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

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