What is immunization?

Immunization or vaccination is the vaccine given to someone to protect them from some specific diseases. Antibodies from the mother will give temporary shelter for about six months, the baby should be protected from immune to the disease.

Immunizations given to children and infants is the most effective and cost-effective to protect them from the disease tuberculosis (TB), diphtheria, pertussis (whooping cough), tetanus (tetanus), poliomyelitis, measles, rubella and hepatitis B.

However there are still children who are not immunized because of lack of knowledge about vaccines and immunization schedules, misconceptions about the contraindications, concerns about vaccine side effects and complications.

What is active immunity?

Acquired active immunity by giving the vaccine by injection or by mouth. Examples of vaccine consists of the following: -

(i) "Live - attenuated vaccines" (live attenuated vaccine), such as poliomyelitis vaccine (OPV), measles, rubella and BCG.

(ii) "Killed vaccines" (dead vaccine), such as pertussis and inactivated poliomyelitis vaccine (IPV).

(iii) 'sub-unit vaccine' (subunit vaccine), such as Pneumococcus vaccine, hepatitis B,influenza.

(iv) "Toxoid" (toksoid) such as tetanus diphtheria vaccine.

Most vaccines protect against disease by stimulating the immune system to produce antibodies. BCG vaccine provides protection by immune cells (cell mediated immunity). OPV also provide local immunity (local immunity) in the intestinal tract.

What is passive immunity?

Passive immunity is obtained by injection of human immunoglobulin. Although the protection given is immediate, but it is only effective for a few weeks. There are two types of immunoglobulins, namely:

(i) "Normal Human Immunoglobulin" (HNIG) obtained from plasma donors and contains antibodies against the virus which is now in the general population. Example of use is HNIG grant to children lacked immune (immunosuppressed children)exposed to measles if they have not been infected.

(ii) immunoglobulin specific for tetanus, hepatitis B, rabies and varicella / zoster(chicken pox). This immunoglobulin is derived from blood donors who are recovering from these diseases, blood donors immunized new laws and those found to have high antibody levels. Thus each specific immunoglobulin containing antibodies to higher levels than HNIG. Instances where specific immunoglobulin used is the administration of "Hepatitis B immunoglobulin" (HBIG) to the newborn if the mother is HbsAg positive.

When infants and children should be immunized?

They were immunized according to the Ministry of Health immunization schedule.

(i) Baby

(ii) Children aged 1-4 years

1 ½ - 2 years of additional doses of DPT and OPV first

(iii) School children

Standard 1 - DT and two additional doses of OPV

BCG (if no scar)

Rubella (for girls only)

Standard 6 - BCG

Form III - Tetanus Toxoid

(iv) mothers

Beginning of the first dose of tetanus Toksoid during pregnancy 24-28 weeks (Kementerian Kesihatan promotes toksoid tetanus given when pregnancy confirmed)Tetanus Toxoid second dose 6-8 weeks after the first dose of tetanus toxoid Extension One dose of each pregnancy.

What are the contraindications to immunization?

1) Fever due to serious illness. Delayed immunization only

2) Immunodeficiency conditions are contraindications to the "live-attenuated vaccines" only. "Killed vaccines" can be given.Immunodeficiency conditions, including:

(i) illness, inherited immunodeficiency

(ii) leukemia, lymphoma, Hodgkin's disease and others. Immunization be deferred until 6 months after treatment finished.

(iii) immunosuppressive treatment and radiation. Immunization be deferred until 6months after treatment finished.

(iv) treatment with corticosteroids such as prednisone 2 mg / kg / day for> 7 days orlow dose / moderate every day for> 2 weeks. Immunization be deferred until 3 months after treatment finished. Children aregiven a low dose / moderate for <2 weeks and those given a low dose every other day for longer periods of time can be"live-attenuated vaccines.“

Inhaled steroids are not contraindicated.

3. Pregnancy "live-attenuated vaccines" should not be granted4. Specific contraindications:

(i) BCG - HIV infection is a bersimptomatik

(ii) Hepatitis B - There are no contraindications

(iii) Pertussis -

(a) a progressive neurological disease such as infantile spasms

(b) in response to earlier doses, such as

- anaphylaxis

- The "shock"

- Convulsions and fever in 72 hours

- Fever> 40.5 C within 48 hours

- Encephalopathy in 7 days

(iv) Diphtheria - no contraindications

(v) Tetanus - no contraindications

(vi) Polio - diarrhea (vaccine given, but this dose is not counted. The dose should be repeated later)

(vii) Rubella - Pregnancy

(viii) Measles (measles) - anaphylaxis to egg protein

The following is not a contraindication to immunization 

- Low or moderate fever <38.5 C due to common illness such as coughs, colds and diarrhea- Skin diseases like eczema, boils and ringworm- Low birth weight- Malnutrition- Progressive neurological disease that is not as cerebral palsy, later developments, a seizure because of f ever, seizures under control and down syndrome.- Neonatal jaundice, G6PD deficiency- History of measles disease without serologic evidence- Pregnant women (unless the rubella vaccine)--- - History of miscarriage in pregnant mothers (ATT)- HIV (refer to the BCG)- History of epilepsy in the family- Congenital heart disease

* Reference to the doctors to make decisions about immunization is recommended

What are the complications of vaccination?

Immunisation is safe, but sometimes there may be some complications. Localcomplications such as swelling, inflammation, boils or ulcers at the injection siteshould be referred to a doctor if serious.

Low fever can be treated with paracetamol, but high fever, crying non-stop for more than two hours or any other neurological symptoms should be referred to the hospital.

If the occurrenceof seizuresor anaphylactic reactions, emergency  treatment should be referred to the hospital before.

How does a nurse or doctor can make sure all children are fully immunized?

Each time a child is being treated at a clinic or hospital immunization status should be reviewed. If there are any that have not been granted immunity, he must be immunized prior to leaving the clinic or hospital.

Any decision to postpone or not immunize should be made after carefully considering the consequences of our actions on the child. In this case, a doctor must provide a written comprehensive immunization schedule for children.