Immunization in children

Immunization in children
Prepared by :
lamiaa400@yahoo.com
Pediatric nursing

Immunization
Objective:
At the end of this lecture the students will be
able to:
1)Define immunization, vaccination, immunity,
antigen, antibody
2)List different types of immunization
3)Enumerate routine vaccination
4)Describe common side effects of different
vaccine
5)Identify Storage & transportation of vaccine

Immunization
Introduction:
This lecture will increase the knowledge
& skills among student nurse regarding
immunization during infant & childhood.

Immunization
Immunization is one
of the most important
ways parents can
protect their children
against serious diseases.

Immunization
Immunization
Definition
It is an effort to prevent or modify
natural infection by administration of
antigen or an antibody. Its aim to build
up resistance in the child against
certain infectious disease.

Immunization
Another definition of vaccine:
Suspension of live (usually) attenuates
or inactivated microorganism e.g.
bacteria-virus or fracture of
microorganism administered to induce
immunity & to prevent infectious
disease.

Immunization
Immunity:
The ability to combat/ fight a particular
antigen may be either active

Immunization
Antigen:
A variety of foreign substances
including bacteria, viruses, toxins &
foreign proteins that stimulate the
formation of antibodies

Immunization
Antibody:
Protein found mostly in serum that is
formed in response to exposure to a
specific antigen.

Immunization
Types of vaccine
Attenuate: Reduce the virulence
infectiousness of the pathogenic
microorganism by such measures as
treating it with heat or chemical or
cultivating it on certain medium.

• Antitoxin: - solution of antibodies as
diphtheria an antitoxins and derived
from the serum of animal immunized
with specific antigen and used to
confer passive immunity and for
treatment.

• Immunoglobulin (IG): - (or intravenous
immune globulin (IVIG) Sterile solution
containing antibodies from large pools
of human blood plasma indicated for
routine maintenance of immunity of
certain immunodeficent persons.

Immunization
Types of immunization
Active: -
A-Natural (disease): -
Natural disease when child produce
antibodies after natural invasion of the
pathogen (e.g.: measles) (naturally acquired
active immunity).
*- Active antibodies or child ability to
produce antibiotics rapidly should the
specific antigen measles invade against (last
life time

Types of immunization
 B-Artificial (vaccine): -
 When pathogen are artificially
injected into the child by
immunization. The child receives
artificially acquired active immunity

 Passive: -
 Natural Passive (mother to child): -
 *- Naturally acquired passive
immunity Last only months
 *-Some antibodies transferred across
the placenta may have slightly longer
lifetime as measles (anti bodies have
been isolated up to age 1 year.

Protection from infections
Before we proceed, let us have a look at the following diagram

 Passive Artificial (gamma globulin): -
(Artificially acquired passive immunity)
 *- When children exposed to disease
against which they have no
antibodies made synthetically or
obtained from animal serum may be
injected into the child to give rapid
immunity this like naturally acquired
passive antibodies these last only
approximately 6weeksImmunization in children

Passive Artificial
Child who susceptible to tetanus would
receive tetanus antibodies after a stab
wound (many people has antibody protection
against measles –rubella-poliomyelitis-
hepatitis B) among other infectious disease it
offers among other infectious diseased it
offer artificially acquired passive immunity
Example Immune serum: Are available
against diphtheria –Tetanus-Pit viper snake-
Black widow spider and respiratory virus
provide passive immunity.

Vaccine componentsAttenuated
pathogen
Killed pathogen
Bacterial
Diseases
Typhoid (PO)
BCG (M. bovis)
(Salmonella)
Typhoid fever
Pertussis
Viral Diseases Measles
Mumps
Rubella
Chickenpox
Polio (Sabin - PO)
Polio (Salk)
Hep. A
Influenza

BCG Vaccine (Bacillus of camlet
Guerin(
It is a life attenuated vaccine strain of bovine
type of mycobacterium TB
Intradermally at the site the left deltoid muscles
Side Effect
Cold abscess
Regional Lymphadenitieds

