Introduction about immunization Definition of immunization Importance of

Introduction about immunization. Definition of immunization. Importance of immunization. Statistical about vaccinations. The Jordanian national immunization program. the role of community health nurse about immunization. • Summary • Article • • •

At the end of this seminar the students will be able to: 1. Identify the definition of immunization. 2. Explain the importance of immunization. 3. Identify the Jordanian national immunization program that use it in health care center. 4. Demonstrate the role of community health nurse in immunization.

Introduction Immunization against communicable diseases has been, and continues to be, one of the most important public health programs available. Although many diseases have now been curtailed or eradicated by immunization programs in Jordan, children and adults require immunization for continued protection.

• Immunization is the process of inducing immunity artificially by either vaccination (active imm. )or administration of antibodies (passive imm. ).

Immune bodies are actively formed against specific antigens, it could be: Ø Naturally: by having had the disease clinically or sub clinically. Ø Artificially: by introducing vaccine into the individual in a weakened attenuated or killed micro-organism which causes the disease or its toxins to produce active immunity.

Temporary immunity by transfusing plasma protein which contain antibodies, it could be: Ø Naturally: from mother to fetus via placenta or breast feeding. Ø Artificially: from another human& animal that has been actively immunized against an antigen.

• • • To decrease mortality and morbidity rates. Eradication of certain diseases. Improvement in national economy. eradication of disease EX: smallpox Elimination of disease EX: polio Control of disease EX: diphtheria

• Immunization is one of the most costeffective health interventions. • Investing in vaccines SAVES more money than it costs.

• Immunization saves the lives of approximately 3 million people each year, all over the world.

• All children deserve to get full access to all the vaccines they need. • Immunization is the foundation of the public health system-without it, other health programs would fail

• Immunization is among the safest of modern medical interventions. • Vaccines are easier and safer to administer than ever before. • Being immunized is much safer than risking infection and disease.

Vaccination coverage among children age 19 through 35 months. 2011 data, as reported September 2012

BCG It is given in first month to protect children against TB , It is found world-wide. • Incidence rates have fallen in industrialized countries. • Morbidity rates increase with age. • Among older persons are higher in males than in females. • Higher in urban than in rural areas. • Epidemics have been reported among people living in crowded condition. SIDE EFFECTS Skin ulceration, Subcutaneous abscess

DPT: It protects against Tetanus, pertussis, and Diphtheria. Given in second, third , fourth and eighteen months. Side effects: Fever, Redness, swelling, poor appetite and Vomiting. Contraindications: 1. Encephalopathy (coma , altered level of consciousness , prolonged seizures ) within 7 days of previous dose 2. Progressive neurological disorder till neurological state is clarified.

1. Fever more than 40. 5, during 48 hrs of previous dose 2. Collapsed or shock like state during 48 hrs of previous vaccine dose 3. Seizures during 3 days or less of previous vaccine dose 4. Persistent inconsolable crying more than 3 hr during 48 hr of previous vaccine dose

OPV Polio is a disease of the nervous system, caused by infection of the polio virus. Infection may lead to appraises in any of the muscles of the body and permanent disability. More common on summer & early autumn. Given in the third , fourth and ninth. CONTRAINDICATIONS : pregnancy, immunodeficiency

MMR In ninth month take measles. At the one year old and 18 months take MMR. Contraindications: 1. A life-threatening allergic reaction to gelatin, neomycin, or to a previous dose of MMR vaccine 2. Pregnant women 3. known severe immunodeficiency like severely symptomatic HIV infection Precautions: Recent blood transfusion or were given other blood products less than 11 months, vit A

Hepatitis B Vaccine Ø Viral infection characterized by: – Fever, headaches, nausea, vomiting, abdominal pain, liver may enlarge. • Is a very safe vaccine • Very effective • • Adverse effect: Swelling at injection sites. Fever Prolong crying.

Haemophilus Influenzae Type B protect against hemophilis influenza type B infection. Studies in infants ages 2 -6 months show the high risk Require minimum of 3 doses & one booster for maximum immunity INDICATIONS Children under 5 years of age High risk children. SIDE EFFECTS: Local pain and erythema. Mild fever Contraindicated in less than 6 weeks of age • Children over 5 years old usually do not need.

