Amanda Twining
IMMUNIZATION PROJECT
1.
Discuss these diseases in 2 to 3 sentences; the causative agent, how it is transmitted, and manifestations of the disease if it is contracted. Be sure to include why these are serious diseases. (_________/30)
DISEASE
Haemophilus
Influenzae B
Hepatitis A
Hepatitis B
Polio
Diphtheria
CAUSATIVE AGENT
Bacterium
Haemophilus
Influenzae
Hepatitis A Virus
(HAV)
Hepatitis B Viris
(HBV)
Poliovirus
Corynebacterium diptheriae bacterium
TRANSMISSION
Direct contact, droplet
Fecal-oral
Birth, blood, sexual contact
Person-to-person contact
Droplet, direct contact, indirect physical contact via a vector
DISEASE MANIFESTATIONS
Depends on which part of the body is affected. Lungs: fever, cough, shortness of breath, chills, sweating, angina that comes and goes with breathing, headache, muscle pain, excessive tenderness. Blood: fever, chills, excessive fatigue, stomach pain, NVD, anxiety, shortness of breath, confusion. Brain & Spinal Cord: fever, headache, stiff neck, NV, photophobia, confusion. Why it’s serious: Can cause lifelong disability
and be deadly.
Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored stools, joint pain, jaundice.
Why it’s serious: Can become a severe case that can last several months.
Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored stool, joint pain, jaundice.
Why it’s serious: Can become a chronic infection that can result in long
term health problems and death.
72% of affected people are asymptomatic. 24% of affected people have minor symptoms: fever, fatigue, nausea, headache, flu-like symptoms, stiffness in the back and neck, and pain in the limbs. Less than 1% will have permanent paralysis of the legs, and of those who experience paralysis, 5-10% will die when paralysis reaches the respiratory muscles.
Why it’s serious: Polio is a crippling and potentially fatal infectious disease.
The bacteria that cause diphtheria invade the respiratory tract, and produce a toxin that causes weakness, sore throat, fever, and swollen glands in the neck. A pseudomembrane builds up in the throat, nose and mouth, making it hard to breathe. Why it’s serious: This pseudomembrane gets in the way of breathing, and the toxin may invade the bloodstream, affecting the heart, kidneys and nerves. Infected persons may die, even with treatment.

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Tetanus
Pertussis
Mumps
Measles
Rubella
“German
Measles”
Varicella
Clostridium tetani bacteria
Bordetella pertussis bacterium
Mumps virus
Measles virus
Measles virus
Varicella-zoster virus
(VZV)
Streptococcus pneumonia
Streptococcus pneumoniae bacteria
Breaks in the skin or through a wound
Droplet
Droplet, indirect contact
Droplet, indirect contact
Droplet, indirect contact, direct contact
Droplet, direct contact,
Droplet, direct contact
Painful muscular contractions, abdominal rigidity.
Why it’s serious: Tetanus can lead to laryngospasms, fractures, hypertension, pulmonary embolism, aspiration pneumonia, and death.
Early symptoms: Runny nose, low-grade fever, mild, occasional cough, apnea. Later symptoms: Fits of many, rapid coughs followed by a highpitch “whoop”, vomiting, exhaustion.
Why it’s serious: Pertussis can cause life-threatening complications such as apnea, pneumonia, seizures, encephalopathy, and death.
Fever, headache, muscle aches, tiredness, loss of appetite, swollen and tender salivary glands under the ears on one or both sides. Up to half of infected persons do not experience symptoms, and thus, do not know they are infected. Why it’s serious: Though rare, complications can arise from mumps, including encephalitis, meningitis, oophoritis, mastitis, and deafness.
Fever, runny nose, cough, rash all over the body, conjunctivitis, Koplik’s spots. Why it’s serious: 30% of infected persons will develop pneumonia, ear infections, or diarrhea. 1 in 1000 children with measles will develop encephalitis, and 1 or 2 will die from it. Pregnant women who contract measles are at risk for a miscarriage, low birth weight, and premature birth.
Rash that starts on the face and spreads to the rest of the body, low fever, swollen glands, cold symptoms. About half of the people who are infected with Rubella do not develop symptoms. Why it’s serious: Pregnant women who are infected with the virus risk birth defects for the fetus including deafness, cataracts, heart defects, mental retardation, spleen and liver damage.
A rash that turns into itchy, fluid-filled blisters, which turn into scabs.
Other symptoms include high fever, tiredness, loss of appetite, and headache. Why it’s serious: Serious complications can arise from chickenpox, including dehydration, pneumonia, bleeding problems, encephalitis, strep A infections, sepsis, TSS, bone infections and joint infections.
Streptococcus pneumonia can cause different symptoms depending on the affected body part, including pneumonia in the lungs, meningitis, sepsis,

