版權(quán)說明:本文檔由用戶提供并上傳,收益歸屬內(nèi)容提供方,若內(nèi)容存在侵權(quán),請進行舉報或認領(lǐng)
文檔簡介
IMMUNIZATIONImmunizationistheprocessofinducingimmunityagainstaspecificdisease.Immunitycanbeinducedeitherpassivelythroughadministrationofantibody-containingpreparationsoractivelybyadministeringavaccineortoxoidtostimulatetheimmunesystemtoproduceaprolongedhumoraland/orcellularimmuneresponse.IMMUNIZATIONItistheprocessofrenderingasubjectimmunebyinoculatingwithaspecificantigen.Itisthemethodofchoiceforpreventionofinfectiousdisease.GOALOFIMMUNIZATIONTheimmediategoalofimmunizationistopreventdiseaseinindividuals,buttheultimategoalistoeliminateoreveneradicateacommunicabledisease.Asaresultofeffectiveandsafevaccines,smallpoxhasbeeneradicated,polioisclosetoworldwideeradication,andmeaslesandrubellaarenolongerendemicintheU.S.IMMUNIZATIONActiveimmunityPassiveimmunityHerdimmunityACTIVEIMMUNITYActiveimmunizationinvolvesadministrationofallorpartofamicro-organisimormodifiedproductofthatmicro-organisim(eg.atoxoid,apurifiedantigen,oranantigenproducedbygeneticengineering)toevokeanimmunologicresponsemimickingthatofnaturalinfectionbutthatusuallypresentslittleornorisktotherecipient.PASSIVEIMMUNITYPassiveimmunizationentailsadministrationofpreformedantibodytoarecipient.Thisproducesimmediateprotection,whichonlylastsforsomeweeksormonths,untildonatedantibodiesarebrokendownorusedupbytheindividualHERDIMMUNITYHerdimmunityexistsifthenumberofpeopleinacommunitywhohaveactiveimmunityagainstaninfectionexceedsacriticallevel.Iftheselevelisachievedthenevennon-vaccinatedindividualsareprotectedfromgettingthedisease.Inthiswaytransmissionfallsorstopswithoutuniversalimmunity.VACCINEVaccinesaredefinedaswholeorpartsofmicroorganismsadministeredtopreventaninfectiousdisease.Thevaccineisusuallyaproteinsimilartopartofavirulentinfectiousorganismthatcanberecognizedbytheindividual’simmunesystem,whichthenproducesantibodiesorcellmediatedimmunityagainsttheantigeninthevaccine.TYPESOFVACCINELiveattenuatedvaccinesKilled,orinactivatedvaccinesConjugatedvaccinesToxoidvaccinesGeneticallyengineeredvaccinesLIVEATTENUATEDVACCINESLiveattenuatedvaccineisone,whichproducesactiveimmunitybycausingamildinfection.Avirulentorganismisweakenedsothatitproducesanantigenicresponsewithouttheseriousconsequencesofawildorganism.LIVEATTENUATEDVACCINESBCGPoliodropsMMRYellowfeverKILLED,ORINACTIVATEDVACCINESKilled,orinactivatedvaccineispreparedfromvirulentorganismsorpreformedantigeninactivatedbyheat,phenol,formaldehydeorsomeothermeans.KILLED,ORINACTIVATEDVACCINESPertussisCholeraInfluenzaInjectablepolioRabiesCONJUGATEDVACCINESTheresponsetopolysaccharidevaccineisincompleteandunreliableandconsequentlythesehavesometimesbeenconjugatedwithotherantigensinanattempttoimprovetheimmunologicalresponse.POLYSACCHARIDEVACCINESMeningococcalPneumococcalH.influenzaetypeb.TOXOIDVACCINESThesearetoxins,whichhavebeenrenderednon-toxicbytreatmentwithformaldehyde,buttheirantigenicityismaintained.TOXOIDVACCINESDiphtheriatoxoidsTetanustoxoidsAtoxoidisamodifiedbacterialtoxinthatismadenontoxicbutisstillabletoinduceanactiveimmuneresponseagainstthetoxinGENETICALLYENGINEEREDVACCINESHepatitisBVaccinedevelopmentandtesting.MorbidityandMortalityWeeklyReport(MMWR).AmericanAcademyofFamilyPhysicians(AAFP)VACCINATIONSCHEDULEThefollowingsarethecommoninfectiousdiseasesagainstwhichworldhealthorganization(WHO)recommendsroutineimmunization.TuberculosisDiphtheriaPertusisTetanusPolioMeaslesHepatitisB.EXPANDEDPROGRAMMEONIMMUNIZATION(EPI)AgeVaccineDoseRouteAtbirthBCGOPV00.05ml2dropsI/D(Rt.Deltoid)Oral6weeksDPT1OPV1HBV10.5ml2drops0.5mlI/MOralI/M10weeksDPT2OPV2HBV20.5ml2drops0.5mlI/MOralI/M14weeksDPT3OPV3HBV30.5ml2drops0.5mlI/MOralI/MEXPANDEDPROGRAMMEONIMMUNIZATION(EPI)AgeyearsVaccineDoseRoute9monthsMeasles0.5mls/c15monthsMMR0.5mls/c18monthsDPTboosterOPVbooster0.5ml2dropsI/MOral5yearsDTboosterOPVbooster0.5ml2dropsI/MOral10yearsTdbooster0.5mlI/MVACCINATIONSCHEDULE
PREGNANTWOMENPregnantwomen(pregnancy4th-8thmo)TT1&TT2atonemothinterval(1stpregnancy)TTonedose(subsequentpregnancy;ifwithin5yr)TTtwodoses(subsequentpregnancy;ifbeyond5yr)VACCINATIONSCHEDULE
GENERALWOMENGeneralwomen(age15-49)TT-1atanyageTT-2afteronemonthTT-3after6monthTT-4after1yrTT-5after5yrPRECAUTIONSANDRECOMMENDATIONSLivevaccinesshouldnotbeadministeredtochildrenwithimmuno-deficiencydisease.Injectionshouldbegivenintothelateralthighorintothedeltoid.Deepinjectionandmassagereducestheincidenceofantigeniccysts.DPTinjectionmaycausemildfeverwithin12-24hoursanditisnotacontraindicationforfurtherimmunization.PRECAUTIONSANDRECOMMENDATIONSIfconvulsionsoccurwithin72hoursofDPTinjectionfurtheradministrationofpertussisvaccineiscontra-indicated.ThengiveDTaloneAfter2yearsofagechildrenshouldnotreceivepertussisvaccine.Childrenwithbraindamageorprevioushistoryofconvulsionshouldnotreceivepertussisvaccine.Incaseofhighriskduetocontactwithacaseofpertussis,DPTcanbeinitiatedat2weekofage.Intheeventofanepidemicorhighrisk,measlesvaccinecanbegivenat6monthsage.PRECAUTIONSANDRECOMMENDATIONSImmunizationshouldbedelayedonlyincaseofillnesswithhighfever,sothatanysignoftheillnesswillnotattributedtothevaccination.Administrationofaliveattenuatedvaccinesshouldbedelayedforatleastsixweekswhenarecentinjectionofpolyvalentimmuneglobulinhasbeengiven.CONDITIONS,WHICHARENOTCONTRA-INDICATEDTOIMMUNIZATIONMinorillnesssuchasupperrespiratorytractinfectionsordiarrhea,withfever<38.5oC.Allergy,asthma,orotheratopicmanifestations.Prematurity,smallfordateinfants.MalnutritionFamilyhistoryofconvulsionsTreatmentwithantibiotics,lowdosecorticosteroidsorlocallyactingsteroids.CONDITIONS,WHICHARENOTCONTRA-INDICATEDTOIMMUNIZATIONDermatitis,eczema,orlocalizedskininfections.Chronicdiseasesoftheheart,lung,kidneyandliver.StableneurologicalconditionssuchascerebralpalsyandDownsyndrome.Historyofjaundiceafterbirth.BCGVACCINEBacilleCalmetteGuerin(BCG)isthemostwidelyusedvaccineBCGismadeofalive,weakened(attenuated)strainofmycobacteriumbovisIdealageforvaccinationisthenewbornperiod(1stweek)ifnotgivenatbirththenat6weeksItiseffectiveinreducingthelikelihoodandseverityofTBininfantsandyoungchildren.VACCINEDOSEItisgivenintra-dermallyinadoseof0.05mlfornewbornsand0.1mlforallotherchildrenVACCINEEFFICACY0-80%forTBlung75-86%formeningitisandmiliarytuberculosis.Durationofimmunityunknownbutsomeevidencethatduration10-15yrs.COURSEOFBCGThewhealofinjectiondisappearsin30minutesTwotothreeweekslateranoduleformswhichindurateandformsasuperficialabscess,itulceratesandhealsin4-6weeks.Thewholeprocessiscompletedin2monthsandleavesascar.COMPLICATIONSOFBCGKoch’sphenomenoni.e.,acceleratedreactionwhichcompletesinabout10daysErythemanodosumDeepabscessandulcerationLymphadenopathyofsupra-clavicularoraxillarynodesGeneralizedtuberculosis.POLIOMYELITISVACCINEVaccineavailableagainstpoliomyelitisare:Liveattenuatedoralpoliovirusvaccine(OPV,Sabin)[ContainattenuatedpoliovirusI,IIandIII]Injectablepoliovirusvaccine(IPV,Salk)VACCINEEFFICACY>90%inindustrializedcountries72-98%inhotclimatesLowerprotectionagainsttype3LifelongimmunityafterboosterdoseADVANTAGEOFOPVItiseasytoadministerIthassuperiorantibodyresponseProvidesrapidimmunitywithin1weekProvidesherdimmunitySIDEEFFECTOFOPVParalyticpolioinimmunizedchild(1:6million)CONTRA-INDICATIONOFOPVInfectionwithHIVKnownimmunedeficiencyTETANUSIMMUNIZATIONActiveimmunizationPassiveimmunizationACTIVEIMMUNIZATIONActiveimmunization:TetanustoxoidTetanustoxoid(TT)ispreparedbyinactivatingthetoxinwithformaldehyde.NewbornscanbeprotectedfromtetanusifmotherisactivelyimmunizedduringpregnancyDOSEOFTOXOIDVaccineisadministeredintra-muscularlyinadoseof0.5mlTwo0.5mldoseI/Mat4-8weeksintervalThirddoseafter1yrBoosterdoseafter5-10yrsPASSIVEIMMUNIZATIONPassiveimmunization:Tetanusimmunoglobulin(TIG)ItisusedforprophylaxisandtherapyProvidesprotectionfor30daysProphylacticdoseis250IUI/MTherapeuticdoseis1000-10000IU,I/MTETANUSANTITOXIN(ATS)Tetanusantitoxin(ATS)Protectionlastfor7-15daysProphylacticdoseis1500-3000IU,I/MTherapeuticdoseinneonates10000I/MTherapeuticdoseinchildren40000-60000IU(halfI/M,halfI/V)HEPATITISBVACCINERoutinevaccinationisgiventoallinfants,childrenandadolescentsHEPATITISBVACCINEDOSEDoseofvaccineis0.5mlifageislessthan19yrsDoseis1mlifageismorethan19yrsOptimally,threeI/MdosesofhepatitisBvaccineareneeded,schedule,0,1,and6moths.HepatitisBvaccineshouldbegivenonlyinthedeltoidmuscleforadolescentsandchildren,andintheantero-lateralthighmuscleforinfantsandneonantsHEPATITISBVACCINEInfantborntoHBsAgpositivemothers:InfantborntoHBsAgpositivemothersshouldreceive0.5mlofhepatitisBimmuneglobulin(HBIG)within12hoursafterbirth,andhepatitisBvaccineataseparatesite.Theseconddoseofvaccineisrecommendedatage1-2monthsandthirddoseatage6month.At12-15monthsofageimmunizedinfantsshouldbetestedforantibodytoHBsAg(ant-HBs),ifanti-HBsispositive,vaccinationhasbeeneffective.Ifnegativeimmunizationhasfailedandtheinfantisachroniccarrier.HAEMOPHILIUSINFLUENZAETYPEBVACCINEH.influenzaetypeb(Hib)isacommoncauseofbacterialmeningitisandvarietyofseriousandpotentiallylifethreateninginfectious,includingpneumonia,epiglottitisandsepsisininfantsandolderchildrenItisadaptedtotheroutinescheduleandgiventogetherwithDPT,aswellasaboosterdoseat18months.Olderchildrenandadultsrequireonly1dose.OTHERS
PneumococcalvaccinesTyphoidvaccineCholeravaccineRabiesimmunizationPNEUMOCOCCALVACCINESStreptococcuspneumoniaeisresponsibleforthreetypesofdiseases,pneumonia,otitisandmeningitis.Itistheleadingcauseofseverepneumoniainchildrenunder5yearsage.ThecurrentvaccineagainstS.pneumoniaeiscomposedofcapsularantigento7,9or23serotypes.(dose0.5mlIMorSC)Recommendationsaretoagivedoseofvaccinetochildrenover2yearsofoldwhoarehighrisk(sicklecelldisease,chronicrenalfailure,immunosupressionfromorgantransplantationandHIVinfection)Thevaccineisoflimitedefficacyinchildrenunder2yearsofage.TYPHOIDVACCINEInmostendemicareastheincidenceoftyphoidfeverishighestinchildren5-19yearsofage;henceavaccineisneededthatcanestablishdurableimmunitypriortoschoolage.PurifiedViantigenisusedasaonedoseinjectablevaccineThedoseofViisasingleintramusculard
溫馨提示
- 1. 本站所有資源如無特殊說明,都需要本地電腦安裝OFFICE2007和PDF閱讀器。圖紙軟件為CAD,CAXA,PROE,UG,SolidWorks等.壓縮文件請下載最新的WinRAR軟件解壓。
- 2. 本站的文檔不包含任何第三方提供的附件圖紙等,如果需要附件,請聯(lián)系上傳者。文件的所有權(quán)益歸上傳用戶所有。
- 3. 本站RAR壓縮包中若帶圖紙,網(wǎng)頁內(nèi)容里面會有圖紙預覽,若沒有圖紙預覽就沒有圖紙。
- 4. 未經(jīng)權(quán)益所有人同意不得將文件中的內(nèi)容挪作商業(yè)或盈利用途。
- 5. 人人文庫網(wǎng)僅提供信息存儲空間,僅對用戶上傳內(nèi)容的表現(xiàn)方式做保護處理,對用戶上傳分享的文檔內(nèi)容本身不做任何修改或編輯,并不能對任何下載內(nèi)容負責。
- 6. 下載文件中如有侵權(quán)或不適當內(nèi)容,請與我們聯(lián)系,我們立即糾正。
- 7. 本站不保證下載資源的準確性、安全性和完整性, 同時也不承擔用戶因使用這些下載資源對自己和他人造成任何形式的傷害或損失。
最新文檔
- 《安全感悟分享》課件
- 《職業(yè)適應與發(fā)展》課件
- 《生產(chǎn)安全事故應急》課件
- 2024教師發(fā)言稿(34篇)
- 藝術(shù)與人生和社會的關(guān)系
- 單位管理制度匯編大全【人事管理】
- 單位管理制度分享合集【人員管理篇】十篇
- 單位管理制度分享大合集【人員管理】十篇
- 單位管理制度范文大合集【員工管理篇】十篇
- 單位管理制度呈現(xiàn)大全【人員管理】
- 《中華人民共和國職業(yè)分類大典》電子版
- 施工現(xiàn)場鐵皮圍擋承包合同
- 管理學案例分析(超全有答案)(已處理)
- ICU病人早期康復-ppt課件
- 藥品開發(fā)與上量-宿家榮
- 海商法術(shù)語中英對照
- 北京海淀區(qū)初一上數(shù)學期末試題(帶標準答案)_
- 化工原理課程設(shè)計空氣中丙酮的回收工藝操作
- 【家庭自制】 南北香腸配方及28種制作方法
- 廠房施工總結(jié)報告
- 先進物流理念主導和先進物流技術(shù)支撐下的日本現(xiàn)代物流
評論
0/150
提交評論