Malaysian immunization

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<ul><li> 1. </li></ul> <p> 2. What isimmunization? Immunizationorvaccinationis thevaccinegiven to someone toprotect them from somespecificdiseases.Antibodies from the motherwill givetemporary shelterfor aboutsixmonths, thebabyshould beprotected fromimmunetothe disease. Immunizationsgiven tochildrenand infantsis the mosteffective andcost-effectiveto protect themfrom thediseasetuberculosis (TB), diphtheria,pertussis(whooping cough), tetanus(tetanus),poliomyelitis, measles,rubellaand hepatitisB. Howeverthere are stillchildren who arenotimmunizedbecause oflack of knowledge aboutvaccinesandimmunization schedules,misconceptionsabout the contraindications,concernsaboutvaccineside effectsandcomplications. 3. What isactive immunity? Acquiredactiveimmunityby givingthe vaccineby injectionorby mouth.Examples of vaccineconsists of the following:- (i)"Live-attenuatedvaccines"(liveattenuatedvaccine), such aspoliomyelitis vaccine(OPV), measles,rubellaandBCG. (ii)"Killedvaccines"(deadvaccine), such aspertussisandinactivatedpoliomyelitis vaccine(IPV). (iii)'sub-unitvaccine'(subunitvaccine), such asPneumococcusvaccine, hepatitisB,influenza. (iv)"Toxoid"(toksoid)such astetanusdiphtheriavaccine. Most vaccinesprotect againstdiseaseby stimulatingthe immune systemto produce antibodies.BCG vaccineprovides protectionbyimmunecells (cellmediated immunity). OPValsoprovidelocalimmunity(localimmunity)in the intestinal tract. 4. What ispassiveimmunity? Passiveimmunityis obtainedby injectionofhumanimmunoglobulin.Although the protection givenis immediate,butit isonlyeffectivefora few weeks.There aretwo types ofimmunoglobulins, namely: (i)"NormalHumanImmunoglobulin"(HNIG)obtained fromplasmadonorsand contains antibodiesagainst the viruswhich is now inthe general population.Example ofuse isHNIGgrantto childrenlackedimmune(immunosuppressedchildren)exposed tomeaslesif theyhave not beeninfected. (ii)immunoglobulinspecific fortetanus, hepatitisB,rabiesandvaricella/zoster(chicken pox).Thisimmunoglobulin isderivedfrom blooddonorswho arerecovering fromthese diseases, blooddonorsimmunizednewlaws andthosefound to havehigh antibodylevels.Thuseachspecificimmunoglobulincontainingantibodiesto higher levelsthanHNIG.Instances wherespecificimmunoglobulinusedis the administration of"HepatitisBimmunoglobulin"(HBIG)to thenewbornifthe mother isHbsAg positive. 5. Wheninfantsand childrenshould beimmunized? They wereimmunizedaccording tothe Ministry of Healthimmunization schedule. (i)Baby 6. (ii)Children aged1-4years 1-2years ofadditionaldoses ofDPTandOPVfirst 7. (iii)School children Standard 1-DTandtwoadditionaldoses ofOPV BCG(if noscar) Rubella(for girlsonly) Standard 6-BCG Form III-TetanusToxoid (iv)mothers Beginning ofthe firstdose oftetanusToksoidduring pregnancy24-28weeks (Kementerian Kesihatanpromotestoksoidtetanusgiven whenpregnancyconfirmed)TetanusToxoidseconddose6-8weeks afterthe firstdose oftetanustoxoid ExtensionOnedoseof eachpregnancy. 8. What are thecontraindicationstoimmunization? 1) Feverdue toseriousillness.Delayedimmunizationonly 2) Immunodeficiencyconditionsarecontraindicationsto the"live-attenuatedvaccines" only."Killedvaccines"can be given. Immunodeficiencyconditions, including: (i)illness, inheritedimmunodeficiency (ii)leukemia,lymphoma,Hodgkin'sdiseaseand others.Immunizationbe deferred until6months aftertreatmentfinished. (iii)immunosuppressivetreatmentand radiation.Immunizationbe deferred until6months aftertreatmentfinished. (iv)treatment withcorticosteroids such asprednisone2mg/kg/ dayfor&gt;7days orlow dose/moderateevery dayfor&gt;2 weeks.Immunizationbe deferred until3months aftertreatmentfinished.Childrenaregivena lowdose/moderatefor40.5Cwithin48 hours -Encephalopathyin 7 days 10. (iv)Diphtheria-nocontraindications (v)Tetanus-nocontraindications (vi)Polio-diarrhea(vaccinegiven, butthis doseis not counted.The doseshould be repeatedlater) (vii)Rubella-Pregnancy (viii)Measles(measles)-anaphylaxistoeggprotein 11. The followingis not acontraindicationtoimmunization - Lowor moderatefever</p>