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Neisseria meningitides
HPV
Rotovirus
Neisseria meningitides bacteria
Human papillomaviris (HPV)
Rotovirus
Direct contact
(living in close quarters, kissing)
Sexually transmitted
Fecal-oral –
Contaminated hands, toys, food, water. and otitis media. Why it’s serious: Streptococcus pneumonia can result in brain damage, deafness, and in some cases, can be life-threatening.
Meningitis, photophobia, nausea, vomiting. Why it’s serious:
Meningococcal meningitis can be fatal, and death can occur in just a few hours. In non-fatal cases, it can hearing loss and brain damage.
Usually asymptomatic, can cause genital warts. Why it’s serious: HPV can cause cervical cancer, as well as cancer of the vulva, vagina, penis, anus and oropharynx.
Fever, vomiting, diarrhea, and abdominal pain. Why it’s serious: 1 in 70 children who are infected will require hospitalization for fluid replacement, as dehydration is a major complication of the disease, and can happen very quickly.

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2.
According to the most current childhood immunization schedule, list the number of required doses and when the following vaccines are routinely recommended to be given. (________/30). Example provided.
IMMUNIZATION
HPV
NUMBER OF DOSES NEEDED
3 dose series
Hep A
Hep B
DTaP
Tdap
Tb
HIB
Polio
2 dose series
3-4 dose series (depending on brand)
5 dose series
1 dose, and every 10 years if given as a booster
2 dose series*
3-4 dose series (depending on brand)
4 dose series
SCHEDULE
1 st dose now; 2 nd dose = 2 months after dose #1; 3 rd dose = 6 months after dose #1. Routinely recommended for 11-12 years of age
First dose is given at age 1 year and the second 6-18 months later. Recommended for all children age 1 year.
First dose is given at birth, the second at 1-2 months, the third at 4 months (if needed), and the last at 6-18 months. Recommended for all children age 0-18 years.
First dose is given at 2 months, the second at 4 months, the third at 6 months, the fourth at 15-18 months, and the fifth at 4-6 years. Recommended for all children age 6 weeks to 7 years.
Children 11-18 years old who were not previously vaccinated, 1 dose now, and 1 Td booster every 10 years. Recommended for all everyone after age 11.
If the infant is less than one month old, the dose should be halved. If, after the child is one year old, and has a negative TB skin test, a full dose can be given. Recommended when the child is at risk for
Tb. Not routinely given in the US.
First dose is given at 2 months, the second at 4 months, the third at 6 months (if needed), and the last at 12-15 months. Recommended for ages 1-4 as a booster dose.
First dose is given at 2 months, the second at 4 months, the third at 6-18 months, and the fourth at

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MMR
Varicella
Pneumococcal
Meningococcal
Rotovirus
2 dose series
2 dose series
4 dose series
2 dose series
2-3 dose series (depending on brand)
4-6 years. Recommended for all children age 6 weeks to 6 years.
First does is given at 12-15 months, and the second at 4-6 years. Recommended for all children age 1 to 12 years.
First dose is given at 12-15 months and the second at 4-6 years. Recommended for children age 1 to
12 years.
First dose is given at 2 months, the second at 4 months, the third at 6 months, and the fourth at
12-15 months. Recommended for children 6 weeks to 15 months old.
First dose at age 11 or 12, with a booster at age 16.
Recommended for all children age 11 and older, people living in close quarters (such as a college dorm).
First dose is given at 2 months, the second at 4 months, and the third (if needed) at 6 months.
Recommended for children 6 weeks to 8 months old (no later).

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3.
Complete the following table. List the most common side effects for each specific vaccine. Identify by which route they are given.
Discuss who may not be able to receive this vaccine. ( _________/28). Example provided.
IMMUNIZATION ROUTE/DOSE
HPV IM/0.5 mL
Hep A
Hep B
DTaP
IM
<18yrs: 0.5mL
>19yrs: 1mL
IM
<19yrs: 0.5mL
>20yrs: 1mL
IM
0.5mL
COMMON SIDE EFFECTS
Mild problems: redness, swelling, pain, itching at injection site, mild fever
Mild problems: soreness, headache, loss of appetite, tiredness
Mild problems: soreness where the shot was given, low grade fever
Mild problems: fever, redness or swelling at injection site, fussiness, tiredness, poor appetite, vomiting.
WHO MAY NOT RECEIVE
Anyone having a life-threatening allergic reaction to yeast or any other component of the HPV vaccine; Pregnant women.
Anyone with moderate or severe illness.
Anyone who has had an allergic reaction to a previous Hep A vaccine, is allergic to any vaccine component, has any severe allergies (including latex), is moderately or severely ill, or is pregnant.
Anyone having a life-threatening reaction to yeast or any other component of the
Hep B vaccine; anyone who has had an allergic reaction to a previous dose of the vaccine; anyone who is moderately to severely ill.
Children who are moderately or severely ill, had a bad reaction from a previous dose of
DTaP vaccine (life-threatening allergic reaction, brain or nervous system disease within 7 days of last dosage, had a seizure or collapsed after last dosage, cried nonstop for three or more hours after a dose of
DTaP, or had a fever of 105F after the last

