Vaccines & Sera (Universal Immunization Program Schedules)

VACCINES & SERA (UNIVERSAL IMMUNIZATION PROGRAM SCHEDULES)

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Introduction

·       Vaccines

o   Vaccines are biological preparations that provide active acquired immunity to a particular infectious disease.

o   They typically contain an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins.

·       Sera

o   Sera (plural of serum) are preparations that contain antibodies obtained from the blood serum of an immune individual or animal.

o   They are used to provide passive immunity against diseases.

Classification

o   Live Attenuated Vaccines: Contain live, but weakened, forms of the microorganism (e.g., MMR vaccine, BCG vaccine).

o   Inactivated Vaccines: Contain killed microorganisms (e.g., Hepatitis A vaccine, IPV).

o   Subunit, Recombinant, Polysaccharide, and Conjugate Vaccines: Contain parts of the microorganism (e.g., Hepatitis B vaccine, Hib vaccine).

o   Toxoid Vaccines: Contain inactivated toxins produced by the microorganism (e.g., Diphtheria and Tetanus vaccines).

o   mRNA Vaccines: Contain messenger RNA that encodes a part of the virus, teaching cells to produce a protein that triggers an immune response (e.g., COVID-19 vaccines like Pfizer-BioNTech).

o   Viral Vector Vaccines: Use a modified virus to deliver genetic material into cells to stimulate an immune response (e.g., Johnson & Johnson COVID-19 vaccine).

Pharmacokinetics

1.     Absorption: Vaccines are usually administered via injection (intramuscular, subcutaneous, or intradermal) or orally.

2.     Distribution: After administration, the vaccine's components are distributed to the immune system's cells (e.g., lymph nodes) where they trigger an immune response.

3.     Metabolism: Vaccines are generally not metabolized in the same way as traditional drugs.

4.     Excretion: The components of the vaccine that are not utilized by the body are eventually broken down and excreted.

Mechanism of Action

·        Vaccines

o   Vaccines stimulate the body's immune system to recognize and fight pathogens (viruses, bacteria).

o   They introduce an antigen (a piece of the pathogen) to the body, which triggers the immune response.

o   The immune system then produces antibodies and memory cells, which help in protecting the individual from future infections.

·        Sera

o   Sera provide passive immunity by directly introducing antibodies into the bloodstream.

o   These antibodies neutralize the pathogen or its toxins, offering immediate, but temporary, protection.

Uses

·        Vaccines: Prevent various infectious diseases such as measles, mumps, rubella, polio, diphtheria, tetanus, hepatitis, and influenza.

·        Sera: Used in the treatment of specific conditions like snake bites (anti-venom sera), botulism, and diphtheria (antitoxin sera).

Adverse Effects

·        Vaccines

o   Mild: Fever, redness, or swelling at the injection site, fatigue, and mild rash.

o   Severe: Anaphylaxis (rare), seizures (very rare), intussusception (with rotavirus vaccine, rare).

·        Sera

o   Mild: Fever, chills, rash.

o   Severe: Serum sickness (a delayed hypersensitivity reaction), anaphylactic shock.

Contraindications

·        Vaccines

o   Severe allergic reactions to previous doses or components of the vaccine.

o   Immunocompromised individuals (for live vaccines).

o   Pregnancy (for certain vaccines like MMR).

·        Sera

o   Previous severe allergic reactions to sera.

o   Immunocompromised individuals (risk of infections from animal-derived sera).

Role of Nurse

1.     Assessment

o   Evaluate the patient's health status and immunization history.

o   Screen for contraindications and allergies.

2.     Education

o   Provide information on the benefits, risks, and side effects of vaccines and sera.

o   Educate about the importance of following the UIP schedules.

3.     Administration

o   Administer vaccines according to recommended schedules and techniques.

o   Ensure proper storage and handling of vaccines and sera.

4.     Monitoring

o   Observe patients post-vaccination for adverse reactions.

o   Report any adverse events following immunization (AEFI) to the appropriate authorities.

5.     Record Keeping

o   Maintain accurate records of immunizations given.

o   Ensure documentation is complete and up-to-date.

6.     Advocacy

o   Promote immunization programs within the community.

o   Address vaccine hesitancy and provide evidence-based information to parents and caregivers.

Universal Immunization Program (UIP) Schedules

·       The UIP schedule includes vaccines that are provided to all eligible children and pregnant women to protect against several life-threatening diseases.

·       The schedule is regularly updated based on the latest evidence and recommendations.

·        At Birth: BCG, Oral Polio Vaccine (OPV 0), Hepatitis B (HepB-0).

·        6 Weeks: DPT (1st dose), OPV (1st dose), HepB (1st dose), Hib, IPV, Rotavirus.

·        10 Weeks: DPT (2nd dose), OPV (2nd dose), Hib, IPV, Rotavirus.

·        14 Weeks: DPT (3rd dose), OPV (3rd dose), Hib, IPV, Rotavirus.

·        9-12 Months: Measles/MMR, JE vaccine (in endemic areas).

·        16-24 Months: DPT (Booster), OPV (Booster), Hib (Booster), Measles/MMR (2nd dose).

·        5-6 Years: DPT (Booster).

·        10 and 16 Years: Tetanus Toxoid (TT).

For pregnant women:

·        TT (2 doses) or Td (1 dose with a 2nd booster).

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