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Documentation
- day, month, year
- manufacturer, expiration date, lot number
- person, title, address where given
- site and route
- evidence of informed consent
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Best sites for injection
- Vastus Lateralis
- Ventrogluteal
- Deltoid; after 18-24 months
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Antitoxin
Passive immunity developed from animals
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Incubation
Period from when body exposed to infections before symptoms become apparent
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Intravenous Immune Globulin (IVIG) (IG)
Antibodies from large groups of people
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Prodromal
Usually very communicable period of infection with non-specific symptoms
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Hepatitis B (viral)
- first vaccine
- main reason for liver failure in kids
- Spread by all bodily fluids
- 90% of infants infected perinatally
- IM injection given 3-4x, usually started w/i 1st month after birth
- If mom is positive for the antigen, HbsAg or status is unknown, then baby is given an active vaccine and passive vaccine (HBIG) at least 12 hours after birth
- incubation: 120 days
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Haemophilus influenzae type B (HIB) (bacterial)
- Greatest morbidity from birth to 4 years
- can cause bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, sepsis
- given IM in a series of 3-4 vaccines, usually starts at 2 months
- often given in a combo vaccine; cannot be given before 6 weeks
- tx: multiple antibiotics
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Diphtheria, Tetanus toxoids and acellular Pertussis (DTaP)
- IM given in a 5 vaccine series starting at 2 months (2,4,6,18 and 5 years)
- Boosters are given when the child is between 11-12 years and 2-5 years between last vaccine for rest of life
- may cause mild reactions: fever, mm. aches, chills, fatigue
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Diphtheria (bacterial)
- spread via respiratory and skin secretions
- prodromal symptoms: common cold to a thick, purulent nasal and pharynx discharge; cannot breathe/suffocate/has an odor
- complications: myocarditis, neuritis, setpic shock
- incubation: 2-5 days
- contagious: 2-4 weeks
- tx: penicillin and erythromycin
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Tetanus (bacterial)
- thrives in anaerobic conditions: puncture wound, umbilical chord, burns, drug users
- complications: tonic spasms, respiratory paralysis, ridgidity of the voluntary mm., esp neck and lower jaw (caused by the toxins acting on the myoneural junction); first sign on an infant is if they cannot suck
- tx: Penicillin and Erythromycin; TIG (Tetanus immune globulin)
- incubation: 3 days-3 weeks
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Pertussis (bacterial)
- contagious for up to 4 weeks after onset of cough
- dry hacking cough; worse at night; kids under 6 months may not have this "whooping" cough
- complications: myocarditis, pneumonia, failure to thrive or dehydration
- tx: Erythromycin
- incubation: 5-21 days
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Polio (viral)
- originally given orally, but no longer b/c of assoc. risks
- SQ of 4-5 series @ 2 months
- symptoms: flu like all the way to paralysis
- complications: muscular atrophy syndrome, respiratory arrest, permanent paralysis, or kidney problems
- tx: no meds or gamma globulin; treat symptoms
- incubation: 5-35 days
- communicability: source not exactly known; up to 6 weeks in feces
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Pneumococcal (bacterial)
- IM or SQ @ 2 months
- 4 or 5
vaccine series - protections against Streptococcus pneumoniae: otitis, pneumonia, meningitis, and septicemia
- tx: antibiotics
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Rotavirus
- most common cause of severe infant diarrhea
- worldwide source of infant death
- 2-3
vaccines @ 2 months - oral (live virus)
- tx: hydration
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Measles, Mumps and Rubella (MMR)
(virus ALL)
- SQ
- 3 vaccines; 2 are not done until after 12 months; maternal antibodies will interfere with immune response
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Measles AKA Rubeola
- passed via respiratory secretions, blood and urine
- Koplik spots (small irregular red spots with bluish white centers in back of mouth or near molars); Rash (starts at the face and goes downward for 7-14 days); eye sensitivity to light
- sesonal: winter and spring; targets infants and adolescents
- complications: Otitis media, pneumonia, cornea ulcerations and encephalitis
- tx: IVIG (intravenous immunoglobulin)
- incubation: 10-20 days
- communicability: 4 days before to 5 days after rash
- starts off w/flue like symptoms and fever
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Mumps
- source: saliva
- flu-symptoms and fever for 24 hours and then --> jaw and ear pain (parotid gland)/swelling in the scrotum (males)
- complications: dehydration, deafness, encephalitis, myocarditis, and male sterility; hard to drink, feel like you cant swallow
- tx: hydration; prevent dehydration
- incubation: 14-21 days
- communicability: 1 week before lymph swelling
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Rubella AKA German Measles
- spread thru respiratory secretions, blood, urine and stool
- seasonal: spring; esp school age and adolescents
- complications: greatest danger is teratogenic effect (esp. fetal deafness) on fetus when pregnant women get disease
- incubation: 14-21 days
- communicability: 7 days before and 5 days after rash (usually lasts about 3 days)
- starts w/flu like symptoms
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Varicella AKA Chicken Pox (viral)
- most contagious the day before lesions break out
- macule, papule, vesicles and scab lesions can all be present at the same time
- immuno suppressed children especially at risk
- SQ
- complications: bacterial infections from lesions, encephalitis, herpes zoster (shingles), Reye's Syndrome
- tx: anti-viral meds and VZIG (varicella-zoster); skin care
- incubation: 2-3 weeks
- communicability: 1 day before symptoms and up to 6 days after vesicles crust
- itching can be severe; starts in warm area (genitals, armpits)
- starts w/flu like symptoms
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Hepatitis A (viral)
- IM
- given after 1st year and at least 6 months apart
- spread via fecal-oral route; contaminated food/water
- carriers shed virus 2-3 weeks before symptoms appear
- complications: liver failure
- incubation: 15-50 days, shedding of virus 2-3 weeks before symptoms
- jaundice is rare
- in children under 6 years, symptoms may be asymptomatic
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Mennigococcal (MCV4)
- offers protections against 4 serogroups of Neisseria meningitidis (bacterial)
- # of vaccines depends on risk level and at what age started
- start @ 2-3 years
- tx: antibiotics
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Human Papillomavirus
- Recommended for preteens
- Females: Bivalent Human Papillomavirus Vaccine (VHPV)
- Males: Quadrivalent Human Papillomavirus Vaccine (QHPV)
- can be transmitted from male to femal and vice versa
- could prevent 70% cervical cancer and 90% of genital warts
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