• Moderate or severe illness with or without fever • Anaphylactic reaction to vaccine or vaccine constituent • Live attenuated vaccines – Pregnant women – Immunocompromised / Immunosuppressed children – within 3 -11 months of immunoglobulin administration

1) Educating the Parent/ Caregivers Among all the barriers, mother’s lack of knowledge is the most important for the low immunization rate. Nurses are trained to keeps aside her values and beliefs and guides the parents towards responsible decision making by providing them accurate information and reliable resources. Nurses are a vital resource not only for administering immunizations, but also in playing a major role in promoting the benefits of immunizations.

• Vaccination are safe in most of the cases, but some times side effects appear. It is important to remind parents that not taking vaccination will put their child in serious risks, the chance to get the disease if not immunized is more risky than side effects.

1. pain • Some times, the injections are painful, through the child cries for a while. Local swelling at the site of injection would disappear soon. It is important to remember the benefits that we gain from vaccination outweigh some tears. Both children and adult can comprehend and understand. It is necessary to provide them with information they need and pursues them so they accept the idea. Never threaten a child using vaccination as a punishment, you should play with him/her reduce his stress.

2. Local effect • The site of injection become sore and red, it is a normal side effect last for 2 days can be controlled by giving the child an antipyretic (i. e. Paracetamol) according to his/her weight, and to repeat the dose every 4 -6 hours. you shouldn't give Aspirin. Also, you can ( tab water) compress

3. Mild elevation in temperature • Lasts for 2 days, should be monitored and treated by antipyretic medication (i. e. Paracetamol) according to his/her weight, and to repeat the does every 4 -6 hours.

: Parents should inform the pediatrician if the child experiences any of the following symptoms after DPT vaccination, even though it's rarely happen: Ø Ø Ø Continuous crying for more than 3 hours. Most the time sleepy and difficult to awake. Pallor and fatigability. Temperature of more than 40 C. Convulsions (could be caused by high temperature, only 1%).

1 Myths about immunizations: There are many myths that surround the administration of vaccines, but the sad part is that these myths may cause many children to miss the vaccines they need. some of these myths or concerns are that vaccines are not safe, the danger of a disease is gone and vaccines aren’t necessary, vaccines don’t work, infants are too young to be immunized, its better to be naturally infected than immunized, vaccines weaken the immune system, vaccines contain other infectious agents that may cause damage to the child, vaccines cause autism

Cont’ 2: Parental decisions influenced by media: Parental decisions may also be influenced by information through wide spread media via television and the Internet. The disadvantage is that some of this information may be incorrect, incomplete or misleading and may influence parents to make decisions that may have deleterious consequences on their children’s health. In today’s media ruled world, parents and primary caregivers are confused as if immunizations are really the best choice for their loved ones or not.

2) Safe delivery of vaccines and nurses’ knowledge: Besides taking care of her clients’ immunization requirements, a nurse updates her immunizations to prevent the risk of infection in the vulnerable population she cares for. “Nurses have a responsibility to maintain their own health, and follow the recommendations of public health departments and their own health care provider with respect to immunizations”

Barrier in safe delivery of vaccine 1: Brand-new graduate nurses. 2: Distractions during the immunization process

Practice-Proven Interventions to Increase Vaccination Rates and Broaden the Immunization Season • • The Centers for Disease Control and Prevention (CDC) recommends that most (73%) persons residing in the United States be vaccinated against influenza each year. The actual rate of influenza vaccination is substantially below target levels: about 60% of persons 65 years (target is 90%) and only 10% to 40% of other groups (target is 60% for younger persons who have risk factors and 60% for healthcare personnel). Vaccinating patients throughout the influenza vaccination season (from October into January and beyond). Vaccination rates may also be increased by interventions that increase patient demand access to vaccine and overcome practice-related barriers. Such interventions include vaccination-only clinics, standing orders, strong recommendations from healthcare providers, as well as reminder and recall efforts. For maximum impact on immunization rates, interventions should be combined into a multifaceted immunization program rather than used alone.

• http//www. cdc. com • www. WHO. com • Youtube. com

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