pentavalent vaccine.pptx

7/30/2019 PENTAVALENT VACCINE.pptx

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The pentavalent vaccine which wasintroduced in Nepal from April 2009 is acombination of five vaccines in one againstthe diseases: diphtheria, tetanus, whooping

cough, hepatitis B and Haemophilus influenzatype b (the bacteria that causes meningitis,pneumonia and otitis).

It has also led to a reduction in cases ofimmuno-preventive illnesses, especiallymeningitis caused by Haemophilus influenzatype b.


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The National Immunization Programme (at the

time known as the Expanded Programme on

Immunization - EPI) was initiated in 1979 in

three districts with only two antigens (BCG and

DPT) and was rapidly expanded to include all 75

districts with all six recommended antigens

(BCG, DTP, OPV, and measles) by 1988.

In 2003, with the support of the GAVI

Alliance, monovalent Hepatitis B (HepB)

vaccine was introduced, which was lateradministered as a single tetravalent (DPT-HepB)

injection.


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In2009,vaccinationagainst Haemophilus influen

zae type b was introduced through out the

nation in a phase wise manner starting in FarWestern (FWDR) and Western (WDR)

Development Regions.

Also in 2009, Japanese encephalitis (JE)vaccine was introduced into the routine

immunizationprogramme in 16 JE endemic

districts following JE mass vaccination

campaigns


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Pentavalent is a conjugate adsorbed vaccine

containing five antigens Diphtheria , Pertussis

, Tetanus , Hepatitis B and Hib (Haemophilus

influenzae type b).

It is a homogenous liquid containing

purified diphtheria and tetanus toxoids,inactivated whooping cough (pertussis)

organisms, highly purified, non-infectious

particles of Hepatitis B surface antigen (HBsAg)

and Hib component as a bacterial subunitvaccine containing highly purified, non-

infectious Haemophilus Influenza type b (Hib)

capsular polysaccharide chemically conjugated

to a protein (Tetanus Toxoid)


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It shouldnot be frozen. It should be stored in

a refrigerator between 4 to 8 degree celsius.

The vaccine should be used before the date

of expiry indicated on vial.When issued to a subcentre,the vaccine

should be used within a week.

The vaccine will lose potency if kept at room

temperature over a longer period of time.


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Pentavalent can be used in future immunizationsession for up to a maximum of 4 weeks, provided thatall of the following conditions are met-

1. The expiry date has not passed.2. The vaccines are stored under appropriate cold chainconditions.3. The vaccine vial septum has not been submerged inwater.4. Aseptic technique has been used to withdraw all doses5. The vaccine vial monitor (VVM), if attached, has notreached the discard point (see figure).

The vaccine should be visually inspected for any foreignparticulate matter and/or variation of physical aspectprior to administration. In event of either being observeddiscard the vaccine.


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Vaccine vial monitors (VVMs) are part of the

label.

The color dot which appears on the label of

the vial is a VVM. This is a time temperature sensitive dot that

provides an indication of the cumulative heat

to which the vial has been exposed.

It warns the end user when the exposure toheat is likely to have degraded the vaccine

beyond an acceptable level.


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The interpretation of the VVM issimple.

Focus on the central square. Itscolour will change progressively.

As long as the color of this square islighter than the colour of the ring,then the vaccine can be used.

As soon as the colour of the central

square is the same colour as the ringor of a darker colour than the ring,then the vial should be discarded.


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For active immunization of infants and pre-

school children, it is recommended that

three deep intra muscular injection of 0.5 ml

be administered with an interval of fourweeks between doses. (i.e.6,10,14 weeks)

One of the priciple recommendation of

1984,Global Advisory Group is that for childunder one year of age it should be

administered in lateral aspect of thigh.


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A booster dose of Diphtheria, Tetanus,

Pertussis, Hepatitis B and Haemophilus

Influenza type b Conjugate Vaccine Adsorbed

can be given at the age of 15-18 months.


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Fever and mild local rxns are common.

It is estimated that 2 to 6 % of vacinees develop

fever of 39 degree celcius or higher.

5 to 10% experience swelling and induration or

pain lasting more than 48 hrs.Most severe complications are neurological

(encephalitis/encephalopathy, prolonged

convulsions , infantile spasms and Reye

syndrome) The type and rate of severe adverse reactions do

not differ significantly from the DTP, HepB and

Hib vaccine reactions described separately.


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Individuals infected with the human immune-

deficiency virus (HIV), both asymptomatic

and symptomatic, should be immunized with

combined vaccine according to standard

schedules.


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Any children who are seriously ill or need

hospitalization.

It should not be repeated if a severe rxn

occur after a previous dose.(such rxnsinclude collapse or shock like

state,persistent screaming

episodes,temperatur above 40 degree C,

convulsions ,other neurological symptomsand anaphylactic reactions)


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Known hypersensitivity to any component of

the vaccine, or a severe reaction to the

previous dose of the combination vaccine or

any of its constituents is an absolute

contraindication to subsequent doses of the

combination vaccine or the specific vaccine

knows to have provoked an adverse reaction.

In this case the vaccine should not be givenas a combination vaccine but DT should be

given instead of DPT and Hep B and Hib

vaccines given separately.


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ADRENALINE INJECTION (1:1000) MUST BEIMMEDIATELY AVAILABLE SHOULD AN ACUTEANAPHYLACTIC REACTION OCCUR DUE TO ANYCOMPONENT OF THE VACCINE.

For treatment of severe anaphylaxis the initialdose of adrenaline is 0.1

0.5mg (0.1

0.5 ml of

1:1000 injection) given s/c or I/m. single doseshould not exceed 1mg (1 ml)

For infants and children the recommended doseof adrenaline is 0.01 mg/kg (0.01ml/kg of 1:1000

injection). Single pediatric dose should notexceed 0.5 mg (0.5ml). The mainstay in thetreatment of severe anaphylaxis is the promptuse of adrenaline, which can be life saving.


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pentavalent vaccine.pptx

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