4(i). immunization

8/9/2019 4(i). Immunization

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ImmunizationMartira MaddeppungengChild Health Department

Medical Faculty Hasanuddin University

Dr Wahidin Sudirohusodo Hospital


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The hepatitis Bvirus

Bordetella pertussis

The measles virus

Clostridium tetani Corynebacterium

diphtheriae

Introduction


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ImmunizationGive protection on specific infection disease!accine"preventa#le disease$

%he rights of the child&arents' health employer(s guaranteed thatimmunizations are availa#le for all children


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ImmunizationPassive

Active


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&assive ImmunizationPassive immunity : get readymade antibodiesMaternal antibodies are transferred to the fetus

through the placenta (3rd trimester !"ample: tetanus to"oid administered topregnant mother #ill decrease neonatal tetanus


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&assive Immunization$uman immunoglobulin to protect from measles%pecific immunoglobulin to protect from

tetanus& diphtheria& hepatitis B& rabies' ( M)& varicella


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)ctive ImmunizationAdministration of antigenic material to stimulateimmune response li*e natural infection

+ong life immunological memory+ong life protection to infection disease


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)ctive Immunization,sed:

-hole organism (live or *illedomponent organism (sub unit vaccine&

polisaccharide vaccineModification of organism product

(to"oid vaccine

Manufactur of organism component(recombinant vaccine


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Ideal !accine.ive protection on infection disease.ive long/life immunity

0o side effect%ingle dosean be given by combination


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Ideal !accine *$!asy administration& no pain%table in many conditions

an be *ept for long time duration1easonably priced


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Bacteria

Virus Live : BCG

Inactive: diphteria,pertussis, tetanus,cholera,pneumococcu

s, meningococcus,Hib, Typhoid

Live : OV , measles, varicella, parotitis,rubella, yello! "ever

Inactive : in#uen$a,IV , rabies, Hepatitis%, Hepatitis B


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&&IProgram Pengembangan Imunisasi :

B .

$epatitis B2TPPolioMeasles


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Recommended Immunization Schedule

(IDAI 2006)

& )dminister * doses separated #y + ,ee-s or longer$ to children ≤ . years ,ho are receiving influenzavaccine for the first time or ,ho ,ere vaccinated for the first time last season #ut only received one dose


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'ecommended Immuni$ation (chedule

)*+*


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BCG

/ Optimal administered age ) - months/ I" age . - months : /antou0 1 tuber2ulin test/ I" tuber2ulin pra BCG can not be done, BCG can beadministered,

must be observed 3 days/ I" accelerated local reaction (+) , need "urtherevaluation

4TB diagnostic5


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Hepatitis B

%dministered 6rst HepB !ithin +) hours o"birth


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7T 8 olio

9 O V administered !hen 6rst visit/ Baby that !as born in hospital : administered O V!hen baby

!ill discharge "rom hospital to prevent viraltransmission to

others baby/ Continue administer !ith OPV or IPV/ 7T vaccine "or children . ; !ee2s/ Can be administered 7T! or 7Ta or combination!ith Hep B

or Hib/ 'epeat dose 7T should be administered at age +<


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/easles

%dminister the second dose o" //' at

age = 3 yearsBI%( rogram : proposed and updated!ith recommended immuni$ationschedule by health department


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0CG


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0CGBaby 3 months2ose : 4&45 ml I 6 I2

1ight deltoidIf age 7 3 months : Mantou" 6 tuber*ulin test+evel of protection only 89 (-$; 54/


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2I&I 3 !)452e6adian I-utan &asca Imunisasi Vaccine AdverseEvents Report)0CG Superficial ulcus 7 ,ee-s crusta scar +"8 ,ee-s

9imphadenitis : 0CG itisDisseminated 0CG"itis ; severe immunodeficiency


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D%&


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D%&Prevent diphteria& tetanus& pertussisontain: 2ipteria to"oid&

Tetanus to"oid&Pertussis vaccine : / whole cell / acellular


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D%&Basic ; 3 times since age 9 months interval +"8 ,ee-s1epeat :

" ?=/98 months 5/< years

?9 years (BIA% program: 2T $


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Contraindication D%&

Absolute:is reaction

*=!ncephalopathy )cutely severe neurologicaldisease ,ith long convulsion and?or decrease ofconsciousness and?or focal neurological disorder$


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• Specific precaution :ia

*=Hypotonic hyporesponsiveness in+8 hours

7= &ersistent crying @ 7 hours

+= History of convulsion 7 days afterimmunization

Contraindication D%&


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'ecommended D%&D%& < ; *"+ monthsD%& * ; 7"A months

D%& 7 ; +"B monthsD%& + ; < " * yearsD%& A ; A yearsD% B ;


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Table 2. Approximate rates of adverse event occurring within 48 hours DTP vaccination

Event re!uenc"

#ocal

redness, swelling, pain 1 in 2-3 doses

$ild%moderate s"stemic

fever, drowsiness, fretfulness 1 in 2-3 doses

vomiting, anorexia 1 in 5-15 doses

$ore serious s"stemic

persistent crying, fever 1 in 100-300 doses

collapse, convulsions 1 in 1750 doses

acute encephalopathy 1 in 100,000 doses

permanent neurological deficit 1 in 300,000 doses


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&olio


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&olioPrevent : poliomyelitis Flaccid paralysis, pain at bac* and e"tremity

Polio vaccine :+ive (%abin : oral @illed (%al* : parenteral


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Contraindication&olio : &!

%emperature @ 78'AE CCorticosteroid' radiation

MalignancyHI! infection or familySi#lings ,ith immunocompromised child


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'ecommended i &olio&olio < ; #ornD&% < &olio * ; *"+ months

D&% * &olio 7 ; 7"A monthsD&% 7 &olio + ; +"B monthsD&% + &olio A ; < " * yearsD&% A &olio B ; A years

D% B ;


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Hepatitis 0


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Hepatitis 0Prevent hepatitis B

$epatitis B vaccine:2erivat plasma vaccine1ecombinant vaccine


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Hepatitis 0$B/? administered recom#inant vaccine H0 < mcgintramuscular' ,ithin


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Contraindication Hepatitis 01o contraindication' e>cept pregnant mother


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Measles


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MeaslesLive attenuated virusAge months

2ose 4'5 ml %ontraindication : $igh fever& immunosupression&immunoglobulin or given blood component1epeat : age 5/< years


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Measles " !)45ever 5/?5 on A"B th day after immunization' for *days1ash 5 & on "< th day' for *"+ days4ncephalitis and encephalopathy 3 < ; < miiliondosis ,ithin 7 days after immunization


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1on &&I !accine$ibMM1Typhoid$epatitis A)aricellaInfluenza

Pneumococcus


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4(i). immunization

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