that responses for protecting against infection OR The act of introducing a vaccine into the body to produce protection from a specific disease. Immunization: A process by which a person becomes protected against a disease through vaccination. Importance of vaccination  Prevention rather than cure.  Prevent infection disease.  Prevent handicapping and disabilities.  Restrict measles, mumps ,rubella and poliomyelitis. 50  Community Health Nursing  Stimulate the immune system. Types of immunity 52  Community Health Nursing Different Types of Vaccines Vaccine type Vaccines of this type on U.S. Recommended Measles, mumps, rubella (MMR combined vaccine)Oral Polio (Sabin) Live, attenuated BCG (against tuberculosis) Influence (nasal spray) Polio (IPV) Salk Hepatitis A- B pertussis Inactivated/Killed Influence (injectable) Toxoid Diphtheria, tetanus (DT immunization) Subunit Haemophilus influenzae type b and pneumococcal conjugate vaccines) 53  Community Health Nursing Schedule of vaccination Age Vaccine Comments At birth OPV (Sabin) 2 drops orally on tongue BCG 0.1 ml, ID of left deltoid HBV region 0.5 ml, on right thigh 2 month OPV 2-3 drops Orally IPV 0.5 ml, IM on left thigh Benta (Dpt+HBV+HIB) 0.5 ml, IM on right thigh 4 month OPV 2-3 drops Orally IPV 0.5 ml, IM on left thigh Benta (Dpt+HBV+HIB) 0.5 ml, IM on right thigh 6 month OPV 2-3 drops Orally IPV 0.5 ml, IM on left thigh Benta (Dpt+HBV+HIB) 0.5 ml, IM on right thigh 9 month OPV booster 2 drops orally Orally 12 month MMR 0,5 ml Sc in right arm OPV booster 2 drops orally 18 month DPT boosterOPV 0.5ml I.M in left thigh2 booster drops orally MMR booster 0,5 ml Sc in right arm Note OPV=Oral Poliomyelitis Vaccine BCG=Bacillus Calmette–Guérin HBV=hepatitis B vaccine DPT=Diphtheria, Pertussis and TetanusMMR= Measles, Mumps and Rubella 54  Community Health Nursing Necessary vaccinations (optional and not added to the schedule of the Egyptian Ministry of Health) Age Vaccine Comments 2,4,6 month Rota Orally pneumococcal conjugate IM on thigh vaccine(pcv) 18 month pneumococcal conjugate IM on thigh vaccine(pcv) Note: Rota virus vaccination is given in two or three doses, depending on the type of vaccination used. It is preferable to leave a two-week interval between rotavirus and polio vaccination. Route of vaccination 55  Community Health Nursing Immunization against T.B:  BCG vaccine protects against tuberculosis in infants. The letters, B, C and G stand for bacillus of Calmette and Guérin. “Bacillus” describes the shape of a bacterium; Calmette and Guérin are the names of the people who developed the vaccine.  BCG vaccine comes in powder form and before use must be reconstituted with the accompanying diluent. The reconstituted vaccine is even more sensitive to heat than the powder and must therefore be used within six hours.  BCG vaccine and diluent should be stored at a temperature between 0 C and +8° C.  BCG is live attenuated Vaccine 0,1ml ID of left deltoid.  Is freeze dried vaccine reconstitute it with diluent immediately before use.  BCG is damaged by exposure to sunlight.  Freezing does not damage the vaccine.  Discard any remained vaccine after the vaccination session. Reactions of BCG Vaccine Normal reaction  After 2 weeks a small red soft tender swelling appears at the place of injection.  After 2-3 weeks more the swelling become a small abscess which then becomes ulcer.  The ulcer heals by itself leaving a scare about 5m. This scare is useful because it show that the child has taken the vaccine.  Instruct mother not to put any medication on ulcer. 56  Community Health Nursing Early reaction If the reaction appears before 2 weeks so the child already take thevaccine or had T.B infection. Severe reaction It is severe local inflammation or a deep abscess. This may be due to:  The vaccine was given SC not ID.  The child takes large dose.  The needle was not sterile. Nursing role  No treatment except a dry dressing.  Referral to Dr. for the abscess. Note: BCG is contra-indication prematurely, malnutrition and infectious skin disease. Immunization against poliomyelitis I- Sabin vaccine It is live attenuated vaccine:  The vaccine is clear pink liquid.  Freezing doesn’t damage the vaccine but it is easily damage by exposure to sun light. Advantages 1. Ease of administration. 2. Any vaccination of the community (from the stools of vaccinated babies to surrounding community). 3. Gives a solid and prolonged immunity. Disadvantages 1. Needs proper refrigeration. 2. Infection with other enter viruses can interfere with its effectiveness. 57  Community Health Nursing 3. The baby may vomit the vaccine: repeat it. II- Salk vaccine: (killed vaccine) Advantages 1. Effective in prevention of the disease in vaccinated child. 2. Can be administrated to immune deficient children. 3. Easier to transport. Side-effects: has no side-effects. Immunization against DPT  DPT vaccine protect child from diphtheria, pertussis & tetanus.  DT is toxoid and P is killed vaccine. Reactions of DPT Vaccine 1- Fever may occur at the same day of vaccination. Role: Tap compresses, light clothes paramole. 2- Local soreness: some children have pain, redness, swelling in the leg where they had injection. Role: Reassure the mother is stopping 3-4 days. Tap compress 3- Abscess: If occur may be due to:  Syringe is not sterile.  Not inject the vaccine deep enough I.M. Role: Referral to physician. Abscess needs incision and dressing. 4- Convulsion: It is very rare and it is due to P vaccine and if it happened gives DT after that. Side Effect of Pertussis Vaccine 1. Occur from several hours to 72h. 2. Redness, pain, swelling at injection site. 3. Fever. 4. Anorexia & drowsiness. 58  Community Health Nursing Contraindication of pertussis vaccine  Encephalopathy within 7 days of previous Dpt vaccination.  Convulsions within 48h of previous DPT vaccine.  Personal history of seizures.  Persistent high pitched cry within 48h of DPT vaccine.  Shock within 48h of DPT vaccine.  Allergic reaction to vaccine.  In such cases we give DT instead of DPT. MMR Vaccine This protect against measles mumps and rubella:  It is lived attenuated vaccine.  It should be reconstituted by adding diluent immediately before used.  Freezing doesn’t damage the vaccine.  During the session store the vaccine in cup containing ice.  It damaged by heat. Reactions  Fever & Rash  It occur at 2.3 days after vaccination Role  Reassure the mother  Tap compress  Light clothes  Paramole is given 59