Immunizations

Example of Schedule for Alberta from Alberta Health and Wellness:

AGE	VACCINE
2 months	• DTaP-IPV-Hib • Pneumococcal conjugate • Meningococcal conjugate
4 months	• DTaP-IPV-Hib • Pneumococcal conjugate • Meningococcal conjugate
6 months	• DTaP-IPV-Hib • Pneumococcal conjugate • Meningococcal conjugate
6-23 months	• Influenza
12 months	• MMR • Varicella (Chickenpox)
18 months	• DTaP-IPV-Hib • Pneumococcal conjugate
4 – 6 years	• DTaP-IPV • MMR
Grade 5	• Hepatitis B (3 doses) • Varicella (Chickenpox)
14 – 16 years	• dTap

Diphtheria

• Inactivated toxoid
• Throat: pharyngeal exudates, upper airway obstruction
• Enotoxin: myocarditis, neuritis with paralysis

Tetanus

• Inactivated toxoid
• Clostridium tetani (anaerobic)
• Enters body through open wounds
• Progressive painful muscle spasm due to neurotoxin (resp muscles = asphyxia/death)

Pertussis

• killed organism (acellular)
• Bordatella pertussis

Polio

• Inactivated
• Mild febrile illness –> meningitis
• Paralysis/pain (anterior horn cell damage)
• Residual paralysis

Hemophilus influenza B

• polysaccharide capsule of killed organism conjugated with protein
• Meningitis – neurological sequelae in 10-15% (death in 3%)

Meningococcus C

• Conjugated polysaccharide antigen conjugated with tetanus toxoid as a carrier protein
• Purulent meningitis
• Mortality 10%

Measles

• Live attenuated virus
• Maculopapular rash, fever, coryza, cough, conjunctivitis
• Complication: encephalitis
• Rash and fever 5-10d post-immunization

Mumps

• Live attenuated virus
• Febrile illness with parotid enlargement
• Complications: aseptic meningitis, sensorineural deafness, orchitis

Rubella

• Live attenuated virus
• German measles
• Rash and fever
• Fetus affected in early pregnancy (cataracts, deafness, congenital cardiac disease)

Contraindications

• Live (MMR, Varicella): immunocompromise, pregnancy
• Killed (DTP, HiB, Polio): fever, neurological diagnosis, seizures, anaphylaxis to last dose

For pain prevention – give Tylenol 4 hr prior