CAH- Immunisations

Question 1

What vaccines do you receive at birth?

Answer 1

Hepatitis B

Question 2

What vaccines do you receive at 2, 4 and 6 months?

Answer 2

• Hepatitis B
• DPT
• Hib
• Polio
• Pneumococcal
• Rotavirus

Question 3

What vaccines do you receive at 12 months?

Answer 3

• Hib
• MMR
• Meningococcal C

Question 4

What vaccine do you receive at 18 months?

Answer 4

Varicella

Question 5

What vaccines do you receive at 4 years old?

Answer 5

• DPT
• Polio
• MMR

Question 6

What vaccines do you receive in school?

Answer 6

• Hepatitis B
• Varicella
• HPV
• DPT

Question 7

Absolute contraindications to vaccination?

Answer 7

• Unexplained encephalopathy
• Anaphylaxis to a component of the vaccine
• If live and are immunosuppressed, pregnant or have had previous live vaccine or Ig

Question 8

Additional vaccinations for ATSI children

Answer 8

• HAV (all states - VIC)
• BCG (endemic areas)
• 13v and 23v pneumococcal
• Flu (subsidised)

Question 9

Immunisation Counselling

Important points in introduction & explanation

Answer 9

1. Explanation of role of vaccines
   - Prevent disease and short & long term complications of these diseases
   - Reduce the spread of disease - protect vulnerable people
2. Outline of vaccine schedule
   - Immunisations at birth, 2, 4, 6 months, 12 and 18 months, 4 years

Question 10

Immunisation counselling

What are the general symptoms, complications & Rx of diseases immunised against?

Tetanus, pertusis, polio, hib,

Answer 10

Diphtheria - fever, membrane tonsils, cardiac + nervous system damage. Antibiotic + antitoxin

Tetanus - jaw spasm progressive, resp muscle involvement. IV Ig

Pertusis - whooping cough, breathing difficulty, pneumonia, bronchiectasis, fatal. Clarithromycin

Polio - paralysis. Supportive Rx

HIB - epiglottis, pneumonia, meningitis, orbital cellulitis. 3rd gen ceph

Question 11

Immunisation counselling

What are the general symptoms, complications & Rx of diseases immunised against?

Rotavirus, pneumococcal, Men C, Measles, Mumps

Answer 11

Rotavirus - vomiting, diarrhoea, dehydration. Supportive rx

Pneumococcal - meningitis, pneumonia. Rx - penicillin, erythromycin

Men C - meningitis, pneumonia. 3rd gen ceph

Measles - flu-like, rash, conjunctivitis, encephalitis, pneumonia. Supportive Rx

Mumps - neck, salivary gland LAD, malaise, orchiditis, infertility, deafness. Supportive Rx

Question 12

Immunisation counselling

Risk vs. benefits vs. safety

Answer 12

Risk

• Serious complications rare i.e. allergy
• Minor complications as with any medications i.e. local reactions
• Complications of diseases worse than complications of vaccines

Benefits

• Prevent child getting diseases and their complications, many don’t have treatment
• Stops spread of disease, protects vulnerable people

Safety

• Very safe program
• Rigorously tested and continually monitored for safety

Question 13

Immunisation counselling

Education on Autism link with MMR vaccine

Answer 13

• MMR vaccine does not cause autism
• One paper many years ago made this claim without adequate evidence or review by peers
• It has since been retracted and substantial evidence to determine it is not linked to Autism has been performed

Question 14

Immunisation counselling

Possible side effects

Answer 14

• Local swelling, tenderness
• Fever
• Irritability
• Rarely allergy

Generally short lived

Question 15

Immunisation counselling

Contraindications

Answer 15

• Postpone live vaccines if unwell (relative), pregnant or immunocompromised
• Allergy to egg - flu & MMR
• Previous serious allergy or unexplained encephalopathy

Question 16

Immunisation counselling

What parents should expect on the day

Answer 16

Brief hx taken - exclude contraindications, answer any questions

Injection given into upper arm or thigh

Expect crying, irritability up to a few days. Mild fever, local redness/tenderness may occur

Fluids

Question 17

What general topics/areas should be covered when counselling on immunisations

Answer 17

1. Explanation of purpose and immunisation schedule
2. Overview of diseases, complications and management (if asked or hesitant for vaccine)
3. Discussion of risks, benefits & safety
4. Discuss contraindications
5. Explain what to expect on the day
6. Gain informed consent