| Types of immunity | Naturally acquired immunity
• Active- after infection
• Passive- antybodies transported through placenta
Artificially acquired immunity
• Active- vaccination
• Passive- immune sera ie. anti tetanus serum, anti HBs serum |
| Differences between active and passive immunity | Active immunity
• requires more time
• long acting
• safer
• cheaper
Passive immunisation used mainly after exposure |
| Vaccinations in children definition | Vaccine-preparation containing life or killed or antigen deprived of pathogenicity to induce specific immunity( cell, humoral) againstvaccine antigen.
• Vaccination a medical procedure of giving a vaccine to prevent
infectious diseases |
| • Classification according to type of antigen | Live atenuated
• Bacterial- (BCG) • Viral- mumps, measles, rubella(MMR), polio vaccine OPV( presently withdrawn), varicella vaccine, Rotavirus vaccine
Inactivated-killed
• Bacterial –pertussis ( DTP) • Viral- polio vaccine IPV, influenza vaccine, hepatitis A vaccine
Component vaccines ( subunit vaccines) • Bacterial- Hib vaccine, meningococcus vaccine, pneumococcus vaccine, acellular pertussis• Viral- hepatitis B vaccine
Toxoid vaccines- diphtheria and tetanus vaccines ( DTP)- toxoid- inactivated toxin |
| Classification according to their composition | Single vaccine (hepatitis B vaccine, pneumococcus vaccine
• Combination vaccine (MMR, infanrix hexa,pentaxime) • Monovalent- contains a single strain of a single antigen (hepatitis B vaccine, • Polyvalent- contains multiple antigen ( MMR, DTP, infanrix hexa,pneumococcus vaccine)
All the combination vaccines are polyvalent, single vaccines can be poly- or monovalent |
| Differences between live and killed vaccines | Live vaccines
• Produce immunity faster
• Immunity after one dose
• Immunity lasts longer
• More dangerous- especially in immunocompromised patients |
| Which vaccine do we give 24h after birth? | BCG
HBV |
| Which vaccines do we give at 6 weeks (2month)? | 2 dose of HBV
1 dose DTP
1 dose Hib
1 dose of Pneumococcal |
| What vaccines do we give at 12 weeks? | II dose DTP vaccination
II dose – Hib vaccination
I dose polio vaccination IPV
II dose-Pneumococcal vaccination |
| What vaccines do we give at 18 weeks (5 months)? | IIIdose DTP vaccination
IIIdose – Hib vaccination
IIdose polio vaccination IPV |
| What vaccines do we give at 7 months of life? | III dose – hepatits B (immunization
completed) |
| What vaccine do we give at 13-14 month of life? | MMR vaccination
(positive history of mumps or rubella is not a contraidication to vaccinate)
III dose-Pneumococcal vaccination |
| What vaccine do we give at 16-18 month of life? | IVdose DTP vaccination ( immunization completed)
IVdose – Hib vaccination( immunization completed)
IIIdose polio vaccination IPV (immunization completed) |
| What vaccine do we give at 6 years of age? | DTaP I booster dose
Polio booster dose ( IPV)
MMR revaccination- !!!! |
| What vaccine do we give at 14 years of age? | dTaP II booster dose ( smaller amount of diphteria toxoid) |
| What vaccine do we give at 19 years of age? | Td ( smaller amount of diphteria toxoid) |
| Contraindications for vaccination? | • Severe acute or febrile infections ( pneumonia, pyelonephritis, meningitis) common contagious diseases( chickenpox, rubella, and reconvalescence period( 6 weeks)
• Acute severe non infectious diseases( trauma, acute renal failure, circulatory failure)
• Exacerbation of chronic diseases( asthma, diabetes, congenital heartdefects) |
| Contraindication for live vaccine | • Inherited ( primary) immunodeficiencies- not all
• Acquired immunodeficincies
AIDS, splenectomy,neoplasmatic diseases, radiotherapy,
chemotherapy, systemic steroids, after transplantatiom ( transientcontraindications) |
| Contraindication agains individual vaccines | • Allergy to a vaccine component (anaphilactic reaction to egg protein- MMR,
yeast- hepatitis B vaccine)
• Severe side effects after previous dose of vaccine
-anaphylactic reaction( hives, shok, hypotension)
-other severe side effects( convulsions, fever>40°, hypotonic-hyporesponsiveepisodes, non-stop crying longer than 3 hours after DTP vaccine)
• other : progressive neurological disorder-DTP,MMR, low birth weight- BCG• previous transfusions- MMR( transient contraindication) |
| Perfect time between live vaccines | minimum 4 weeks |
| TUBERCULOSIS VACCINATION | • only 1 dose, in first 24 hours of life( no revaccination)
• live vaccine- brasilian strain of Mycobacterium bovinumrelatively low immunogenity
• intradermal injection , 1/3 upper external part of an arm• proper administration very important to avoid local
complications
• no tuberculin test to check efficacy of vaccination |
| Contraindications agains TB vaccine | acute diseases of neonatal age ( cytotoxic disease, very low birth weight , prematurity, vaccination given later) |