DPT
Diphtheria ,Pertussis, Tetanus
Diphtheria and tetanus are toxoid while pertussis vaccine
is killed organism
Side effect for mild signs pertusses:
Local swelling and tenderness
Slight fever
Moderate signs:
Shock like syndrome
Sever symptoms
Convulsion, encephalopathy and brain damage
NB:If one of sever complication occurs not given
pertusses give DT

DPT vaccine
Contraindication for DPT vaccine
Acute febrile illness
Neurological illness as epilepsy
Sever reaction to pertusses
Vaccine not frozen and not given cold

Polio vaccine
Two
The type of polio vaccine
A Sabin Oral Vaccine:
Live attenuated vaccine virus
Maximum time for storage is 3-6month
Repeat the dose if the child spit out the drops
and if the child has diarrhea repeat the dosage after the
child recovery give two drop
Advantage of vaccine
Easily administration
Gain gastrointestinal immunity
Disadvantage
short life and need proper refrigerator

Polio vaccine
Salk vaccine inactivated vaccine
Advantage
Effective in prevention
Vaccine have longer life than sabin
Disadvantage
It has to be injected
Both Salk and sabin contain three strain of
polio virus

‫السعودية‬ ‫في‬ ‫التطعيمات‬ ‫جدول‬
BCG ID on the left upper arm- Oral polio
Hepatitis B
‫الولةدة‬ ‫عند‬
IPV
DPT
Hepatitis B
HIB
PCV pneumococcal conjugated vaccine
‫شهرين‬ ‫عمر‬
OPV
DPT
Hepatitis B
HIB
‫أشهر‬ ‫أربعة‬ ‫عمر‬
OPV
DPT
Hepatitis B
HIB
‫عمر‬6‫أشهر‬

‫السعودية‬ ‫في‬ ‫التطعيمات‬ ‫جدول‬
Measles( Mono( ‫عند‬9‫شهور‬
OPV
MMR
Varicella(chickenbox(
‫عمر‬12‫شهر‬
OPV
DPT
Hepatitis A
HIB
‫عمر‬18‫شهر‬
Hepatitis A
‫عمر‬2‫سنة‬
OPV ‫ةدخول‬ ‫عند‬

Table 4: Certain available vaccines and their routes of administration.
Vaccine Type Route
BCG Live Bacteria Intradermal ID
DTP D&T = Toxoids
P = inactivated bacteria
Intramuscular
Hepatitis B(HBV) Inactivated viral antigen Intramuscular
Haemophilus
Influenza b
(Hib)
Polysaccharide Intramuscular
MMR Live attenuated viruses Subcutaneous SC
OPV Live attenuated virus Oral
BCG = Bacillus Calmette – Guerin vaccine (tuberculosis).
DPT = Diphtheria, pertussis and tetanus vaccine.
MMR = Measles, mumps and rubella viruses in a combined vaccine.
OPV = Oral Poliovirus vaccines containing attenuated poliovirus types 1,2 and 3.

COLD CHAIN
Cold Chain is a system of
transporting and storing
vaccines at recommended
temperature from the point of
manufacture to the point of use

Role of the nurse
Not put any food or drink in Vaccine storage
Don’t put vaccines in the door shelves
Don’t put vaccine in freezer
Case finding
Early detection
Education
Monitoring follow up
Referral of cases
Training personnel

)Cold Chain
** Vaccines must be kept constantly cold throughout the chain of
storage and transport which they have to pass through before
reaching the child.
Breaks in this "cold chain",
It can happen as a result of the breakdown of the refrigerating
system.
Live vaccines are also damaged by sunlight, which is especially
likely to happen after they have been prepared (reconstituted)
for injection in the clinic or at the school.

The Cold Chain
Failure of a vaccine to protect a child may be due
to a number of reasons.
* The vaccine may no longer be "antigenic" so
that it does not stimulate the body to produce
antibodies.
* Most live vaccines are killed easily by changes
of temperature, such as might occur if they are
left out of the refrigerator for a long time.

Immunization in children

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