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Tdap
Tb
HIB
Polio
MMR
Varicella
IM
0.5mL
Mild problems: pain, redness or swelling at injection site, mild fever, headache, tiredness, nausea, chills, body aches, sore joints, rash, swollen glands
ID
Infants <12mo
0.05mL
Children
>12mo 0.1mL
IM
0.5mL
Swelling; a large scar, an abscess, or enlarged lymph nodes may result from a vaccination given deeply.
Mild problems: redness, warmth or swelling of the injection site.
IM or SC
0.5mL
SC
0.5mL
SC
0.5mL
PCV 0.5mL IM
Mild problems: soreness at the injection site.
Mild problems: fever, mild rash, swelling of the glands in the cheek and neck.
Mild problems: soreness or swelling at the injection site, mild rash, fever.
Mild problems: drowsiness, loss of appetite, dose).
Anyone who has had a life-threatening allergy to a previous dose of Tdap, or any part of the vaccine; if there was a coma, or long, or multiple seizures within 7 days of the last Tdap dosage (unless a cause other than the Tdap was found).
BCG vaccine should not be given to anyone who is immunosuppressed, who are likely to become immunosuppressed, or to someone who is pregnant.
Patients who are younger than 6 weeks old; anyone who has a life-threatening allergy to the vaccine or any component of the vaccine; anyone who is not feeling well.
Anyone with a life-threatening allergy to any component of the vaccine, including allergies to the antibiotics neomycin, streptomycin, or polymyxin B; anyone who had an allergic reaction to a previous dose of IPV; anyone who is moderately or severely ill.
Anyone with a life-threatening allergy to any component of the vaccine, including allergies to the antibiotic neomycin; anyone with an allergic reaction to a previous dose of the vaccine; pregnant women; anyone who is moderately to severely ill.
Anyone with a life-threatening allergy to any component of the vaccine, to gelatin, or to neomycin; anyone who is moderately to severely ill; pregnant women.
Anyone with a life-threatening allergy to

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Pneumococcal
Meningococcal
Rotovirus
PPSV 0.5mL
IM or SC swelling at the injection site, mild fever, fussiness, irritability.
MCV 0.5mL IM
MPSV 0.5mL
SC
Mild problems: pain or redness at the injection site.
Oral
Rotarix 1mL
Rotateq 2mL
Mild problems: irritability, temporary diarrhea, and vomiting. any component of the vaccine; anyone with an allergic reaction to a previous dose of the vaccine; anyone who is moderately to severely ill.
Anyone with a life-threatening allergy to any component of the vaccine, or to a previous dose of the vaccine; anyone who is moderately or severely ill.
Babies who have a severe allergy to any component of the vaccine, or to a previous dose of the vaccine; babies with SCID; babies with intussusception; babies who are moderately to severely ill; HIV, AIDS, long term steroid use, cancer, and cancer treatment all contraindicate the use of the vaccine.
4.
What five things should you document when giving vaccinations? (________/5) a.
Provided a VIS for all vaccines given – date the VIS was given. b.
The edition date of the VIS distributed. c.
Name, address, and title of the individual who administers the vaccine. d.
Date of administration. e.
Vaccine manufacturer and lot number of the vaccine used.

Amanda Twining
5.
Prior to receiving immunization, the child or parent is asked routine health-related questions. List five general health related questions you would ask prior to immunizing. (________/5) a.
Are you sick today? b.
Does the child have allergies to medications, food, a vaccine component, or latex? c.
Has the child had a serious reaction to a vaccine in the past? d.
Has the child had a health problem with lung, heart, kidney, or metabolic disease (e.g. diabetes), asthma, or a blood disorder? If he/she on long term therapy? e.
Does the child have HIV/AIDS, leukemia, cancer, or any other immune system problem?
6.
List all references. (________/2) http://www.ssi.dk/English/Vaccines/BCG%20Vaccine%20Danish%20Strain%201331/Guidelines%20for%20injection%20of%20BCG%20Vaccine%2
0SSI.aspx http://www.drugs.com/pro/bcg-vaccine.html#DA
(The above two were for the Tuberculosis vaccine only)
Immunize.org
CDC.gov
Recommended website: www.cdc.gov
and/or www.immunize.org